Definetion of Pregnancy induced hypertension – This course is designed to understand the care of pregnant women and newborn: antenatal, intra-natal and postnatal; breast feeding, family planning, newborn care and ethical issues, The aim of the course is to acquire knowledge and develop competencies regarding midwifery, complicated labour and newborn care including family planning.
Definetion of Pregnancy induced hypertension
Management of Pregnancy Induced Hypertension:
A. Clinical Features:
1. Blood pressure :>140/90 mm Hg
2. Mild to moderate headache.
3. Pain in the eye
4. Palpitation
5. Altered sleep pattern
B. Investigations:
1. Bed side heat coagulation test (for urinary albumin).
2. Urine R/S.
3. Serum creatinine.
4. USG to assess fetal condition.
5. Liver function tests (to detect HELLP syndrome).
C. Treatment:
1. General measures:
Adequate bed rest.
Diet should be rich in protein
Fluid is restricted
Extra salt in the diet is forbidden
2. Specific:
Oral antihypertensive therapy: a-methyl dopa, Labetolol ete.
3. Close monitoring of the patient:
- Blood pressure should be checked regularly
- Appearance of any type of severe headache.
- Bed side heat coagulation test daily /2-3 times a week or at least once weekly.
- Any oedema.
- Epigastric pain.
- Sleep pattern.
- Daily weight.
- Eye symptoms (dimness of vision or blindness).
- Urine output.
- Assessment of fetal well being
A. Immediate complications:
a) Maternal:
During pregnancy:
- Eclampsia
- Pre-eclampsia
- Acute renal failure
- Cardiac failure
- Abruption placenta
- Premature labour
- HELLP syndrome
- Dimness of vision
During labour:
- Eclampsia
- Postpartum haemorrhage
- Shock
During puerperium:
- Eclampsia
- Puerperal sepsis
- Shock
b) Fetal complications:
- IUGR
- IUD
- Prematurity
- Birth asphyxia
B. Remote complications:
1. Residual gestational hypertension
2. Recurrent pre-eclampsia
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