Quite often, women experience high blood pressure during pregnancy - hypertension. This problem should not be ignored, as deviations can harm the mother and her baby.

During pregnancy Control nifedipine
cranberry berry cranberry
women in the position of 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.

During pregnancy, even in the early stages, it is high blood pressure that is very dangerous. Due to a jump in blood pressure (BP), preeclampsia may develop. This is a very dangerous, unpredictable disease of expectant mothers. It causes disruption of vital organs. First of all, it concerns the circulatory and cardiovascular systems.

You need to keep abreast of changes

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

However, even if during pregnancy you have a high pulse and high blood pressure, but this is not a sign of preeclampsia, you cannot ignore the disease. Specialists of the antenatal clinic remove a lot of attention to the control of blood pressure in registered women. Due to changes in the vessels of the fetus and placenta, blood circulation between mother and child is reduced. 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 during the bearing of a child, blood pressure regularly jumps, and its indicators are at an overestimated level (150 and above), premature detachment of the placenta may begin. This phenomenon greatly complicates the normal development of the child. High blood pressure in the mother can cause premature birth or a miscarriage.

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

Signs of the development 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. At home, it is more convenient to use an electronic blood pressure monitor, but a regular 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 the 39th week of pregnancy, it is very important to determine high blood pressure in 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;
• deterioration in well-being.

Doctor's blood pressure control

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 it is necessary to carry out this diagnosis 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 gland, adrenal glands, thyroid gland.

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

The development of high blood pressure in a singleton 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 also experience it.

It is advisable to get rid of long before conception addiction smoke. It does not add health, and the cardiovascular system is very affected. The same goes for low physical activity. A trained heart copes much better with stress. 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 disease.

Treatment and prevention of the disease

During pregnancy, you should definitely check with your doctor how you can 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 for severely elevated blood pressure in order to reduce the possible risk of complications. The doctor will prescribe the required dosage, tell you about the duration of the reception. Recommendations are individual for each patient, as they are provided on the basis of diagnostics and tests.

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

Possibly nifedipine

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

1. Even with a slight increase in blood pressure, you need to normalize your diet. It is advisable to draw up a special menu and include foods rich in trace elements and vitamins.
2. Thromboforming foods, smoked, salty, fatty, sweet foods 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. It is best to give preference to weak tea with lemon slices, hibiscus tea. These drinks improve your condition and are an excellent preventive measure.
3. Do not interfere with the reception of motherwort, valerian.
4. Be sure to go in for sports, if the doctor allows physical exercises, walk in the fresh air, go to the pool.

You should not independently decide what to do if during pregnancy it was not possible to reduce high blood pressure with the help of outpatient treatment. Contact a specialist. He can send for examination to a hospital, where the 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 blood pressure during pregnancy. Folk recipes although they are not a panacea, but in combination with drug therapy they give a good result. In addition, be sure to consider the individual tolerance of the components and consult your doctor before using traditional medicine.

During early and late pregnancy a good remedy from high blood pressure is cranberry. Required:

• half a glass of berries;
• 3 tsp decoys;
• 4 tbsp. spoons 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 them.
2. Pour boiling water over the remaining cake and put on a slow fire for 5 minutes.
3. Strain the broth, pour semolina into it and cook for 15 minutes, while stirring constantly.
4. Put granulated sugar into the mass, wait until the product boils, remove from heat.
5. Beat the resulting porridge in a blender, pouring in cold cranberry juice.

Cranberries are good

There is another harmless remedy that can be used for high blood pressure even at 38 weeks pregnant. All you need is:

• corn grits;
• a glass of warm water.

The remedy should be drunk in 2 tbsp. spoons. Consume before meals.

1. Grind the grains in a coffee grinder.
2. Pour in a glass of water.
3. Infuse for a day, while shaking the contents.

Pumpkin decoction is also a good medicine. Take:

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

The remedy can be used several times a day. It's great for prevention.

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

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At each appointment in the antenatal clinic, a pregnant woman is examined by a doctor and a nurse. So, the nurse fixes 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, about the standard norm of pressure 120/80 mm Hg. everyone heard. “They fly into space with this.” But modern doctors prefer not to talk about standards, since they consider the pressure rate to be an individual trait of each person, depending on many factors, such as his height and weight, lifestyle, and so on. They determine normal pressure not by some kind of average indicator, but by a whole range: from 90/60 mm Hg. Art. up to 140/90 mm Hg Art.

