Pregnancy-induced hypertension

Gestational Hypertension also referred to as Pregnancy-Induced Hypertension (PIH) is a condition characterized by high blood pressure during pregnancy. Gestational Hypertension can lead to a serious condition called Preeclampsia, also referred to as Toxemia. Hypertension during pregnancy affects about 6-8% of pregnant women.

Gestational hypertension, also known as pregnancy-induced hypertension (PIH), is a condition characterized by high blood pressure during pregnancy. Gestational hypertension can lead to a serious condition called preeclampsia, also known as toxemia. Hypertension during pregnancy affects approximately 6-8% of pregnant women.

The different types of hypertension during pregnancy:

High blood pressure can present itself in different ways during pregnancy.
The following are the 3 common types of gestational hypertension:

• Chronic hypertension: women who have high blood pressure (over 140/90) before pregnancy, early in pregnancy (before 20 weeks), or who continue to have it after delivery.
• Gestational hypertension: high blood pressure that develops after the 20th week of pregnancy and disappears after delivery.
• Preeclampsia: Both chronic hypertension and gestational hypertension can lead to this serious condition after the 20th week of pregnancy. Symptoms include high blood pressure and protein in the urine. This can lead to serious complications for both mother and baby if not treated quickly.

Who is at risk?

The following women may have an increased risk of developing gestational hypertension:

• First-time moms
• Women whose sisters and mothers had PIH
• Women carrying multiples
• Women younger than age 20 or older than age 40
• Women who had high blood pressure or kidney disease prior to pregnancy

How do I know if I have gestational hypertension?

At each prenatal checkup, your healthcare provider will check your blood pressure and urine levels. Your doctor may also monitor your blood clotting and kidney functions, order blood tests, perform an ultrasound to check your baby’s growth, and use a Doppler scan to measure the efficiency of blood flow to the placenta.

How is it treated?

Treatment depends on how close you are to your due date. If you are close to your due date and the baby is developed enough, your healthcare provider may want to deliver your baby as soon as possible.
If you have mild hypertension and your baby is not fully developed, your doctor will probably recommend the following:

• Rest, lying on your left side to take the baby’s weight off your major blood vessels.
• Increase prenatal checkups.
• Consume less salt.
• Drink 8 glasses of water a day.

If you have severe hypertension, your doctor may try to treat you with blood pressure medications until you are advanced enough to deliver safely.

How can I prevent gestational hypertension?

Currently, there is no safe way to prevent hypertension. Some factors that contribute to high blood pressure can be controlled, while others cannot. Follow your doctor’s instructions on diet and exercise. Some ways you can help prevent gestational hypertension include the following:

• Use salt as needed for taste
• Drink at least 8 glasses of water a day.
• Increase the amount of protein you eat 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 that contain caffeine
• Your doctor may suggest that you take the prescribed medication and additional supplements.

Pregnancy tests

• An ultrasound will be used to confirm and date your pregnancy.
• Human chorionic gonadotropin (hCG
• Complete Blood Test
• Blood Glucose Test
• Urine C/E
• Blood group
• Anti HCV
• HbsAg
• HIV

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Tests Associated with Pregnancy

