Quite often, women experience high blood pressure during pregnancy - hypertension. You should not ignore this problem, since deviations can harm mom and her baby.

In Pregnancy Control of nifedipine
  Cranberry Berry Cranberry
  women in position eating cranberries Strengthens the immune system

This is a very alarming sign, because the walls of the vessels are very narrow, so oxygen does not reach the fetus in sufficient quantities. As a result, the child develops more slowly.

When pregnancy is still in the early stages, it is very dangerous high pressure. Due to a jump in blood pressure (BP), gestosis can develop. This is a very dangerous, unpredictable disease of expectant mothers. It causes an upset in the functioning of vital organs. First of all, this applies to the circulatory and cardiovascular systems.

It is necessary to constantly monitor changes.

Pathology is formed as a result of the fact that the placenta begins to produce substances, under the influence of which microholes appear in the vessels. Through them, fluid and plasma protein enter the tissue from the blood. This causes severe swelling of the hands, feet, and placenta. If swelling of the extremities is not so terrible, then a lack of oxygen threatens the fetus with serious consequences, which is why the high pressure that occurs during pregnancy is dangerous.

However, even if during pregnancy you have a high pulse and high blood pressure, but this is not a sign of gestosis, you cannot ignore the disease. Specialists of the antenatal clinic remove a lot of attention to monitoring blood pressure for women registered. Due to changes in the vessels of the fetus and placenta, blood circulation between the mother and the child decreases. Scientifically, this phenomenon is called fetoplacental insufficiency. As already mentioned, this threatens with a lack of nutrients, oxygen, which can cause a delay in the intrauterine phenomenon.

When blood pressure regularly jumps during the bearing of a child, and its indicators are at an elevated mark (150 and above), premature detachment of the placenta may begin. This phenomenon greatly complicates the normal development of the child. Increased blood pressure in the mother can cause premature birth or miscarriage.

Usually, during pregnancy, the doctor always tells what threatens the appearance of high blood pressure, so women are aware of another consequence - convulsive syndrome (eclampsia). This will not benefit either the future mother, or her baby.

Signs of hypertension

To find out if you really have high blood pressure in the first and subsequent weeks of pregnancy, measure it with a tonometer. This device is desirable to have at home for every girl. It is more convenient to use an electronic blood pressure monitor at home, but a conventional one is also suitable. Its cost is lower, and some doctors believe that it shows a more accurate result. This is important, because, for example, at 39 weeks of pregnancy it is very important to determine high blood pressure on time.

There are several signs of high blood pressure. According to them, a woman can determine the development of pathology:

• headache;
• severe dizziness;
• noise in ears;
• vomiting, nausea;
• the appearance of red spots on the skin of the chest, face, general redness;
• "Flies" before the eyes;
• worsening of well-being.

Doctor pressure monitoring

Sometimes in the third and other trimesters of pregnancy, high blood pressure is asymptomatic. The woman does not feel any signs, the pathology is not detected. That is why this diagnosis should be carried out regularly.

Reasons for the development of pathology

During pregnancy, there are several reasons for the development of high blood pressure. These include:

• stress;
• lack of compensatory forces;
• heredity;
• smoking;
• weak physical activity;
• obesity;
• kidney disease
• failure of the hormonal activity of the pituitary, adrenal gland, thyroid gland.

Stress arises due to the fact that the body's loads are so large, it just does not have time to rebuild. As a result, jumps in blood pressure begin. During the bearing of a child, the heart is forced to work for two, due to a lack of compensatory forces, the vital organ simply cannot cope with a large volume of circulating blood.

The development of high blood pressure in a single or multiple pregnancy in the later stages depends on heredity. If your relatives suffered from this pathology, there is a high probability that you will encounter this.

It is advisable to get rid of the addiction to smoking long before conception. It does not add health, and the cardiovascular system affects very much. The same goes for weak physical activity. A trained heart does a much better job. Be sure to monitor your diet, the number of kilograms that you gain in each trimester. Keep in mind that high blood pressure also depends on kidney problems. Very often, pathology occurs in people who suffer from kidney diseases.

Disease treatment and prevention

During pregnancy, you must definitely check with your doctor how to reduce high blood pressure. It is strictly forbidden to take medicines on your own, because they can cause irreparable harm to the baby. Drug treatment is necessary with very high blood pressure in order to reduce the possible risk of complications. The doctor will prescribe the necessary dosage, tell you about the duration of admission. Recommendations are individual for each patient, as they are provided on the basis of diagnostics and analyzes.

There are several types of high-pressure tablets that are allowed during pregnancy. These include Hydralazine, Metoprolol, Nifedipine. These pills are safe for fetal development, but they cannot be taken uncontrollably. If you have already been treated and took certain drugs, you still need to consult a specialist, because the usual drugs for you can be dangerous for the baby.

Nifedipine may be prescribed

There is a list of drugs that are not allowed to be used during pregnancy. These include, for example, diuretics that help reduce the amount of circulated blood. This factor harms the bloodstream of the placenta, which can slow down embryonic development. That is why you should not prescribe treatment yourself, because now you should think about your baby.

1. Even with a slight increase in blood pressure, you need to normalize your diet. It is advisable to create a special menu and include foods rich in trace elements and vitamins.
2. Thrombogenic products, smoked, salty, fatty, sweet dishes should be completely excluded. Do not abuse strong tea, chocolate and coffee. They are undesirable not only with high blood pressure, but also in general when carrying a baby. Best of all, give preference to weak tea with lemon slices, tea from hibiscus. These drinks improve your condition and are an excellent preventive measure.
3. Reception of motherwort, valerian will not hinder.
4. Be sure to play sports, if the doctor allows physical exercise, walk in the fresh air, go to the pool.

You should not decide on your own what to do if during pregnancy it was not possible to reduce high blood pressure with outpatient treatment. Contact a specialist. He can be sent for examination to a hospital, where a woman will be constantly under the supervision of medical personnel and qualified doctors.

Effective folk remedies

It is worth noting that it is best to carry out complex treatment of high pressure during pregnancy. Folk recipes, although not a panacea, but in combination with drug therapy give a good result. In addition, be sure to consider the individual tolerance of the components and consult a doctor before using traditional medicine.

With pregnancy in the early and late stages, cranberries are a good remedy for high blood pressure. Required:

• half a glass of berries;
• 3 tsp decoys;
• 4 tbsp. tablespoons of granulated sugar.

The medicine should be taken in 3 tsp. It is advisable to use it several times a day.

1. Rinse the cranberries well and squeeze the juice out of it.
2. Pour the remaining cake with boiling water and put on low heat for 5 minutes.
3. Strain the broth, pour semolina into it and cook for 15 minutes, while stirring constantly.
4. Put sugar in the mass, wait until the product boils, remove from heat.
5. Beat the resulting porridge in a blender by pouring in cold cranberry juice.

Cranberries will help well

There is another harmless remedy that can be consumed from high blood pressure even at 38 weeks of gestation. You only need:

• corn grits;
• a glass of warm water.

Means to drink 2 tbsp. spoons. Use before meals.

1. Grind the grits in a coffee grinder.
2. Pour a glass of water.
3. Insist a day, while shaking the contents.

Also, pumpkin broth is a good medicine. Take:

• 200 gr. pieces of pumpkin;
• 1 tbsp. a spoonful of honey.

The tool can be used several times a day. It is great as a preventative measure.

