A woman with elevated blood pressure in the third trimester can lead to serious consequences for the mother and baby, especially if the rise in blood pressure first occurs after 20 weeks. Gestational hypertension is known as pregnancy induced hypertension, or PIH.
Causes
PIH is most likely caused by problems with the placenta or immunologic issues related to pregnancy, according to research reported by the Mayo Clinic. New studies indicate that screening may identify women at risk by certain proteins found in their blood.
Risk Factors
There are many risk factors for PIH. Paul Gibson, M.D. reported in Hypertension and Pregnancy that some of the most common risk factors are related to maternal factors, such as age, race, pregnancy history and weight. PIH is more common in women under age 18 or over 35, women in their first pregnancy, women with multiple pregnancies, black women and obese women. A family history of PIH also increases the risk.
Other risk factors for PIH are chronic hypertension, a history of diabetes, kidney disease and use of SSRI antidepressants past the first three months of pregnancy.
Diagnosing
PIH is diagnosed by the following factors: blood pressure over 140/90, protein in the urine, rapid weight gain, frontal headache and hyper reflexes, according to Dr. Gibson.
Treating
Mild PIH can be treated with bed rest, lying on the left side to increase blood flow to the placenta. If pre-eclampsia develops, IV with magnesium sulfate is administered to decrease seizure risk. The delivery of the infant may also be necessary, even if premature.
Potential Consequences
According to the Mayo Clinic, maternal complications of PIH pre-eclampsia, eclampsia, stroke, seizures, kidney failure, respiratory failure and the development of HELLP syndrome. DIC (disseminated intravascular coagulation) may occur, resulting in inability for blood to clot.
Fetal complications include placental abruption, intrauterine growth retardation (IUGR), preterm delivery, either induced due to maternal complications or naturally occurring, and fetal death in utero.