Changes in the functioning of a woman's body during pregnancy are grandiose. All her organs and organ systems begin to work differently. An additional load 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 increases. 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 a slight increase in blood pressure in expectant mothers to be normal.

IMPORTANT: The pressure in pregnant women, which is at the upper limit of normal and is 140/90 ml Hg. Art. Doesn't cause concern for doctors

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

IMPORTANT: BP is a variable indicator that can change within a few minutes. A jump in pressure in a pregnant woman can be caused by stress (for example, fear of the gynecologist’s appointment itself or excitement for the child), climbing stairs (you must admit that it’s hard for a pregnant woman in the third trimester to climb to the 5th floor of the clinic), drunk on the eve of the appointment with a cup of coffee. To ensure the reliability of the results of measuring blood pressure, 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 a future mother has high blood pressure. Some of them are not at all related to bearing a child, hypertension could have been present in a woman before, others are caused by the “interesting situation” itself. For example:

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

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

As a rule, it is possible to suspect high blood pressure in a future mother even before measuring this indicator, because a woman literally complains of feeling unwell from the very beginning. 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

Why is high blood pressure dangerous 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 from the consequences of an increase in pressure.
Complications of high blood pressure during pregnancy may include:

IMPORTANT: In order to avoid trouble, high blood pressure during pregnancy cannot be ignored.

High blood pressure during first trimester pregnancy

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, etc. 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 bearing and imminent birth of a child. The situation needs to be kept under control, but perhaps it will resolve itself as soon as the woman's toxicosis passes and she gets used to her new role.

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

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

An increase in blood pressure starting from the second trimester of pregnancy is an alarming harbinger of preeclampsia.

IMPORTANT: The reasons for the development of preeclampsia have not yet been established precisely. 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, diseases of the kidneys, biliary tract, endocrine system

With gestosis, a spasm of blood vessels occurs, which disrupts blood circulation and its coagulability. As a result, tissues and organs receive insufficient amounts of oxygen and nutrients. In them, changes of a dystrophic nature begin to occur, sometimes irreversible, up to death.

The kidneys, heart and brain are the first to suffer from gestosis. 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 couple, preeclampsia is manifested by edema, then by 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 preeclampsia. This is overweight. So that the pressure does not increase, a woman needs to control its increase.

Treatment of high blood pressure during pregnancy. High blood pressure pills for pregnant women

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

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

Usually, without medicines bypass women whose pressure is slightly increased, there are no other signs of dangerous conditions. To normalize it, it is often enough to normalize the daily routine of the expectant mother and her diet.

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

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

Tablets that are safe for a child are:

• Egilok
• Nifedipine
• Labetalol
• Pipazol
• Dopgit
• others

Foods to lower blood pressure during pregnancy

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 sour-milk 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 expectant mother does not increase, she needs:

1. Observe the mode of work and rest Night 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 work at night are contraindicated for her
2. Refuse invigorating drinks - coffee and strong tea
3. Limit your salt intake
4. avoid stress
5. Control your weight
6. Go for walks and exercise

During the period of expectation of a child, the female body becomes very vulnerable, long-standing diseases become 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 examinations, obstetricians-gynecologists control the pressure of the expectant mother every time.

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

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

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

It is important that a woman, when registering for pregnancy in a medical institution, knows the “working” values ​​​​of her pressure.

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

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

Why is the pressure rising?

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

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

Since the period of bearing 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 earlier 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 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 preeclampsia. It occurs after the 20th week of pregnancy and, as a rule, heals itself after childbirth.

The insidiousness of hypertension is that its initial stages can easily be not recognized.

This is especially true for expectant mothers, for whom high blood pressure is habitual.

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 undergoes control using a tonometer.

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

• mild, dizziness;
• rapid pulse;
• increased 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.

There may be pain in the left sternum, insomnia, excessive nervousness, which are so easily mistaken for the features of a "pregnant" organism.

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

Dangerous consequences 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 is carried out by specialists, is caused by the likelihood of consequences that are dangerous for the mother and child.