1. Boil the pumpkin.
2. Cool.
3. Add honey.

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At each appointment in the antenatal clinic, a doctor and a nurse examine the pregnant woman. So, the sister records changes associated with the growth of the child in the womb (for example, weight gain and an increase in the circumference of the abdomen), and also measures blood pressure. If its indicators exceed the norm, there is cause for concern.

Perhaps, the standard pressure standard is 120/80 mm Hg. everyone heard. "With such fly into space." But modern doctors prefer not to talk about standards, as they consider the pressure rate to be an individual feature of each person, depending on many factors, such as his height and weight, lifestyle, etc. They determine the normal pressure not by what - for the average indicator, but by a whole range: from 90/60 mm Hg. Art. up to 140/90 mmHg Art.

Changes in the functioning of a woman’s body during pregnancy are enormous. All its organs and organ systems begin to work differently. An additional burden falls on the heart and blood vessels: another, third, circle of blood circulation is formed. The volume of blood in the body of the expectant mother is increasing. By the middle of pregnancy, it becomes more by 0.5 liters, closer to childbirth - by 1 liter.

The heart needs to pump this blood faster, so doctors consider the norm a slight increase in blood pressure in expectant mothers.

IMPORTANT: Pressure in pregnant women, which is at the upper limit of normal and is 140/90 ml RT. Art. Doctors are not worried

If his indicators are above this boundary, it is necessary to find out the reasons for such an increase in pressure and to take treatment.

IMPORTANT: HELL - a variable indicator that can change over several minutes. A pressure surge in a pregnant woman can be caused by stress (for example, fear of the gynecologist’s reception or worrying about the baby), climbing stairs (you must admit, it’s hard for a pregnant woman to climb to the 5th floor of the clinic in the third trimester), drunk on the eve of taking a cup of coffee. To ensure the reliability of blood pressure measurement results, the pregnant woman should be calm and rested, she should not drink invigorating drinks a few hours before taking

Symptoms of high blood pressure during pregnancy

There are a lot of reasons why the expectant mother has increased pressure. Some of them are not at all related to the bearing of a child, hypertension may have been present in a woman before, others are caused by the “interesting situation” itself. For instance:

1. Hypertension (arterial hypertension). Unfortunately, many women of childbearing age are burdened with chronic diseases, hypertension among which is especially common. This is due to genetic characteristics, improper lifestyle, stress, bad habits, many other factors. During pregnancy, a woman’s condition - hypertension may worsen
2. Other chronic diseases. If the future mother has sick liver, kidneys, organs of the endocrine system, an increase in pressure is quite possible for her
3. Diabetes pregnant. This diagnosis is almost always accompanied by hypertension.
4. Gestosis. But this pathology occurs just during and due to pregnancy. It is characterized by a disorder in the work of many body systems of the pregnant woman and is deadly for both the child and the woman herself

Headache, nausea, tinnitus are signs of hypertension in pregnant women.

As a rule, suspecting increased pressure in a future mother is obtained even before measuring this indicator, because a woman literally from the threshold complains of poor health. She has the following symptoms:

• headache
• dizziness
• nausea
• noise in ears
• "Flies" before the eyes
• redness of the skin on the face and neck

Thematic video

What is the danger of high blood pressure during pregnancy?

Arterial hypertension is dangerous for any person. For a woman “in position” she is doubly dangerous, since she and the baby can suffer the consequences of increased pressure.
  Complications of high blood pressure during pregnancy can be:

IMPORTANT: To prevent misfortune, you can not ignore high blood pressure during pregnancy

High blood pressure during pregnancy in the first trimester

If high blood pressure was recorded in the first half of pregnancy, most likely the woman suffered from hypertension before her, or chronic diseases of the kidneys, thyroid gland, adrenal glands, and others made themselves felt.

IMPORTANT: A slight increase in blood pressure in the first three months of pregnancy can be triggered by stress due to the new condition of the woman and changes in her life associated with the gestation and early birth of the baby. The situation needs to be kept under control, but perhaps it will resolve itself as soon as the woman has toxicosis and she gets used to her new role

Increased blood pressure due to any disturbances in the functioning of the pregnant woman’s body can be dangerous for the child: pregnancy may fail, or pathologies in the baby may develop due to hypoxia.

High blood pressure during pregnancy in the second trimester. High blood pressure during pregnancy in the third trimester

An increase in blood pressure since the second trimester of pregnancy is an alarming harbinger of gestosis.

IMPORTANT: The reasons for the development of gestosis have not yet been established accurately. But it is known that a condition characterized by disturbances in the work of many organs and systems of the expectant mother most often occurs in those who before pregnancy or during pregnancy did not suffer from hypertension, kidney disease, biliary tract, endocrine system

With gestosis, a spasm of blood vessels occurs, because of which the blood circulation and its coagulability are disturbed. Tissues and organs as a result of this receive insufficient oxygen and nutrients. In them, dystrophic changes begin to occur, sometimes irreversible until death.

The first to suffer from gestosis are the kidneys, heart and brain. The placenta also ceases to cope with the performance of its functions, as a result of which the child suffers from a lack of oxygen and nutrients.

In the first pairs, gestosis manifests itself as edema, then - renal failure, preeclampsia and eclampsia.

IMPORTANT: The cause of high blood pressure in the second and third trimesters of pregnancy can be much more commonplace than gestosis. This is overweight. So that the pressure does not rise, the woman needs to control his increase

Treatment of high blood pressure during pregnancy. Pills for high blood pressure for pregnant women

Treatment of hypertension during pregnancy cannot follow the pattern. First of all, the doctor finds out why the pressure increased in a particular pregnant woman, and only then choose drugs and give recommendations.

IMPORTANT: If the future mother has a pressure of 170/110 mm Hg. Art., she is urgently hospitalized, examined and treated already in the hospital

Usually, women who have a slightly elevated blood pressure do without medications, there are no other signs of dangerous conditions. To normalize it, it is often enough to normalize the regimen of the future mother’s day and her nutrition.

If the pressure threatens to disrupt the functioning of the organs and systems of the woman, the deterioration of the uteroplacental blood flow, she is prescribed medication.

"Drug of choice" from high blood pressure in pregnant women.

Safe for the child medications are tablets:

• Egilok
• Nifedipine
• Labetalol
• Pipazole
• Dopgit
• other

Pregnancy-lowering products

To prevent the pressure from rising or normalizing, a pregnant woman should consume foods containing:

• ascorbic acid
• omega - 3 acids
• potassium and magnesium
• folic acid

• natural and high-quality dairy and dairy products
• vegetable oils
• fish and seafood
• cereals and cereals
• bran
• vegetables, herbs, fruits, berries and dried fruits
• lean meat
• egg yolk

So that the pressure of the future mother does not increase, she needs:

1. Observe the regime of work and rest. A night's sleep should be at least 8 hours. If possible, the pregnant woman should sleep during the day, 1-1.5 hours. Overwork at work, overtime work and night work are contraindicated to her
2. Refrain from invigorating drinks - coffee and strong tea
3. Limit salt intake
4. Avoid stress
5. Control your weight
6. Go for walks and go in for sports

During the period of expectation of a child, the female body becomes very vulnerable, long-standing diseases are aggravated, previously unknown sensations appear, sometimes, not always pleasant.

