Associate Professor from Memorial Ankara Hospital, Department of Obstetrics and Gynecology. Dr. Kudret Erkenekli gave information about gestational blood pressure and preeclampsia.
Blood pressure monitoring of pregnant women is vital
Hypertension is defined as a systolic blood pressure of 140 and a diastolic blood pressure of over 90, which is popularly known as systolic blood pressure. Women diagnosed with high blood pressure before pregnancy are chronic hypertension patients. Gestational blood pressure, which occurs after the 20th week of pregnancy but is not accompanied by urinary protein excretion and organ damage, is another condition, and preeclampsia constitutes the third picture. Preeclampsia is a disease known as "pregnancy poisoning" among the people. Blood pressure monitoring of pregnant women is more critical than ultrasound control, and it is vital to measure the blood pressure of the expectant mother at each examination.
The causes of gestational blood pressure are not completely clear.
The cause of gestational hypertension has not been fully determined. However, various factors such as vitamin C deficiency, the patient's weight, whether there is a previous blood pressure disorder, genetic predisposition, multiple pregnancy are the subject of discussion, but it is useful to be a little more careful in patients with high blood pressure in their previous pregnancies.
Older age and overweight increase risk
Advanced age, overweight, kidney disease and additional diseases, blood pressure problems in the mother or sisters of the patient, that is, genetic predisposition, are among the factors that increase the risk of gestational hypertension.
Blood pressure should be monitored with a holter.
If any of the patient's blood pressure values are above 140-90, he should be directed to the cardiology department and followed up with Holter for 24 hours. If blood pressure is high after Holter follow-up, medication should be started and tried to be controlled, so these patients should be followed up in a hospital with a cardiology department and cardiology intensive care unit, and their delivery should be planned according to these conditions.
Preeclampsia is the second leading cause of maternal and infant death.
Preeclampsia, which is associated with high blood pressure during pregnancy, is a serious pregnancy complication characterized by edema and excess protein excretion through urine. It is the condition where the placenta cannot feed the baby due to the excessive narrowing of the thin vessels lining the uterine bed. Preeclampsia can also be experienced in hypertensive patients who have high blood pressure after the 20th week or have no signs of hypertension. Preeclampsia has nothing to do with real poisoning. Preeclampsia, which affects 3-4 percent of pregnancies, ranks second among the causes of maternal and infant deaths with a rate of 16 percent.
If you have high blood pressure and protein leakage in the urine…
Among the findings of pregnancy poisoning; hypertension, that is, the blood pressure is above 4 or 140 twice at 90 hour intervals, protein leakage is seen in the urinalysis, headache, liver enzymes rise twice as much as the determined rate in laboratory tests, platelets called blood platelets fall below a certain value, hand, foot and facial swelling. When this condition affects the brain, epilepsy-headache is seen first and then cerebral hemorrhage may occur. The fatal results are liver rupture, kidney failure, widespread bleeding in the body and brain hemorrhage.
The causes of pregnancy poisoning are not fully known.
The causes of pregnancy poisoning are not known exactly, but there is a general opinion by experts that there is a problem with the development of the placenta. The placenta needs to be placed myometrially in the uterus like the roots of the tree go deep into the soil. If there is a problem in this placement of the placenta, preeclampsia may occur.
Pregnancy poisoning cannot be stopped
There are two categories of pregnancy poisoning: mild and severe. It should be decided whether the patient will be followed up according to the week he is in or whether to plan the birth. There is no such thing as stopping pregnancy poisoning, and when the process begins, it shows an unavoidable development. The only treatment for pregnancy poisoning, which affects all organs and the development of the baby, is to give birth to the mother.
Health of mother and baby must be kept in balance
The emergence of pregnancy poisoning close to the birth is more beneficial for both the mother and the baby, but the desired thing is not always achieved and sometimes the pregnancy may be terminated depending on the patient's weight status. In the case of preeclampsia, the most important factor is to keep the health of the mother and baby in balance. It is necessary to advance the development of the baby without any distress to the mother, and to give birth when the two are in balance. If premature birth is planned in these patients, it should not be forgotten to apply the lung development needle for the baby.
Aspirin use in pregnancies after preeclampsia reduces the risk
People who have preeclampsia problems during pregnancy should start using aspirin after the 12th week in their next pregnancy. If aspirin is not started, the probability of recurrence of pregnancy poisoning is 40-60 percent, while this rate drops to 20-30 percent after aspirin is started.
Blood pressure and pregnancy poisoning are more common in first pregnancies.
Blood pressure problems and pregnancy poisoning are generally more common in first pregnancies. However, if it is seen in the first pregnancy, it also increases the risk of developing it in the second pregnancy, and in advanced age pregnancies, even if it is the 2rd or 3th pregnancy, blood pressure and pregnancy poisoning may occur.
Gestational hypertension can be permanent
Gestational blood pressure can sometimes be permanent in the patient. It is useful to follow the blood pressure of the patients for 12 weeks after the birth and to see if it is permanent. Also, the high blood pressure problem seen in the mother does not pass to the baby after the birth, and only developmental delay can be seen in the babies.
Cardiology control should not be neglected
A heart disease that normally does not show any symptoms can cause more problems and lead to maternal deaths, so it is beneficial for a patient with such a problem to go to the cardiology department for a check-up.
Hypertension patients can give birth normally if conditions are suitable.
The delivery of hypertension patients does not necessarily have to be by cesarean section. The important thing is that the birth is carried out in a serial way. If the patient's examination is suitable for normal delivery and can give birth quickly with artificial pain, normal delivery can be performed.
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