1. High blood pressure in pregnant women is the “response” to the constriction of blood vessels, including those in the uterus and placenta. This leads to difficulty in blood circulation in the "womb-placenta-fetus" system, and, consequently, to. Prolonged hypoxia is the cause of a delay in the intrauterine development of the baby.
2. , which also develops due to vasospasm, can cause spontaneous abortion.
3. Due to the increased blood pressure in the channel between the uterus and the placenta, it can occur, which will lead to malnutrition of the fetus, and also, depending on the extent of the detachment, can cause.
4. Prolonged hypertension can cause functional failure of a woman's vital organs, which poses a danger to the health and life of the mother and her unborn baby.
5. Severe hypertension, as a manifestation of preeclampsia, can lead to the development of complications that are dangerous for the parent and her unborn child - preeclampsia and eclampsia.
6. A significant jump in pressure, especially in childbirth, can cause retinal detachment (and subsequent blindness) or even a stroke.

Is hospitalization necessary?

Since hypertension for a pregnant woman is an extremely dangerous phenomenon, it is unreasonable to refuse the proposed hospitalization. Moreover, it is very likely that favorable prognosis the length of time spent in the hospital will be short.

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

The hospital will determine the degree of hypertension, predict the risk possible complications for women's health and select methods of therapy.

With 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 preeclampsia or diagnose it in a timely manner.

If the degree of hypertension is mild, the pressure is stable and does not adversely affect the well-being of the expectant 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 blood pressure moves to the hospital until the very birth.

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

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

How to reduce blood pressure during pregnancy

Depending on the causes of arterial hypertension, the doctor chooses the tactics of further pregnancy management and therapies aimed at normalizing pressure.

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

Non-drug method

The non-drug method consists in limiting the physical and social load, namely:

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

In addition, it is important to follow some nutritional principles aimed at:

• adjustment of potassium-sodium metabolism (to prevent fluid retention in the body);
• prevention of further excessive weight gain (if it is overweight).
• To improve water metabolism in the body, it is necessary:
• limit or completely exclude 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 reduces vascular tone and magnesium, which also has a slight diuretic property.

To prevent excessive weight gain, you should:

• limit fat intake to 40 g per day, giving preference 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 ways to deal with high blood pressure, folk methods have also found their place:

• An equal amount of rose hips, hawthorn, red viburnum, linden flowers, calendula, blueberry and heather shoots and motherwort herbs are crushed, mixed. Separate 2 tbsp. l. , pour them with 2 cups of boiling water, then simmer for 15 minutes. in a water bath and leave 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 crushed valerian root, cudweed grass, heather shoots and viburnum flowers. Pour 2 cups boiling water over 2 tbsp. l. mixture and insist in a thermos for 2 hours. Sweeten the warm strained infusion 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 the doctor observing the pregnancy in order to exclude possible contraindications.

Medical method

With a slight increase in pressure, there will be enough herbal remedies that have a calming, mild sedative effect, based on motherwort, valerian, lemon balm, mint, etc.

With persistent hypertension, it becomes necessary to use 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 earliest period of pregnancy. Methyldopa does not adversely affect the placental circulation, does not pose a threat to the intrauterine development of the fetus, and also does not cause adverse effects for the newborn child in the future.

The effect of the substance occurs within 2-6 hours and manifests itself:

• 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 a blood plasma enzyme (renin), which can affect blood pressure and sodium metabolism;
• in the removal of vascular hypertension;
• in general sedation.

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

Cardioselective β-adrenergic blockers are often prescribed as a medicine for pressure in pregnant women. they have less side effects compared to non-selective ones.

In the fight against high blood pressure, the effect they have directly on cardiac activity is important:

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

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

Currently, bisoprolol is more preferable because of its ease of use (1 tablet per day), reliable round-the-clock action, the possibility of use in diabetics and a less pronounced “withdrawal syndrome” compared to other drugs.

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 force of muscle contraction depends on the calcium concentration in its cells. The activation of calcium channels occurs under the influence of adrenaline, norepinephrine. Blockade of channels that conduct calcium prevents spasm of the muscles of the heart and blood vessels.

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

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

The intake of 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 increases due to the increase in circulating blood volume with increasing gestational age.

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

If pressure indicators are already elevated in early pregnancy, or “jumps” in pressure have occurred earlier, she should adjust her lifestyle and diet to prevent hypertension.

