Care Plan for Pregnancy Induced Hypertension

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About Condition Signs and Symptoms Complications Follow-ups Exercises Lifestyle Diet Nutrition

Pregnancy Induced Hypertension (PIH)

Pregnancy Induced Hypertension (PIH) is defined as the development of raised blood pressure in pregnancy.

Pre-eclampsia

Pre-eclampsia is a condition that occurs only during pregnancy or immediately after the delivery of a baby. Women suffering from pre-eclampsia develop high blood pressure, together with protein in the urine.

It is known as a multi-system disorder which means it can affect different parts of the body such as the liver, kidneys, and cardiovascular system, and how your blood clots.

How common are these conditions?

PIH occurs in approximately 5% - 8% of all pregnancies and approximately 20% of women with raised blood pressure also develop pre-eclampsia.

Pre-eclampsia usually occurs after the 20th week of pregnancy. It does not always need treatment. Regular check-ups on the health of you and your baby may be all that is required.

Who is at higher risk of Pre-eclampsia?

You may be more susceptible to pre-eclampsia if:

This is your first pregnancy - 1 in 30 women tend to develop pre-eclampsia in their first pregnancy
Your mother and/or sisters have had pre-eclampsia
You have had pre-eclampsia in a previous pregnancy
You are a teenager or a woman aged 40 or more
You have existing medical problems such as diabetes, kidney disease or high blood pressure
You are overweight or obese
You are expecting a multiple birth - twins, triplets, etc

Treatment of pre-eclampsia

Women with pre-eclampsia need admission to hospital and often medicines to lower their high blood pressure. Occasionally, pre-eclampsia is a reason to deliver the baby early - you may be offered induction of labour or caesarean section

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You may experience one or more of the following symptoms:

Severe headaches
Vision problems such as blurring or seeing flashing lights before your eyes
Pain in your upper abdomen
Vomiting
Sudden swelling of your feet, ankles, face and hands, and excessive weight gain because of fluid retention

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Rarely, stroke, impaired kidney and liver function, blood clotting problems, fluid on the lungs and seizures.

Complications to baby:

Your baby may also be born prematurely or small or even stillborn.

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Test	Timing of test
Ultrasound examination is used to assess fetal growth and amniotic fluid volume (with umbilical artery Doppler velocimetry)	At 28-30 weeks and 32-34 weeks.
Blood tests for FBC, electrolytes, renal function, and LFTs.	Every week
Blood pressure	Twice every week
Urinary proteins	As per doctor's advice

All pregnant women should receive antenatal education so that they are aware of the symptoms associated with PIH, its importance, and the need to obtain medical advice.

Aim to keep BP lower than 150/100 mm Hg (140/90 mm Hg if there is organ damage) although do not seek to lower the diastolic level below 80 mm Hg.

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Women with gestational hypertension often need regular, moderate physical activity of around 30 min/ day, such as walking, prenatal aerobics class, or swimming, to help control blood pressure.

The specific amount of physical activity that you need depends on how active you were before you were pregnant, and whether or not you have any other health concerns.
One thing you need to watch is your level of effort, called your exertion level. If you can talk easily while doing an activity, instead of gasping for air, your level of exertion is good. If you cannot talk easily, or find yourself coughing or gasping for air, you need to lower your level of exertion by slowing down or stopping for a while.

GENERAL GUIDELINES FOR PHYSICAL ACTIVITY

Do's

Complete moderate and regular physical activity unless your health care provider tells you not to.
Wear loose, light clothing that won't make you sweat too much or get too hot.
Drink a lot of water before, during, and after your activity.
Eat a healthy diet and gain the right amount of weight (10-12 Kg's).
Watch your level of exertion (Can you talk easily?).

Don'ts

Get too tired while working out or doing physical activity.
Do sit-ups, toe touches or deep knee bends.
Do any activity while lying on your back when you are in your 2nd or 3rd trimester of pregnancy.
Perform activities in very hot weather.
Perform activities that may bump or hurt your belly, or that may cause you to lose your balance.
Fast (skip meals) or do physical activity when you are hungry.
Overexert yourself.

Check out the link:

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Lifestyle	Positive changes
Smoking and Alcohol	Quit ! Both harm your body and baby
Exercise	Stay FIT with regular exercise and it also improves blood sugar levels.
Maintain Body weight	Eating healthy diet rich in vitamins, minerals and antioxidants is necessary. Usually fruits, vegetables, whole grain foods serve the purpose
Sleep	Body needs 7 to 8 hours of sleep
Emotional health	Stay calm and think positive Keep yourself occupied with your job and perceive hobbies like reading, singing, painting etc
Make Hygiene a Habit	Maintain it for your own and baby health.
Group support	Seek such support as it gives motivation at being regular in taking medicines It also helps to have better approach towards life with disease.

How can I prevent Gestational Hypertension:

Currently, there is no sure way to prevent hypertension. Some contributing factors to high blood pressure can be controlled and some can't. Follow your doctor's instruction about diet and exercise.

Use less salt as needed for taste
Drink at least 8 glasses of water a day
Increase the amount of protein you take in and decrease the amount of fried foods and junk food you eat
Get enough rest
Exercise regularly
Elevate your feet several times during the day
Avoid drinking alcohol
Avoid beverages containing caffeine
Your doctor may suggest you take prescribed medicine and additional supplements

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To promote health throughout your pregnancy, it is essential that you work with your health care provider to create a plan for your healthy diet.

Follow DASH diet to reduce hypertension:

Advice:

Use less salt as needed for taste
Drink at least 8 glasses of water a day
Increase the amount of protein you take in and decrease the amount of fried foods and junk food you eat
Avoid drinking alcohol
Avoid beverages containing caffeine

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