Pregnancy-Induced Hypertension

Pregnancy-induced hypertension (PIH), also known as gestational hypertension or pregnancy-related hypertension, is a condition characterized by high blood pressure that develops during pregnancy. It is a significant cause of maternal and fetal morbidity and mortality worldwide.

Definition and Classification

PIH is defined as a systolic blood pressure of 140 mmHg or higher, or a diastolic blood pressure of 90 mmHg or higher, on two separate occasions at least 4 hours apart, in a woman who had a normal blood pressure before pregnancy. The condition can be classified into two categories:

• Mild PIH: systolic blood pressure between 140-149 mmHg and diastolic blood pressure between 90-99 mmHg
• Severe PIH: systolic blood pressure of 150 mmHg or higher, or diastolic blood pressure of 100 mmHg or higher

Causes and Risk Factors

The exact cause of PIH is not fully understood, but several factors are thought to contribute to its development. These include:

• Genetic predisposition
• Environmental factors, such as diet and lifestyle
• Pre-existing medical conditions, such as kidney disease or autoimmune disorders
• Multiparity (having multiple pregnancies)
• Advanced maternal age (over 35 years)
• Obesity

Symptoms and Diagnosis

PIH often develops without noticeable symptoms, but some women may experience:

• Headaches
• Visual disturbances, such as blurred vision or spots
• Nausea and vomiting
• Abdominal pain
• Swelling in the face, hands, and feet

Diagnosis is typically made through regular blood pressure checks during prenatal care. If PIH is suspected, additional tests may be performed to assess kidney function, liver function, and fetal well-being.

Complications and Management

Untreated PIH can lead to serious complications for both the mother and the fetus, including:

• Preeclampsia (a severe form of PIH that can cause seizures and organ damage)
• Placental abruption (premature separation of the placenta from the uterus)
• Fetal growth restriction
• Preterm birth

Management of PIH typically involves:

• Close monitoring of blood pressure and fetal well-being
• Lifestyle modifications, such as rest and stress reduction
• Medications to control blood pressure
• Corticosteroids to promote fetal lung maturity (if preterm delivery is necessary)
• Delivery, either vaginally or by cesarean section, if the condition worsens or if there are concerns about fetal well-being

Prevention and Prognosis

While PIH cannot be completely prevented, certain measures can reduce the risk of developing the condition:

• Maintaining a healthy weight before and during pregnancy
• Eating a balanced diet rich in fruits, vegetables, and whole grains
• Engaging in regular physical activity
• Managing stress through relaxation techniques, such as meditation or deep breathing

The prognosis for women with PIH is generally good if the condition is diagnosed and managed promptly. However, untreated PIH can lead to serious complications, emphasizing the importance of regular prenatal care and close monitoring of blood pressure during pregnancy.