Namely:

• do not limit the duration of sleep and rest;
• avoid excessive physical activity, preferring feasible loads at a calm pace;
• avoid stressful situations;
• control weight gain during pregnancy (no more than 15 kg.);
• adjust the diet and menu, making food intake fractional and refusing products that are undesirable for hypertension;
• regularly monitor the values ​​​​of your blood pressure (daily, at least twice a day) both on the right and on the left hands.

If this happened, at the next appointment with the doctor or during self-measurement, mommy found that the pressure exceeded the norm, then first of all, you should stop panicking, otherwise the indicators will rise even higher.

The most reasonable thing in such a situation is not to self-medicate, but to trust qualified specialists, and then the pregnancy and the birth of the baby will go well.

Regular measurement of blood pressure during pregnancy becomes a mandatory procedure for a woman. So, with each trip to the antenatal clinic, measurements will be a given - this is a necessary ritual designed to identify any deviations in pressure in time, 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 pressure during pregnancy. The pressure can increase both during the bearing of the child, and 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 for the fetus. The fact is that with high blood pressure, the walls of the vessels are narrowed, which interferes with the normal supply of oxygen and nutrients to the baby, and as a result, the growth of the fetus can be slowed down. High pressure during pregnancy is also dangerous because it can provoke premature detachment of the placenta, which is accompanied by strong, dangerous for both 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 a lot of trouble. The mechanism of occurrence of preeclampsia is still not completely clear, there are only assumptions. It is believed that preeclampsia can be caused by increased production by the body of a substance that constricts blood vessels and, conversely, reduced production of a substance that dilates 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 heightened attention from the medical side. Proceeding in a mild form, preeclampsia may not be particularly felt, only accompanied by high blood pressure, but not more than 140/90, sometimes - swelling of the hands and face. Other, more serious symptoms of preeclampsia can be visual disturbances, and acute or vomiting. The greatest danger of preeclampsia is that it can turn into a rare but serious disease - eclampsia. She is accompanied by convulsions and even a coma, and the threat of eclampsia for the life of the mother and child is very, very high.

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

If the set 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 the hospital before giving birth. Qualified medical staff will provide expectant mother proper care, measuring pressure several times a day, controlling the amount of protein in the urine and weight daily, which will make it possible to avoid unwanted complications.

Especially for- Tatyana Argamakova

In the structure of diseases of pregnant women, arterial hypertension is 15-20%. Among these 20%, primary hypertension makes up a third, hypertension with preeclampsia - about 70% and secondary hypertension due to other diseases - 25%. Arterial hypertension is a serious disease that imperceptibly undermines the strength of the body from the inside. The essence of the disease: vasoconstriction occurs under the influence of nerve impulses and certain hormones. At first, arterial hypertension does not manifest itself. The woman does not feel the increase in pressure and performs the same load. However, the internal organs suffer, because little blood flows through the narrowed vessels, there is not enough oxygen (hypoxia), the organs begin to grow connective tissue(its cells can grow in the absence of oxygen). Specialized cells of organs do not live without oxygen, and the organ loses its function. That's when women complain. They can be different: dizziness, headaches, flies before the eyes.

For severe forms hypertension there may be a sharp rise in blood pressure - a hypertensive crisis (a complication of hypertension). There is the following classification of hypertensive crises: neurovegetative form, edematous form, convulsive form. During a crisis, the woman's health deteriorates sharply: a sudden onset, arousal, fear, sweating, pallor of the skin appear (neurovegetative form). 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 whole body increase. With a sudden loss of consciousness, the appearance of convulsions, 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 doctors of the "Ambulance". When a pregnant woman complains of feeling unwell, immediately called " Ambulance". Arterial hypertension has its own classification, which is based on the levels of pressure increase: the optimal pressure is 120 to 80 mm Hg. Art., in pregnant women it is desirable 100-110 and 60-70 mm Hg. Art.