Quite often, one of the symptoms of the development of pathologies during pregnancy is high blood pressure. Therefore, during the examinations, obstetrician-gynecologists each time monitor the pressure of the expectant mother.

Normal pressure during pregnancy, in which the heart and blood vessels perform their functions without experiencing excessive load, are considered indicators:

• 110-120 mm. Hg. Art. for upper (heart) pressure - diastolic;
• 70-80 mm. Hg. Art. for the lower (vascular) - systolic.

For chronic hypotensive patients, these limits may be lower: 90/60 mm Hg. Art.

It is important that a woman, when registering for pregnancy in a medical facility, knows the “working” values \u200b\u200bof her pressure.

Indeed, often (as, for example, in hypotensive patients), increased pressure is ascertained based on an increase in values: more than 30 mm. Hg. Art. for the upper indicator and 15 mm RT. Art. for the lower one, it means that blood pressure has risen beyond the permissible level.

Of course, a one-time increase in pressure for some reason is not a reason for the diagnosis of hypertension. But if the increased level is recorded at least twice in a row, then this is already cause for concern.

Why does the pressure rise?

Factors contributing to the appearance of high blood pressure during pregnancy differ little from the causes of hypertensive conditions in the "non-pregnant" period:

•   (obesity);
• bad habits (alcohol, smoking);
• chronic diseases of the internal organs, which are accompanied by high blood pressure;
• hereditary predisposition;
• hypertension as an independent disease (in the absence of endocrine disorders, diseases of internal organs).

Since the period of carrying a child for the female body is a period of increased stress, then, with a known predisposition, problems with pressure in the expectant mother are quite expected.

Moreover, if previously the expectant mother already suffered from high blood pressure (including during a previous pregnancy), then in the vast majority of cases (about 80%) during the next pregnancy, high blood pressure is inevitable.

However, it also happens that a jump in intracranial pressure in a woman was first noted precisely during the current pregnancy. The reason for this may be:

•   . Then hypertension is one of the symptoms of the triad of this pathology (along with proteinuria and).
• Gestational arterial hypertension, which is not combined with other symptoms of gestosis. It occurs after the 20th week of pregnancy and, as a rule, heals itself after childbirth.

The insidiousness of hypertension lies in the fact that its initial stages can easily be not recognized.

This is especially true for future mothers, for whom high blood pressure is common.

The body has adapted to this state and is in no hurry to respond to it.  Therefore, at each scheduled examination by an obstetrician-gynecologist, a woman passes control with a tonometer.

With a mild degree of hypertension, its signs may be weakly expressed:

• mild, dizziness;
• rapid pulse;
• excessive sweating;
• bright “blush” on the cheeks;
• anxiety.

The severity of these symptoms progresses with a further increase in pressure. To them are added:

• dyspnea;
• areas of redness on the skin throughout the body;
• "tinnitus;
• weakness;
• bouts of nausea, vomiting;
• "Flies", "fog" before the eyes.

Pain may appear in the left sternum, insomnia, excessive nervousness, which are so easily mistaken for the features of a "pregnant" body.

Perhaps this is true, but the doctor must confirm or refute the suspicion.

Dangerous effects of high blood pressure during pregnancy

Of course, high blood pressure is a pathology and requires immediate correction.

Careful monitoring of blood pressure values, which are experts, is caused by the likelihood of dangerous consequences for the mother and child.

1. Increased pressure in pregnant women is the “answer” to narrowing of blood vessels, including in the uterus and placenta. This leads to obstruction of blood circulation in the uterus-placenta-fetus system, and, therefore, to. Prolonged hypoxia is the cause of intrauterine growth retardation of the baby.
2.   , which also develops due to vasospasm, can cause spontaneous abortion.
3. Due to the increased blood pressure in the bed between the uterus and the placenta, it can occur, which will lead to insufficient nutrition of the fetus, and also, depending on the extent of detachment, it can cause.
4. Prolonged hypertension can cause functional failure of the vital organs of a woman, which is dangerous for the health and life of mom and her unborn baby.
5. Severe hypertension, as a manifestation of gestosis, can lead to the development of complications that are dangerous for the mother and her unborn child - preeclampsia and eclampsia.
6. A significant jump in pressure, especially during childbirth, can cause retinal detachment (and subsequent blindness) or even stroke.

Do I need hospitalization?

Since hypertension is a very dangerous phenomenon for a pregnant woman, it is unreasonable to refuse the proposed hospitalization. In addition, it is very likely that with a favorable prognosis, the time spent in the hospital will be small.

If hypertension was listed in the woman’s medical history even before being registered for pregnancy, a referral to hospitalization will be issued at the first appointment with an obstetrician-gynecologist.

The hospital will determine the degree of hypertension, predict the risk of possible complications for a woman’s health and select treatment methods.

At the initial detection of hypertension during pregnancy, hospitalization is also indicated to search for the causes that caused the increase in pressure.

If the growth of indicators occurred in the second trimester, it is important to exclude the development of gestosis or to diagnose it in a timely manner.

If the degree of hypertension is mild, the pressure is stable and does not negatively affect the well-being of the future mother, then the next hospitalization according to the plan will follow at the beginning of the third trimester, since during this period the likelihood of a crisis increases.

At 38-39 weeks of pregnancy, the expectant mother with high pressure moves to the hospital until the birth.

During this time, she will be examined, in order to clarify her condition and choose a method of delivery, preparatory procedures.

In the case of an exacerbation of the hypertensive state in a woman, treatment is mandatory. This is necessary to determine the factors that caused the aggravation of hypertension and the appointment of appropriate treatment.

How to lower blood pressure during pregnancy

Depending on the reasons that caused arterial hypertension, the doctor chooses the tactics of further pregnancy and treatment methods aimed at normalizing pressure.

As a rule, a combination of drug and non-drug therapy is used.

Non-drug method

The non-drug method is to limit the physical and social workload, namely:

• refusal to participate in stressful situations.
• the creation of a comfortable psychological environment.
• the exclusion of excessive physical effort, therapeutic gymnastics is allowed, swimming at a calm pace.
• Compliance with sleep, rest.

In addition, it is important to observe some nutrition principles aimed at:

• adjustment of potassium-sodium metabolism (to prevent fluid retention in the body);
• prevention of further excessive weight gain (if it is excessive).
• To improve water metabolism in the body:
• limit or completely eliminate the use of table salt with food, as a source of sodium, leading to fluid retention in tissues;
• include in the diet foods rich in potassium, which reduce the tone of blood vessels and magnesium, which also has a light diuretic property.

To prevent excessive weight gain:

• limit fat intake to 40 g per day, giving priority to vegetable fats;
• minimize the presence of simple carbohydrates in the diet: sugars, refined foods, treats;
• adjust the mode of eating in the direction of fractional nutrition.

Folk ways

Among non-drug methods of dealing with high blood pressure, alternative methods have also found their place:

• Grind, mix an equal amount of rose hips, hawthorn, red viburnum, linden flowers, calendula, blueberry and heather shoots and motherwort grass. Separate 2 tbsp. l , pour them with 2 cups boiling water, then simmer for 15 minutes. in a water bath and insist at room temperature. Drink 100 g of strained mixture with honey after meals 3-4 times a day. The duration of the course is 1.5 months.
• Mix half a glass of cranberry juice with the same amount of honey. Take 1 tsp. 3 times a day. The course of treatment is 14 days.
• Mix an equal amount of shredded valerian root, dried cinnamon grass, heather shoots and viburnum flowers. Pour 2 cups boiling water 2 tbsp. l mix and insist in a thermos for 2 hours. Sweetened strained infusion sweeten with honey and take ¼ cup 4 times a day. The course of admission is 1-1.5 months.

