Signs of High Blood Pressure in Pregnancy or Preclampsia - Dr. Nidhi Agrawal | Doctors' Circle

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Cloudnine Hospitals, Patparganj, New Delhi
Preclampsia is a condition where a lady in her pregnancy develops high blood pressure which is usually after the 20th week or in the fifth month of pregnancy and in addition to the high blood pressure the lady would have a protein leak in urine which is called albumin leak and it may be associated with a lot of pedal edema. There's a puffiness of the feet so in toto. This condition is called preclampsia and what are the risk factors who all are prone to get so primy gravida a lady who is entering into her first pregnancy she is at risk of developing a preclampsia in her pregnancy more so if she's a young primi like if she is in her pregnancy and she's just 19 years of age. So she'll be more at risk. Then if the lady has a history of a chronic hypertension if the lady has a history of a chronic kidney disease if she's obese you know if her BMI is high or if she has a family history or preeclampsia. These are the factors which push you towards developing that risk of having preclampsia. And how do we manage it. So first of all management involves both the things the diagnosis and the treatment. So that is the reason why at every visit we are checking your blood pressure and anytime if the you know it just rises from 120/80. We tell you to monitor your VP even at home because we do not want to miss when you reach 140/90 and when you reach 140/90. That is when we are alarmed that yes you are developing gestational hypertension or preeclampsia. So what is the difference? Difference is the urine albumin. So we do a dipstick method. We do a 20 - 24 hour urine protein and quantify the protein and then depending upon how severe is your BP how severe is your albuminurea. We also run a few more tests like LFT, KFT and depending upon that we may prescribe you medications to control your blood pressure at home. We tell you some lifestyle measures which would lower your BP. Sometimes we may admit you for 2 - 3 days for your blood pressure monitoring and your optimization of your anti-hypertensive drugs what is their dosage which is ideal to control your BP. Side by side we also do a fetal surveillance. Depending upon the period of gestation at which you develop high blood pressure we start your medicine and we always try to take your pregnancy to 37 completed weeks. But in case your BP shoots up goes uncontrolled or goes on like more than one drug two drug or three drug or are we are at a maximum dosage of a certain drug then we may plan your delivery after the optimization for the the baby's lung maturity and. Those are the cases wherein the baby has a risk of prematurity. So we give the baby steroid cover we give the baby neuroprotection and then we plan a delivery we may induce you for a normal delivery or we may take you for a planned cesarian section depending upon the obstetric indications. Preeclampsia per se is not an indication for cesarean section patient can have both the roots of delivery. Normal vaginal delivery or cesarean section. It will depend upon case to case how was the baby's growth. Is the baby grown enough to take the obstetric stress the labor pain stress. Then we will induce you and if we feel that baby is quite growth restricted the dopplers are getting affected deranged or your blood pressure is very high or maybe you are having those premonitory signs of preclampsia like headaches or epigastric pain or you're having a blurring of vision. In that case we would like to terminate the pregnancy because those are impending signs of eclampsia and we do not want our mother to throw fits. So we do us elective insection at that time and we also start the mother on prophylactic magnesium sulfate so that her risk of getting seizures is brought down.
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