PURPOSE	TEST NAME	WHY PERFORMED	WHEN PERFORMED	WHO PERFORMED ON/SAMPLE
Genetic tests for inherited diseases	Genetic testing for inherited diseases	Check carrier status for certain genetic diseases to determine risk of having a baby with such a disease	Preconception or first trimester	Mother and father (blood sample)
	Genetic testing for hemoglobin disorders	Check carrier status for certain abnormal hemoglobin disorders to determine risk of having a baby with such a disease	Preconception or during pregnancy	Mother and father (blood sample)
	Cystic fibrosis carrier testing	Check carrier status for CF	Preconception or first trimester	Mother and father (blood sample)
Testing to detect health conditions in the mother	Blood glucose or hemoglobin A1c	To screen women at risk of type 2 diabetes (which is different than gestational diabetes)	Preconception or first trimester	Mother (blood sample)
	Pap test and HPV testing	Screen for cervical cancer and some STDs	Preconception or first trimester	Mother (cells from her cervix)
	Immunity to rubella (German measles)	Check for immunity to the virus, which can cause birth defects	Preconception or first trimester	Mother (blood sample)
	HIV screening test	Check for HIV infection so steps can be taken to reduce likelihood of transmission to the baby	Preconception or first trimester; may be repeated in third trimester if at high risk	Mother (blood sample)
	Gonorrhea, chlamydia, and syphilis tests	Check for STD infections, which can cause miscarriage or infect the baby during delivery	Preconception or first trimester; may be repeated in third trimester if at high risk	Mother (cervical cells, urine or blood sample, depending on test)
	Hepatitis B and hepatitis C screening	Detect hepatitis B or hepatitis C infection	Pre-conception or first trimester; may be repeated in the third trimester if at high risk	Mother (blood sample)
	Varicella zoster virus testing	Check for immunity to chickenpox, which can cause birth defects	Preconception or first trimester	Mother (blood sample)
	TORCH panel	Check for infection with toxoplasmosis and other infections that can cause birth defects	Preconception or first trimester, if infections suspected	Mother (blood sample)
	Bacterial vaginosis	Detect infection, which can cause pre-term labor	Preconception or whenever symptoms experienced	Mother (vaginal secretions)
	Urine culture for bacteriuria	Detect bacterial infection in the urinary tract, which can lead to kidney infection or increased risk of pre-term delivery and low birth weight	First prenatal visit or between 12 and 16 weeks of pregnancy; may be repeated in third trimester	Mother (urine sample)
	Group B streptococcus	Detect infection, which can harm the baby during birth and infect the mother’s uterus, urinary tract, and any incision made during a cesarean section	Between weeks 35 and 37 of pregnancy	Mother (specimen from vaginal and rectal areas)
Confirmation and monitoring of pregnancy and health of mother	Pregnancy test (hCG)	Confirm pregnancy	First trimester	Mother (blood sample)
	Urine screen for glucose and/or protein	Check for signs of kidney or bladder infection, undiagnosed diabetes or gestational diabetes, or pre-eclampsia	Each prenatal visit	Mother (urine sample)
	Complete blood count (CBC)	Check for anemia and/or detect low platelet count	Preconception and/or early in the first trimester; repeated in third trimester	Mother (blood sample)
	Blood typing and antibody screen	Check for potential incompatibility in blood type between mother and fetus (such as Rh factor antibodies)	First trimester; antibody screen repeated between weeks 28 and 29 of pregnancy	Mother (blood sample)
	Glucose challenge test/oral glucose tolerance test	Check for gestational diabetes	Between 24 and 28 weeks of pregnancy	Mother (blood sample)
	Thyroid stimulating hormone (TSH)	In women with known thyroid conditions, to adjust medication if necessary	Throughout pregnancy	Mother (blood sample)
Detection of fetal abnormalities or assessment of risk	First trimester Down syndrome screen	Assess risk of carrying a fetus with certain chromosomal abnormalities, such as Down syndrome	Usually between 11 and 14 weeks of pregnancy	Mother (blood sample plus ultrasound)
	Second trimester maternal serum screen	Assess risk of carrying a fetus with certain chromosomal abnormalities or open neural tube defects	Between 15 and 20 weeks of pregnancy	Mother (blood sample)
	Cell-free fetal DNA	Assess risk of carrying a fetus with certain chromosomal abnormalities; currently recommended for women at high risk of having babies with these disorders	During or after the 10thweek of pregnancy	Mother (blood sample)
	Chorionic villus sampling	Detect chromosomal disorders in the fetus	Between weeks 10 and 12 of pregnancy, if recommended	Mother (cells from the placenta)
	Amniocentesis	Detect certain birth defects and chromosomal abnormalities	Between 15 and 20 weeks of pregnancy, if recommended	Mother (amniotic fluid)
	Cordocentesis	Detect chromosomal abnormalities, blood disorders, and certain infections	Between weeks 18 and 22 of pregnancy, if recommended	Mother/fetus (fetal blood sample obtained from vein in the umbilical cord)
Fetal maturity/readiness for birth	Amniocentesis	Check fetal lung development	After week 32 of pregnancy if risk of pre-term delivery	Mother (amniotic fluid)
	Fetal fibronectin (fFN)	Detect fFN; negative result is highly predictive that pre-term delivery will NOT occur in the next 7-14 days	Between week 22 and 35 of pregnancy, if having symptoms of pre-term labor	Mother (cervical or vaginal fluid sample)

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