Before using herbal remedies, you should get approval from a doctor who is pregnant to rule out possible contraindications.

Medication method

With a slight increase in pressure, phytopreparations that have a calming, light sedative effect based on motherwort, valerian, lemon balm, mint, etc., will suffice.

With persistent hypertension, there is a need for the use of more serious pharmacological agents.

The most common remedy, due to its availability and safety at the same time as its effectiveness, is methyldopa (“Dopegit”).

The drug for pressure is approved for use from the very early stages of pregnancy. Methyldopa does not adversely affect placental circulation, does not pose a threat to fetal development, and also does not cause adverse effects in the long term for a born child.

The action of the substance occurs within 2-6 hours and is manifested:

• in a relaxing effect for the central nervous system;
• in suppressing the activity of hormones that cause an increase in pressure;
• in suppressing the activity of the blood plasma enzyme (renin), which is able to affect the level of blood pressure and sodium metabolism;
• in the removal of vascular hypertonicity;
• in general sedative effect.

With pressure in late pregnancy, when a protein is detected in a urinalysis and taking into account all the possible risks to the fetus, β-blockers are prescribed.

As a medicine for pressure, pregnant women are often prescribed cardioselective β-blockers, because they have fewer side effects compared to non-selective ones.

In the fight against high blood pressure, the effect exerted by them directly on cardiac activity is important:

• reduced heart rate and strength;
• the body's susceptibility to stress is reduced;
• renin activity decreases;
• conductivity in the AV node is reduced to the desired level, normalizing the contractile-conducting activity of the heart departments;
• the oxygen demand of the heart muscle is normalized (anti-ischemic effect);
• the risk of cardiac arrhythmias is reduced.

Popular β-blockers prescribed for pregnant women help to relieve pressure during pregnancy: atenolol, metaprotolol, labetalol, nebivolol, bisoprolol.

Bisoprolol is currently preferable because of its ease of use (1 tablet per day), reliable round-the-clock action, the possibility of use in diabetics and the less pronounced "withdrawal syndrome" in comparison with other means.

Calcium antagonists or calcium channel blockers are similar in effectiveness to β-blockers.

But they do not act on the nervous system, but on the channels in the cardiac and vascular muscles through which calcium enters the muscle cells.

The strength of muscle contraction depends on the calcium concentration in its cells. Activation of calcium channels occurs under the influence of adrenaline, norepinephrine. The blockade of calcium-conducting channels prevents spasms in the muscles of the heart and blood vessels.

According to the direction of action of calcium antagonists, it can be conditionally divided into groups:

• acting only on smooth vascular muscles (nifedipine, normodipine, amlodipine, etc.) and therefore are recommended for use simultaneously with β-blockers;
• acting on muscles and heart and blood vessels (verapamil) and therefore are prohibited for use simultaneously with β-blockers.

Taking calcium antagonists during pregnancy does not exclude a possible detrimental effect on the fetus and is often accompanied by unpleasant side effects.

Therefore, they are prescribed in the case when taking other groups of antihypertensive drugs is impossible.

Measures to prevent high blood pressure during pregnancy

Blood pressure in a woman during pregnancy almost inevitably rises due to an increase in the volume of circulating blood with an increase in the duration of pregnancy.

Therefore, a slight increase in blood pressure in some pregnant women may be the physiological norm.

If the pressure indicators are increased already in the early stages of pregnancy, or the “jumps” in pressure occurred earlier, she should adjust her lifestyle and diet for the prevention of hypertension.

Namely:

• do not limit the duration of sleep and rest;
• avoid excessive physical activity, preferring feasible exercise at a calm pace;
• avoid stressful situations;
• to control weight gain during pregnancy (not more than 15 kg.);
• adjust the diet and menu, making the meal fractional and abandoning unwanted foods with hypertension;
• regularly monitor your blood pressure (daily, at least twice a day) on both your right and left hands.

If this happened, at the next doctor’s appointment or with an independent measurement, mom found that the pressure exceeded the norm, then in the first place the panic should be stopped, otherwise the indicators will rise even higher.

The most reasonable thing in this situation is not to self-medicate, but to trust qualified specialists and then the pregnancy and the birth of the baby will be successful.

Regular measurement of blood pressure during pregnancy becomes a mandatory procedure for a woman. So, with every trip to the antenatal clinic, measurements will be a given - this is a necessary ritual, designed to timely identify any deviations in pressure, thereby protecting the expectant mother and baby from serious complications due to high blood pressure during pregnancy.

As you know, pressure indicators are usually characterized by two numbers, for example, 120/80, where 120 is systolic pressure and 80 is diastolic. So, when the first indicator is 140 or exceeds this figure, they talk about high blood pressure during pregnancy. The pressure may increase both during the bearing of the child, and may be increased already before pregnancy - in this case, doctors talk about chronic hypertension, which requires increased attention and caution during pregnancy.

High pregnancy pressure is a very bad sign, both for the mother and the fetus. The fact is that with increased blood pressure, the walls of the vessels are narrowed, which interferes with the normal flow of oxygen and nutrients to the baby, and as a result, fetal growth can be slowed down. High pressure during pregnancy is also dangerous because it can provoke premature detachment of the placenta, which is accompanied by a strong, dangerous for the pregnant woman and the baby.

High blood pressure during pregnancy can also be a symptom of a very dangerous condition called preeclampsia - a condition that can bring many troubles. The mechanism of the occurrence of preeclampsia is still not fully understood, only assumptions exist. It is believed that preeclampsia can be caused by increased production by the body of a substance that narrows the blood vessels and, conversely, a decreased one - a substance that dilates the blood vessels. Of course, other factors play a role here, such as the amount of protein in the diet of a pregnant woman. In any case, preeclampsia is a condition that requires increased attention from doctors. Leaking in a mild form, preeclampsia may not be particularly felt, only accompanied by increased pressure, but not more than 140/90, sometimes with swelling of the hands and face. Other, more serious symptoms of preeclampsia may include visual impairment, and, acute or vomiting. The greatest danger of preeclampsia is that it can turn into a rare but serious disease - eclampsia. Her convulsions and even coma accompany her, and the threat of eclampsia to the life of the mother and child is very, very great.

In order to avoid problems with high blood pressure during pregnancy, regular visits to the doctor are necessary. Finding that a pregnant woman has high blood pressure, first of all, doctors, as a rule, recommend a diet that excludes fatty, salty foods, sweets. Moderate physical activity is also shown. But all this is only if the form of the disease is mild. If high pressure during pregnancy causes anxiety among doctors, one will have to resort to medical treatment to correct the condition. There are drugs to normalize high blood pressure during pregnancy, which practically do not pose a threat to the fetus and mother, unlike serious forms of hypertension. Among them - papazol, metoprolol, nifedipine. The doctor selects the drug for treatment, its dosage and duration of administration exclusively on an individual basis, focusing on the indicators of the pregnant woman's analysis.

If the complex of measures taken is not effective, the condition not only does not improve, but also worsens, if the pregnant woman suffers from chronic hypertension, there is a need to go to hospital before delivery. Qualified medical staff will provide the expectant mother with proper care by measuring the pressure several times a day, monitoring the amount of protein in the urine and weight daily, which will make it possible to avoid undesirable complications.