I degree - 140-159 and 90-99 mm Hg. Art.
II degree - 160-179 and 100-109 mm Hg. Art.
III degree - 160-179 and more 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, hypercortisolism, etc.), which can contribute to the development of hypertension during pregnancy;
• there are mental and (or) neurogenic disorders, which can also serve as triggers for increasing 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;
• heartbeat;
• sleep disorders;
• 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, they do not feel it. Due to the peculiarities of pregnancy at its beginning, blood pressure decreases in all expectant mothers. In addition, the presence of preeclampsia, which is also manifested by an increase in pressure, masks hypertension. It is possible to make a diagnosis of "arterial hypertension" only under certain criteria: the presence of a disease in the next of kin and an increase in pressure in a woman at least once in her life, in comparison with blood pressure levels during previous pregnancies, if any, complaints of a pregnant woman about frequent headaches, nasal bleeding or pain in the heart, etc. Naturally, the main criterion for hypertension is the fact of increased blood pressure. At the first stage of hypertension, a pregnant woman does not experience any inconvenience. May complain of recurrent 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 of the eye are the first to suffer in hypertension. In the second stage of arterial hypertension, there are constant headaches, limitation of physical activity and stress due to shortness of breath. Here hypertensive crises can appear. There are changes in the fundus when examined by an ophthalmologist, 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 hypertension in a pregnant woman, it is necessary to begin immediate treatment to create conditions normal growth and maturation of the fetus. First you need to create a calm environment for a pregnant woman, protect her from stress and worries, provide her with sufficient good sleep and rest, and a balanced diet. With excessive excitability, sessions of auto-training and hypnosis, acupuncture can help well. The expectant mother should be under the constant supervision of a general practitioner, who must prescribe certain drugs to reduce pressure. Women should remember: many drugs that they took before pregnancy to reduce pressure are not suitable during pregnancy, as they negatively affect the child. Arterial hypertension has an adverse effect on the course of pregnancy, woman and child. The child suffers the most. Against the background of hypertension, preeclampsia develops, accompanied by insufficiency of all organs. The placenta, which nourishes and protects the fetus, uteroplacental 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 injury or hypoxia. It is important for pregnant women with hypertension to be hospitalized for less than 12 weeks. The clinic specifies 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 supervision of a doctor, pregnancy is possible and the child 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 at 28-32 weeks to prevent excessive stress on the heart and blood vessels. The third hospitalization - two to three weeks before childbirth to prepare for childbirth, determine the tactics of childbirth and the necessary methods of anesthesia. Often women give birth to a child themselves, a caesarean section is needed only for certain indications. The basis for the course of pregnancy in a woman with arterial hypertension is the correct daily routine, lack of stress, proper nutrition, regular medication and observation by specialists.

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

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

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

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

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

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

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

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

In addition to the appointment of drug treatment, 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, Special attention on your diet, give up certain foods. Moderate physical activity is very important.

It often happens that in the early stages of pregnancy, the pressure decreases even in those women who 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.

At the same time, a woman has severe headaches, sometimes even vision is impaired.

Very dangerous complications of hypertension during pregnancy can be cerebral hemorrhage and retinal detachment. That is why, throughout the entire period of pregnancy, a woman should regularly undergo medical examinations, follow all the doctor's instructions, be sure to measure blood pressure, do an ECG, and take a urine test to determine the protein content. Consultations of the oculist are not less necessary.

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

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

If, despite following all the recommendations, a hypertensive crisis occurs during pregnancy, signs of late toxicosis appear, or a woman feels a noticeable deterioration in her condition, it is better for her not to 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 a special therapy aimed at lowering blood pressure. At the same time, doctors carefully monitor the condition of the fetus. Sometimes a woman is given C-section. In some cases, they cause premature birth.

High blood pressure during pregnancy can cause fetal death and prematurity, placental abruption, and several other problems. Therefore, timely assistance of a specialist is necessary.

Diagnostics and treatment of arterial hypertension in pregnant women

During each examination, the doctor necessarily measures the blood pressure of a pregnant woman and writes down its indicators in the card. This is necessary to monitor the dynamics of blood pressure on different terms pregnancy.

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

For example, in a healthy woman, during an appointment with a doctor, pressure can noticeably “jump”, while this does not happen at home and the expectant mother feels good. If you know this feature behind you, if you are afraid of doctors and react to them in this way, warn your doctor in advance about the possibility of receiving incorrect blood pressure numbers 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 is convinced of your "sensitivity to the medical staff." In this case, you will have to independently control blood pressure at home throughout the pregnancy.

Treatment of the expectant mother is aimed at stabilizing pressure and eliminating complications for the baby (if any have begun). Quite often, a pregnant woman is required to be hospitalized for examination and normalization of her condition.

