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pregnancy Induce Hypertension : PIH - Coggle Diagram
pregnancy Induce Hypertension : PIH
meaning
Systolic increased from the original ≥ 30 mmHg
Diastolic increased from the original ≥ 15 mmHg
BP ≥ 140/90 mmHg
Mean arterial pressure ≥ 105 mmHg increased from the original ≥ 30 mmHg
Classification of hypertension in pregnant women
1.Transient or Gestational
hypertension
Hypertension for first time after 20 weeks without proteinuria. BP returns to normalbefore 12 weeks postpartum.
4.Chronic hypertension with superimposed
pre-eclampsia or eclampsia
Proteinuria + Edema
3.Pre-eclampsia
Pre-eclampsia without severe features or Mild pre-eclampsia
urine protein 24 hr.detected proteinuria < 5 gm/L Urine stick 1+ - 2+
Blood pressure: Diastolic < 110 mmHg,
Systolic < 160 mmHg
Pre-eclampsia with severe features or Severe pre-elampsia
urine protein 24 hr. detected proteinuria > 5 gm/L
Urine stick 3+ - 4+
Blood pressure: Diastolic > 110 mmHg.,
Systolic > 160 mmHg.
Visualance ,Visualance,Epigastric pain, Hyperreflexia
2.Chronic hypertension
Hypertension antedates pregnancy and detected before 20 weeks lasts more than12 weeks postpartum.
Risk factors
Pregnancy interval is more than 10 years from the previous pregnancy.
Pregnant women with a history of preeclampsia
Pregnant under 18 years old or over 35 years old
Pregnant women with close relatives have high blood pressure. while pregnant
First pregnancy or first pregnancy with new spouse
twin pregnant women
Pregnant women with pre-pregnancy medical conditions ,DM , HT, chronic kidney disease, Iupus/SLE.
Complications
Maternal
Congestive Heart Failure
HELLP syndrome , DIC
Acute kidney injury
thrombocytopenia
cerebral hemorrhage
Eclampsia
Fetal
IUGR
Fetal distress/ Respiratory DistressSyndrome
Preterm labour, DFIU
Placental insufficiency
Stiil birth
Sign&Symptom
Nausea and vomiting
Headache
Swelling in Extremities
Blurred Vision
High Blood Pressure
Treatment
Antihypertensive drugs = Calcium-channel blockers : Nifedipine (Adalat)
Anticonvulsant = Magnesium Sulfate
Proper antenatal care
Expectant treatment
Treatment of eclampsia
Control hypertension
Prevention and control of convulsions
Termination of pregnancy
Intrapartum care
Postpartum care