Especially for  - Tatyana Argamakova

In the structure of diseases of pregnant women, arterial hypertension is 15-20%. Among these 20%, primary hypertension is one third, hypertension with gestosis - about 70% and secondary hypertension due to other diseases - 25%. Arterial hypertension is a serious disease that imperceptibly undermines the body's strength from the inside. The essence of the disease: there is a narrowing of blood vessels under the influence of nerve impulses and some hormones. Initially, arterial hypertension does not manifest itself. The woman does not feel the increase in pressure and performs the same load. However, internal organs suffer because little blood enters the narrowed vessels, not enough oxygen (hypoxia), connective tissue begins to grow in the organs (its cells can grow with a lack of oxygen). Specialized cells of organs do not live without oxygen, and the organ loses its function. It is then that complaints appear in women. They can be different: dizziness, headaches, flashing flies before the eyes.

In severe forms of hypertension, there may be a sharp rise in blood pressure - a hypertensive crisis (a complication of hypertension). The following classification of hypertensive crises exists: neuro-vegetative form, edematous form, convulsive form. During a crisis, a woman’s well-being deteriorates sharply: a sudden onset, agitation, fear, sweating, pallor of the skin (neuro-vegetative form) appear. Another form of crisis is edematous: the development is gradual, the woman has drowsiness, lethargy, there is a decrease in activity and poor orientation in space, swelling and puffiness of the face and the whole body are growing. With a sudden loss of consciousness, the appearance of seizures, a convulsive form develops, threatening sudden death as a result of cerebral edema. First aid for hypertensive crisis in pregnant women should be carried out only by ambulance doctors. When a pregnant woman complains about feeling unwell, an ambulance is immediately called. Arterial hypertension has its own classification, which is based on levels of pressure increase: the optimal pressure is 120 to 80 mm Hg. Art., in pregnant women, preferably 100-110 and 60-70 mm RT. Art.

I degree - 140-159 and 90-99 mm RT. Art.
II degree - 160-179 and 100-109 mm RT. Art.
III degree - 160-179 and more than 110 mm Hg. Art.

Causes of Hypertension during Pregnancy

Arterial hypertension during pregnancy often occurs if:

• the woman had hypertension before pregnancy;
• a woman suffers from kidney diseases (pyelonephritis, glomerulonephritis, kidney infarction, diabetic nephropathy, etc.) and (or) diseases of the endocrine system (hypothyroidism, hypercorticism, etc.), which can contribute to the development of hypertension during pregnancy;
• there are mental and (or) neurogenic disorders, which can also serve as triggers to increase blood pressure.

Symptoms and signs of hypertension during pregnancy

The main symptom of hypertension is an increase in blood pressure. An increase in blood pressure may be asymptomatic, but often a woman may experience the following unpleasant symptoms.

• headache;
• palpitations
• sleep disturbances;
• fatigue;
• visual impairment;
• noise in ears;
• nosebleeds, etc.

The main difficulty in diagnosing arterial hypertension in pregnant women is as follows: young women do not measure their pressure, and if there is hypertension, then they do not feel it. In connection with the features of pregnancy at its beginning, blood pressure decreases in all expectant mothers. In addition, the presence of gestosis, which is also manifested by an increase in pressure, masks hypertension. The diagnosis of arterial hypertension can only be made under certain criteria: the presence of the disease in the next of kin and an increase in pressure in the woman at least once in her life, compared with blood pressure levels in previous pregnancies, if they were, complaints of the pregnant woman for frequent headaches, nasal bleeding or pain in the heart, etc. Naturally, the main criterion for hypertension is the fact of an increase in blood pressure. At the first stage of hypertension, a pregnant woman does not experience any inconvenience. May complain of recurring headaches (often after a stressful situation), tinnitus or nosebleeds. At the same time, there are no changes in other organs, the kidneys, the brain and the fundus are the first to suffer from hypertension. In the second stage of arterial hypertension, there are constant headaches, limitation of physical activity and exercise due to shortness of breath. Hypertensive crises may appear here. Fundus changes are observed upon examination by an optometrist, the wall of the left ventricle of the heart thickens (hypertrophy). With hypertension of the third degree, pregnancy and the ability to conceive a child are unlikely due to adverse conditions. When diagnosing a pregnant woman with hypertension, it is necessary to begin immediate treatment to create conditions for normal growth and maturation of the fetus. To begin with, you need to create a calm atmosphere for the pregnant woman, protect from stress and anxiety, provide her with adequate sleep and rest, a balanced diet. With excessive excitability, sessions of auto-training and hypnosis, acupuncture can well help. The expectant mother should be constantly monitored by a general practitioner, who must prescribe certain drugs to reduce blood pressure. Women should remember: many drugs that they took before pregnancy to reduce blood pressure are not suitable during pregnancy because they negatively affect the baby. Arterial hypertension has an adverse effect on the course of pregnancy, a woman and a child. The child suffers the most. Against the background of hypertension, gestosis develops, accompanied by insufficiency of all organs. The placenta that nourishes and protects the fetus, utero-placental blood flow suffers. These manifestations lead to a lack of oxygen, nutrients, and the fetus dies. Labor activity in arterial hypertension is also perverted: childbirth either lasts slowly or very quickly, which threatens the child with trauma or hypoxia. Pregnant women with hypertension should be hospitalized for less than 12 weeks. The clinic clarifies the severity of the disease, its complications, the possibility of bearing a child. At the first stage of hypertension, the prognosis for expectant mothers is favorable: with all the recommendations and the supervision of a doctor, pregnancy is possible and the baby will be born healthy. In the second stage, the possibility of maintaining pregnancy is decided on an individual basis and depends on the severity of complications from other organs. The third stage is a contraindication for pregnancy. The second time the expectant mother is hospitalized in the period of 28-32 weeks to prevent excessive load on the heart and blood vessels. The third hospitalization - two to three weeks before the birth to prepare for childbirth, determine the tactics of delivery and the necessary methods of pain relief. Often women give birth to a baby themselves, a caesarean section is needed only for certain indications. The basis of pregnancy in a woman with arterial hypertension is the correct regimen of the day, lack of stress, proper nutrition, regular medication and follow-up by specialists.

Arterial hypertension is dangerous for its complications during pregnancy, as it can cause:

• placental insufficiency;
• massive bleeding;
• premature birth
• fetal death of the fetus;
• premature detachment of the placenta, etc.

During pregnancy, the internal organs and vital systems of the baby are laid. A lot depends on the health of the woman. What if the expectant mother has hypertension?

Of course, the situation should not be dramatized, although it would be unreasonable to completely ignore the risk.

Arterial hypertension in our time is very common in people of all ages. Therefore, it is difficult to surprise anyone with increased pressure. Most people know from their own experience what it is, so they don’t think that a pregnant woman with hypertension needs special care. This is an erroneous opinion. After all, relatives and friends should first of all be interested in her well-being and a successful pregnancy.

The vast majority of women with hypertension tolerate pregnancy well and give birth to healthy babies. But problems can certainly arise and often arise. The modern level of development of medicine allows them to cope. However, there is severe stage III hypertension. At this stage of the disease, pregnancy is deadly for a woman's life. Fortunately, stage III is extremely rare, and stages I and II of hypertension are not a contraindication to pregnancy.