With hypertension, the expectant mother is shown:

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

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

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

Regardless of the degree of risk for each individual patient, there are general recommendations. They relate to the correct mode, the absence of overload, the obligatory 8-9-hour sleep. During pregnancy, a woman in the diet should limit the amount of fats and carbohydrates. The diet should contain as little salt as possible, no more than 5 g. This rule is common for people suffering from arterial hypertension, but during pregnancy it is especially important.

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

However, despite various non-drug remedies, blood pressure may increase. If blood pressure rises to 160/100 mm Hg. Art. and above, the patient must be prescribed antihypertensive drugs. Medicines make it possible to control the level of blood pressure. But, it must be said, even the reception medications, is not always a reliable protection against the onset of preeclampsia. That is why, even if a pregnant woman belongs to a low-risk group, she should undergo an examination in a timely manner.

In some cases, in patients with I degree of arterial hypertension, the pressure decreases to normal level. Then there is no need to take medication. But you still need to control your blood pressure. If a pregnant woman is at high risk, she is usually advised to start antihypertensive therapy immediately. Timely treatment will make it possible to avoid a number of complications. If the blood pressure level is 140/90 mm Hg. Art., then the uteroplacental circulation is disturbed, which entails various pathologies of fetal development. The child does not have enough oxygen, since it is the blood that carries it. Due to high pressure, premature detachment of the placenta can begin. There is also a risk of slowing down the development of the fetus.

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 medication, as they are worried about the harmful effects on the fetus. With severe arterial hypertension, this is unacceptable. Lack of treatment will do much more harm.

There are some general rules for pregnant women regarding the intake of medicines.

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

A number of drugs do not have a harmful effect on either the expectant mother or the unborn child. The first-line drug for the treatment of arterial hypertension during pregnancy is methyldopa (dopegyt, aldomet). Many years of research and observation of children born have allowed scientists to assert 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 people experience 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 drug should be taken with caution, the patient should be constantly under the supervision of the attending physician.

Calcium channel blockers are also used to treat hypertension during pregnancy. Nifedipine, a dihydropyridine group drug, is 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 the function of platelets. It is very important that beta-blockers do not negative influence on the volume of blood plasma. Examples of beta-blockers include pindolol, atenolol, metoprolol, oxprenolol, and some others.

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

The most severe 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 during pregnancy

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

There is a risk of preeclampsia progressing to the last and most severe 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 dysfunction of vital organs, that is, the brain, lungs, kidneys, liver, and heart. The consequences of preeclampsia and eclampsia can affect the rest of your life if you do not carry out appropriate treatment in time. This applies to both mother and child. According to the World Health Organization, preeclampsia is responsible for 15-40% of maternal and 38% of perinatal deaths worldwide.

Preeclampsia is most common during the first pregnancy. In the risk group - the most young 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 the blood flow through the placenta is disturbed, that is, the child may be born underdeveloped. In some cases, preeclampsia also causes preterm labor. A newborn may have pathologies such as impaired vision and hearing, cerebral palsy, epilepsy.

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

If we talk about swelling of the hands, feet and face, then such symptoms are often accompanied normal pregnancy. Also, a clear correlation 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 whose blood pressure is normal. The presence of protein in the urine is a later sign of preeclampsia. Approximately 5-10% of pregnant women with preeclampsia first have seizures, and then proteinuria, that is, protein in the urine, appears. Based on this, it was concluded that if the patient developed preeclampsia, then there are morphological damage to the kidneys, such as pyelonephritis, glumerulonephritis, nephrosclerosis. Before protein appears in the urine, other symptoms occur: the concentration of urea and creatinine in the blood plasma increases.

Preeclampsia also manifests itself in early term pregnancy, up to 20 weeks. In this case, the cause may be disease. gestational sac in a pregnant woman, which is characterized by the growth of the surface layer of the villous membrane (chorion) and edema of the substance of the villi (cystic drift).

There are several types of preeclampsia.

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

Professionals often use the term mild preeclampsia". In this case, the outcome is favorable, because the pregnant woman has only a single increase in blood pressure. There are no other symptoms associated with preeclampsia. With a mild degree of preeclampsia, special measures are usually not taken. A woman should only limit activity, take care of her health.

If there is a risk of preterm birth, then with preeclampsia, special treatment is carried out, which must be prescribed by the attending physician. Sometimes it is better for a woman to be in a hospital in order to be constantly monitored. At a long gestational age, childbirth can be forced.

