|
Treatment of high blood pressure in Pregnancy Preeclampsia Treatment
|
|
The only definitive
"treatment" for preeclampsia (Pregnancy induced hypertension) is delivery the fetus, either vaginal
or cesarean (c-section). Inducing labor is the treatment of choice for women who have reached a
gestational age of at least 37 weeks. In all cases, the consensus is that all women with
preeclampsia (Pregnancy induced hypertension) should be delivered by 40 weeks, and the use of
induction drugs and cervical ripening agents is common.
Specific treatment for pregnancy-induced
hypertension
will be determined by your
physician based on:
expectations for the course of the disease
your opinion or preference
your pregnancy, overall health, and medical
history
extent of the disease
your tolerance for specific medications, procedures, or
therapies
The goal of treatment is to
prevent the condition from becoming worse and to prevent it from causing other
complications.
For women who have not
reached 37 weeks, treatment focuses on allowing the baby to mature as much as possible before
inducing labor. The goal of preeclampsia (Pregnancy induced hypertension) treatment is to avoid
progression of the disease and/or complications. A number of studies have shown that close
outpatient monitoring is as effective as hospitalization for the majority of women, though women
with severe disease usually require careful monitoring that is best accomplished in a hospital
setting. In general, outpatient preeclampsia (Pregnancy induced hypertension) treatment
means:
Visiting the doctor every
one to three days for a checkup
Having weekly or twice weekly lab tests to check liver enzymes and
kidney function
Limiting difficult physical activity
High blood pressure medications are generally not given to women who
are being treated on an outpatient basis, though certain medications are sometimes used during
hospital-based treatment for severe preeclampsia (Pregnancy induced hypertension). Similarly, there
is currently no indication for either restricting salt intake or using diuretics in cases of
preelampsia (Pregnancy induced hypertension) though both of these are commonly used for the initial
treatment of high blood pressure not related to pregnancy. Bed rest is a well-known treatment
measure, but, like salt restriction and diuretics, it has not been proven to improve ultimate
outcomes.
The guiding factor in the
treatment of preeclampsia (Pregnancy induced hypertension) is the health of the mother and the
baby. In situations where the health of the mother or the baby appears to be in jeopardy, labor
is usually induced. Specifically, signs that indicate labor induction should be started
include:
Persistent headaches or
vision disturbances (blurry vision)
Persistent abdominal pain
Signs of severe fetal growth
delay/restriction
Signs of impaired fetal well-being
Maternal platelet count less than 100,000
Worsening maternal liver function as observed on blood
tests
Worsening maternal kidney function as observed on blood tests
(Creatinine >2)
When delivery must be induced at a gestational age of less than 34
weeks, a course of steroids (usually betamethasone or dexamethasone) is given. This is done to help
the baby's lungs develop, since babies born before 34 weeks almost always have some difficulty
breathing because their lungs are still immature.
In cases of mild to severe
preelampsia (Pregnancy induced hypertension) magnesium is usually given intravenously to prevent
seizures and other serious potential complications to prevent eclampsia . Numerous studies have
shown that magnesium is vastly superior to other drugs for this purpose.
|