Usually a woman suffering from hypertension knows about her before pregnancy. Most likely, she already has a certain idea about the disease, regularly or periodically takes some medications and is observed by a cardiologist.

At the very beginning of pregnancy, a woman who is diagnosed with "hypertension" should always consult a cardiologist, and then, throughout the entire period of pregnancy, regularly undergo examinations, including blood pressure measurements, urinalysis (to determine the protein), as well as an electrocardiogram (ECG). It is very important that the specialist regularly monitors the development of the fetus. Not all medications can be taken during pregnancy. That is why an independent choice of medications is unacceptable. Only a doctor prescribes drugs that do not have a teratogenic effect, that is, they will not harm an unborn child. When choosing drugs, individual characteristics of a woman’s body, as well as the presence of concomitant diseases, are very important.

In addition to prescribing medication, the doctor must give the necessary recommendations that relate to the lifestyle of a woman suffering from hypertension. During pregnancy, such patients will have to reconsider their lifestyle, pay special attention to their diet, and abandon some foods. Moderate physical activity is very important.

It often happens that in the early stages of pregnancy, blood pressure decreases even in those women who have had high blood pressure before pregnancy. In some cases, on the contrary, there is a sharp increase in blood pressure. Sometimes it is during pregnancy that a woman learns about a new diagnosis for herself - arterial hypertension.

The consequence of hypertension in pregnant women can be late toxicosis, which occurs in severe form.

In this case, the woman has severe headaches, sometimes even impaired vision.

Very dangerous complications of hypertension during pregnancy can be brain hemorrhage and retinal detachment. That is why, throughout the entire period of pregnancy, a woman should regularly undergo medical examinations, comply with all the doctor’s prescriptions, be sure to measure blood pressure, do an ECG, and take a urine test to determine the protein content. Consultations with an oculist are no less necessary.

During pregnancy, patients with arterial hypertension should visit a antenatal clinic once every 14 days and do a urinalysis. After 30 weeks of pregnancy, a urinalysis should be taken every week.

If the level of diastolic pressure rises above 90 mm Hg. Art. in a sitting position, a pregnant woman requires therapy with antihypertensive drugs.

If, despite following all the recommendations, a hypertensive crisis occurs during pregnancy, signs of late toxicosis appear, or a woman feels a noticeable worsening of her condition, she’d better not refuse hospitalization.

At least 2 weeks before the expected birth, even with a favorable course of pregnancy, experts still recommend that the woman go to the hospital. This is associated with the risk of unexpected complications in the expectant mother or child. When complications occur, a woman is prescribed special therapy aimed at lowering blood pressure. The condition of the fetus is carefully monitored by doctors. Sometimes a woman has a cesarean section. In some cases, cause premature birth.

High blood pressure during pregnancy can cause death and prematurity of the fetus, premature detachment of the placenta, and some other problems. Therefore, timely specialist assistance is needed.

Diagnosis and treatment of arterial hypertension in pregnant women

During each examination, the doctor must measure the blood pressure of the pregnant woman and write his indicators on the map. This is necessary to monitor the dynamics of blood pressure at different stages of pregnancy.

Often you can meet a situation where blood pressure rises as a reaction to the “white coat”.

For example, in a healthy woman, during the appointment with the doctor, the pressure may “jump” noticeably, while this does not happen at home and the future mother feels well. If you know this peculiarity, if you are afraid of doctors and react to them that way, notify your doctor in advance about the possibility of receiving incorrect blood pressure figures at the appointment.

Most often in this case, the doctor prescribes home monitoring of blood pressure. It is good if you begin to measure and record blood pressure data three times a day for a long time, so that the doctor becomes convinced of your "sensitivity to medical staff." In this case, you will have to independently control blood pressure at home throughout pregnancy.

The treatment of the future mother is aimed at stabilizing the pressure and eliminating complications for the baby (if any). Quite often, a pregnant woman is entitled to hospitalization for examination and normalization of her condition.

With hypertension, the expectant mother is shown:

• consultation of a psychologist in order to eliminate psychoemotional negative manifestations (stress, fears, anxiety, etc.);
• dieting;
• daily quiet walks in the fresh air, preferably in nature (park or forest zone);
• day rest;
• weight gain (avoid overweight);
• daily measurement of blood pressure at home;
• physiotherapy.

Antihypertensive drugs prescribed and controlled by a doctor should be taken continuously, since skipping medications can cause sudden surges in pressure, which is dangerous for blood vessels.

In the second semester of pregnancy, but sometimes even in the first semester, blood pressure often decreases. In the third semester, blood pressure becomes the same as usual. In some cases, exceeds the normal rate. If during the examination of a pregnant woman the doctor notes high blood pressure, he definitely recommends a thorough examination in order to clarify the nature of hypertension, to find out the presence of concomitant diseases, and also to determine the need for antihypertensive treatment.
Treatment is carried out depending on the degree of risk. If the patient has normal ECG and EchoCG results, there is no protein in the urine, and blood pressure levels are 140-149 / 90-199 mm Hg. Art., then it belongs to the low-risk group. If the patient has severe arterial hypertension, poor obstetric history, there are concomitant diseases (collagenoses, diabetes mellitus, kidney diseases) and changes in internal organs are especially dangerous, then she is at high risk.

Regardless of the degree of risk for each particular patient, there are general recommendations. They relate to the correct regimen, lack of overload, mandatory 8-9 hour sleep. During pregnancy, a woman needs to limit the amount of fats and carbohydrates in her diet. The diet should have as little salt as possible, not more than 5 g. This rule is common for people suffering from hypertension, but during pregnancy it is especially important.

If the patient belongs to the low-risk group, often she is not prescribed special drugs. There is enough non-drug therapy, which consists in eliminating excessive loads, following a diet, exercise, taking care of one’s emotional state. Every day she must be sure to walk as long as possible. It is advisable to take walks not in the gassed city streets, but in the forest or park. Good results are given by autogenous training, relaxation. In this difficult, but very important for the baby’s health, period, the expectant mother must learn not to take all anxieties and troubles to heart. It is very important that relatives provide the woman with psychological support, do not cause trouble.

However, despite various non-medications, blood pressure may increase. If blood pressure rises to 160/100 mm RT. Art. and above, the patient must be prescribed antihypertensive drugs. Medications make it possible to control blood pressure. But, I must say, even taking medications is not always a reliable protection against the onset of preeclampsia. That is why even if a pregnant woman belongs to the low-risk group, she should be examined in a timely manner.

In some cases, in patients with grade I arterial hypertension, the pressure decreases to normal levels. Then taking medication is optional. But controlling blood pressure is still necessary. If a pregnant woman is at high risk, usually she is recommended to immediately begin antihypertensive therapy. Timely treatment will make it possible to avoid a number of complications. If the level of blood pressure is 140/90 mm RT. Art., then the utero-placental circulation is disturbed, which entails various pathologies of the development of the fetus. The child does not have enough oxygen, since it is the blood that carries it. Due to high pressure, premature placental abruption may begin. There is also a risk of slowing the development of the fetus.

The treatment of arterial hypertension in pregnant women is complicated by the fact that not all drugs are harmless to the child. But modern medicine is at a very high level.

Despite the clear need for treatment, some pregnant women themselves try not to take medicine, as they are worried because of the harmful effects on the fetus. In severe arterial hypertension this is unacceptable. Lack of treatment will do much more harm.