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

These signs include:

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

Similar signs are associated with the fact that the properties of the blood are deteriorating, microthrombosis is present. Probable insufficiency of the function of the kidneys, lungs, myocardium. The severity of the patient's condition exacerbates vascular spasm, 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 helps prevent seizures and lower blood pressure. It is also possible to use various drugs that lower blood pressure. Fluid control is important. An extreme measure is the immediate induction of childbirth, regardless of the gestational age.

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

Eclampsia in pregnancy

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

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

In 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, her daughter has a 49% chance of developing it. If the patient's sister had eclampsia, then the patient's risk of developing eclampsia increases to 58%. With multiple pregnancies, the likelihood of developing eclampsia increases. The risk of this condition is also high in pregnant women under the age of 25 and in women after 35 years.

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

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

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

The increased load on the heart leads to tachycardia and expansion of the cardiac cavity. There is circulatory insufficiency, it only exacerbates hypoxia and hypercapnia.
Violation of cardiac function in eclampsia is often accompanied by pulmonary edema. As a result, hypoxia and hypercapnia are aggravated.

There are severe bouts of eclampsia. With them, a very strong hypercapnia develops, which affects the peripheral vessels and the vasomotor center. In this case, in addition to the central circulatory insufficiency, there is also a peripheral one.

More than 70% of patients with eclampsia have liver failure, and impaired renal function is also manifested. 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 patency of the respiratory center and there is no brain damage. Otherwise, a mixed form of acidosis may develop and hypoxia and hypercapnia may worsen. 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 cerebral hemorrhage, paralysis of the respiratory center, cardiac arrest. The lungs swell, or respiratory and metabolic acidosis occurs. Death may not occur immediately, but after a few days. Thus, the main cause of death in eclampsia is (in 70%) cerebral hemorrhage, followed by respiratory failure with pulmonary edema, acute kidney failure, postpartum hemorrhage, placental abruption, liver rupture, septic shock. If the patient has had 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 disorders, psychosis. Pathologies of other vital organs and systems of the body may also appear.
The development of eclampsia is considered a syndrome of multiple organ failure, because in this condition there is a failure of a number of systems and organs: respiratory, cardiac, renal, hepatic. There are also pronounced disorders in the distribution of blood flow, rheological properties of blood, various kinds metabolism.

Complications of severe eclampsia may include:

• 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 placental abruption, miscarriage, hypoxia, developmental delays and even death.

Against the background of multiple organ failure, convulsive seizures develop. These seizures are not associated with impaired cerebral circulation. Convulsive seizures are rare. But a whole series of seizures can occur, which follow one after another. This phenomenon is called "eclamptic status". After a seizure, a woman sometimes loses consciousness, that is, an eclamptic coma develops. (Sudden loss of consciousness may occur without an attack of convulsions.)

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

A convulsive 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. Period of tonic convulsions. It also lasts about 30 seconds. The muscles of the whole body are reduced, the torso is tensed. The face turns blue, breathing stops.
3. period of clonic convulsions. Continues 30 s. There is twitching of the facial muscles, muscles of the whole body and limbs. Convulsions become weaker. Breathing becomes hoarse, there is foam from the mouth with blood.
4. Consciousness gradually returns. The woman does not remember anything that happened to her just a few minutes ago.

The excitability of the central nervous system during 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 necessarily controlled. But if the patient is taking 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 of great importance. It is necessary for women who have suffered preeclampsia and eclampsia. Rehabilitation therapy can lower blood pressure, improve microcirculation and hemodynamics of the brain.

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

If the patient has had eclampsia or preeclampsia, then even after discharge she should be under the supervision of a cardiologist, urologist, internist and neuropathologist. Prompt treatment and follow-up can prevent severe consequences that can lead to disability.

Arterial hypertension in pregnant women

The concept of "arterial hypertension in pregnancy" is used to refer to various painful conditions.

First of all, we mean the following diseases:

• Hypertension in pregnancy. Pregnant hypertension is said to be when a pregnant woman's blood pressure is greater than 140/90 mm PC and rises for the first time after the 20th week.
• Severe hypertension in pregnancy. If blood pressure readings exceed 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 of the eye can also indicate preeclampsia.
• Eclampsia. The most severe form of preeclampsia, accompanied by convulsive seizures.

Measurement of blood pressure. Important conditions are a wide cuff and rest, otherwise the indicators may be unreliable.