There are some general rules for pregnant women regarding medication.

1. Most experts believe that during pregnancy, angiotensin receptor antagonists should not be used (for example, valsartan, ibesartan, etc.), because they have teratogenic effects.
2. In the first trimester of pregnancy, it is better not to take angiotensin-converting enzyme inhibitors with teratogenic effects (for example, quinapril, enalopril).
3. After the eighth week of pregnancy, some drugs may have an embryotoxic effect (in particular, a number of antibiotics, antidiabetic, anti-inflammatory drugs). Therefore, it is considered undesirable to use a drug that worsens the hemodynamics of the mother, because it also worsens the blood supply to the fetus. A drug that reduces the coagulability of the blood in the mother, therefore, reduces the coagulation of the blood of the fetus.

A number of drugs have no harmful effect on either the unborn mother or the unborn baby. The first-line drug for the treatment of arterial hypertension during pregnancy is methyldopa (dopegitis, aldomet). Years of research and monitoring of children born allowed scientists to argue that methyldopa is absolutely safe. Usually it is prescribed in 3-4 doses of 0.75-4 g per day. Taking the drug can lead to the fact that some have fluid retention in the body. Therefore, if long-term use of the drug is required, it is combined in small doses with diuretics. If the patient has impaired renal or hepatic function, the medicine should be taken with caution, the patient should be constantly monitored by the attending physician.

Calcium channel blockers are also used to treat hypertension during pregnancy. The drug of the dihydropyridine group nifedipine is very often used. Doses are set by the doctor. The drug is able to quickly stop the impending hypertensive crisis.

The undoubted advantages of beta-blockers include a gradual effect on blood pressure. Also, drugs stabilize platelet function. It is very important that beta-blockers do not adversely affect blood plasma volume. As an example of beta-blockers, pindolol, atenolol, metoprolol, oxprenolol and some others can be mentioned.

It is important to remember that the choice of the necessary drugs remains with the doctor, because it is the specialist who must take into account the individual state of health of the patient and other factors affecting the course of pregnancy.

The most serious complications of pregnancy with arterial hypertension are preeclampsia and eclampsia. Such complications are very dangerous for the life of a woman and a child.

Preeclampsia in Pregnancy

Preeclampsia is a condition that occurs late in pregnancy. In this condition, a woman has high blood pressure. Protein is found in urine. The legs and arms of the woman swell. A woman feels a headache, there is vomiting, visual disturbances. There are also signs of nephropathy.

There is a risk of preeclampsia moving to the last and most difficult phase. In this case, there is a threat of coma or death of both the mother and the child during or after childbirth, if the necessary treatment is not carried out. Severe forms of preeclampsia and eclampsia lead to impaired function of vital organs, that is, the brain, lungs, kidneys, liver, heart. The consequences of preeclampsia and eclampsia can affect the rest of your life if you do not carry out appropriate treatment on time. This applies to both mother and child. According to the World Health Organization, preeclampsia is the cause of 15–40% of maternal and 38% of perinatal deaths worldwide.

Most often, preeclampsia occurs during the first pregnancy. At risk are the youngest girls and women who are over 35 years old.

Risk factors are:

• arterial hypertension, which was diagnosed before pregnancy;
• obesity;
• multiple pregnancy;
• diabetes;
• rheumatoid arthritis;
• systemic lupus erythematosus;
• cases of preeclampsia that have already been observed in the past in the patient herself;
• cases of preeclampsia in the sister or mother of the patient.

Preeclampsia leads to the fact that blood flow through the placenta is disturbed, that is, the child may be born underdeveloped. In some cases, preeclampsia also causes premature birth. A newborn can have such pathologies as visual and hearing impairment, cerebral palsy, epilepsy.

Some doctors tend to underestimate the risk of preeclampsia. A simplified view of it is based on the fact that the main problem is high blood pressure, swelling and proteinuria (excretion of protein in the urine). But such symptoms are only superficial manifestations of multiple organ and polysystemic insufficiency syndrome. These signs make it possible to diagnose preeclampsia itself, but they are not the cause of the disease.

If we talk about swelling of the hands, feet and face, then such symptoms often accompany normal pregnancy. Also, a clear relationship has not been established between the fact that one or another degree of arterial hypertension is observed and edema is present at the same time.

Often, edema can occur in those women who have normal blood pressure. The presence of protein in the urine is a later sign of preeclampsia. Approximately 5-10% of pregnant women with preeclampsia first have convulsions, and then proteinuria appears, that is, protein in the urine. Based on this, it was concluded that if the patient developed preeclampsia, then there are morphological damage to the kidneys, for example pyelonephritis, glomerulonephritis, nephrosclerosis. Before protein appears in the urine, other symptoms arise: in the blood plasma, the concentration of urea and creatinine increases.

Preeclampsia appears in early pregnancy, up to 20 weeks. In this case, the cause may be a disease of the fetal egg in a pregnant woman, which is characterized by the growth of the surface layer of the villous membrane (chorion) and swelling of the substance of the villi (cystic skid).

There are several types of preeclampsia.

• Type I - there is a low pressure in the pulmonary artery system, low cardiac output. Total peripheral vascular resistance is high.
• Type II - there is a high pressure in the pulmonary artery system, high cardiac output. Total vascular resistance is high.
• Type III - normal pressure in the pulmonary artery system, high cardiac output. Total peripheral resistance is low.
• IV type - there is a high pressure in the pulmonary artery system, there is a high cardiac output. Plasma volume is normal or increased.

Specialists often use the term "mild preeclampsia." In this case, the outcome is favorable, because a pregnant woman only has a one-time increase in blood pressure. There are no other symptoms characteristic of preeclampsia. With a mild degree of preeclampsia, special measures, as a rule, are not taken. A woman should only limit activity, take care of her health.

If there is a risk of premature birth, then with preeclampsia, special treatment is carried out, which the doctor must prescribe. Sometimes it is better for a woman to be in a hospital to constantly be monitored. At a long gestation period, labor can be forced.

If a pregnant woman manifests gestosis (late toxicosis of pregnant women, nephropathy is a complication, accompanied by a violation of the function of the placenta and the condition of the fetus), then this means that there are signs of a critical state, expressed to varying degrees.

These signs include:

• hypovolemia - a decrease in the volume of blood circulating in the body (it may be associated with a restriction in fluid intake or its loss);
• hypoxemia - reduction of gas exchange in goblin, hemoglobin in the blood;
• impaired blood circulation in the kidneys, brain, liver.

Similar signs are associated with the fact that the properties of blood are deteriorating, microthrombosis is present. Probable insufficiency of the kidneys, lungs, myocardium. The severity of the patient's condition exacerbates vascular spasm, a violation of all types of metabolism, and especially water-salt.

Severe forms of preeclampsia are very dangerous for a woman during pregnancy. Lack of special treatment can lead to her death. In some cases, other treatments are prescribed, for example, magnesium sulfate (magnesia) is used. It makes it possible to prevent the occurrence of seizures and reduce blood pressure. It is also possible to use various drugs that lower blood pressure. Controlling fluid intake is important. An extreme measure is the immediate call of childbirth, regardless of gestational age.

If a pregnant woman with manifestations of gestosis is observed in a hospital, eclampsia in her develops very rarely. This is due to the fact that the patient is under the constant supervision of specialists, a variety of intensive care methods are used to improve her condition. Due to this, the development of the convulsive stage is prevented.

Eclampsia in pregnant women

The term "eclampsia" comes from the Greek. the words "eklampsis", which means "flash". The main symptom of eclampsia is muscle cramps and loss of consciousness.

For specialists, the ability to predict eclampsia, despite the suddenness of its onset, is very important, but at the same time a difficult problem. There are certain criteria that allow one or another patient to be considered at risk.

With eclampsia, great importance is given to the study of hereditary factors. This is very important because eclampsia most often develops during the first pregnancy. If the patient’s mother had eclampsia, the daughter has a 49% chance of her developing. If the patient's sister had eclampsia, then the patient's risk of developing eclampsia rises to 58%. With multiple pregnancy, the likelihood of developing eclampsia increases. There is also a high risk of a similar condition in pregnant women under the age of 25 years and in women after 35 years.

Eclampsia leads to spasm of the respiratory muscles, while breathing is disturbed, the tongue is sagging, hypoxia (oxygen starvation) and hypercapnia occur.

As a result of hypercapnia, the secretion of glands is enhanced, increased separation of saliva, bronchial secretion, gastric and intestinal juice begins. There is no cough reflex with loss of consciousness. An accumulation of bronchial secretions and saliva occurs, and the airways narrow. Their lumen can completely close, which leads to a violation of gas exchange.
With hypercapnia, the excitability of the respiratory center decreases, and a violation of gas exchange is aggravated. The vasomotor center and sinoaortic receptors are irritated, resulting in increased blood pressure.

Vascular spasm progresses, an excess of blood enters the circulatory channel from spasmodic muscles. As a result, the load on the heart increases significantly. This load is exacerbated by hypoxia and hypercapnia. Therefore, with eclampsia, a violation of the heart rhythm is observed. (These changes are clearly diagnosed on the ECG.)

An increased load on the heart leads to tachycardia and expansion of the heart cavity. Circulatory failure occurs, it only exacerbates hypoxia and hypercapnia.
Violation of cardiac function with eclampsia is often accompanied by pulmonary edema. As a result, hypoxia and hypercapnia are exacerbated.

There are severe attacks of eclampsia. With them, very strong hypercapnia develops, which affects the peripheral vessels and the vasomotor center. In this case, in addition to central circulatory failure, peripheral arises.

More than 70% of patients with eclampsia have liver failure, and renal dysfunction also manifests. Various changes in kidney function lead to the fact that the filtration of the body is disturbed. Due to impaired renal function, compensation occurs only as a result of increased ventilation if there is free passage of the respiratory center and there is no brain damage. Otherwise, a mixed form of acidosis may develop and exacerbated hypoxia, hypercapnia. At the same time, intracranial pressure increases and seizures become more frequent.

It happens that it is not possible to stop what is happening. Then there is a risk of hemorrhage in the brain, paralysis of the respiratory center, cardiac arrest. Pulmonary edema, or respiratory and metabolic acidosis occurs. A fatal outcome may not occur immediately, but after a few days. Thus, the main cause of death in eclampsia is cerebral hemorrhage (70%), followed by respiratory failure with pulmonary edema, acute renal failure, postpartum hemorrhage, placental abruption, rupture of the liver, septic shock. If the patient suffered eclampsia and survived, in the future she may experience a number of complications. In particular, disorders of the central nervous system, such as paralysis, autonomic disorders, headache, memory impairment, psychosis. Pathologies of other vital organs and systems of the body may also appear.
The development of eclampsia is considered a multiple organ failure syndrome, because in this condition there is a failure of a number of systems and organs: respiratory, cardiac, renal, and hepatic. There are also pronounced violations of the distribution of blood flow, rheological properties of blood, various types of metabolism.

Complications of severe eclampsia can be:

• disseminated intravascular coagulation with uncontrolled bleeding;
• capillary leak syndrome;
• intrahepatic bleeding;
• heart attacks;
• acute renal failure.

Arterial hypertension associated with the presence of late taxicosis can cause premature detachment of the placenta, miscarriage, hypoxia, developmental delay of the child and even his death.

Against the background of multiple organ failure, convulsive seizures develop. These seizures are not associated with impaired cerebral circulation. Convulsive seizures are single. But a series of seizures that follow each other can happen. This phenomenon is called "eclampsic status." After a seizure, a woman sometimes loses consciousness, that is, an eclampic coma develops. (Sudden loss of consciousness can be without an attack of seizures.)

Before convulsions appear, the head begins to hurt sharply, insomnia occurs, and pressure rises. The woman feels very anxious. The seizure lasts from 1 to 2 minutes.

A seizure consists of several stages.

1. Preconvulsive period. It lasts approximately 30 s. The muscles of the face twitch, the corners of the mouth drop, the eyelids close.
2. The period of tonic convulsions. It also lasts about 30 seconds. The muscles of the whole body contract, the body tenses. The face turns blue, breathing stops.
3. The period of clonic seizures. Lasts 30 s. Twitching of the facial muscles, muscles of the whole body and limbs is observed. Cramps become weaker. The breathing becomes hoarse, foam appears from the mouth with blood.
4. Gradually, consciousness returns. The woman does not remember anything that happened to her just a few minutes ago.

The excitability of the central nervous system with eclampsia increases markedly. A new attack can occur from a variety of stimuli, such as light and noise.

Magnesium sulfate is often used in the treatment of eclampsia. This drug is also used for preeclampsia. Magnesium sulfate is administered slowly intravenously or intramuscularly. At the same time, tendon reflexes and respiratory rate are controlled. But if the patient takes calcium channel blockers, magnesium sulfate is not prescribed, because there is a danger of a sharp drop in blood pressure.

With eclampsia, chlorpromazine or diazoxide is sometimes administered intravenously. It is also possible intravenous, then drip administration of diazepam (seduxen).

Long-term rehabilitation therapy is very important. It is necessary for women who have suffered preeclampsia and eclampsia. Restorative therapy can lower blood pressure, improve microcirculation and hemodynamics of the brain.

During rehabilitation therapy, patients are advised to take Mildronate 1 tablet (125 mg) three times a day after delivery. Mildronate affects the redistribution of blood flow in the brain, helps eliminate functional disorders of the nervous system, improves blood circulation to the brain.

If the patient has suffered eclampsia or preeclampsia, then even after discharge she should be under the supervision of a cardiologist, urologist, therapist, and neuropathologist. Timely treatment and further monitoring can avoid the serious consequences that can lead to disability.

Arterial hypertension in pregnant women

The term "pregnant arterial hypertension" is used to denote various painful conditions.

First of all, the following diseases are meant:

• Hypertension of pregnant women. Hypertension of pregnant women is said if the blood pressure of a pregnant woman is more than 140/90 mm PC and rises for the first time after the 20th week.
• Severe hypertension in pregnant women. If your blood pressure exceeds 160/110 mm PC.
• Preeclampsia The diagnosis is made when, along with high blood pressure, protein in the urine is observed in an amount of more than 300 mg per day. Clinical manifestations such as headaches, double vision and ripples in the eyes, pain in the upper part can also indicate preeclampsia.
• Eclampsia. The most severe form of preeclampsia, accompanied by convulsive seizures.

Blood pressure measurement. Important conditions are wide cuff and peace, otherwise the indicators may be unreliable.