Pregnancy Induced Hypertension (PIH), a Relatively Common Complication of Pregnancy

Pregnancy is usually a joyous time. However, for some women, pregnancy can also be marked by problems. One such problem is pregnancy induced hypertension, also called PIH. PIH is one of the more common complications during pregnancy. Pregnancy induced hypertension is high blood pressure that develops during pregnancy anytime after twenty weeks of gestation. Any blood pressure reading above 140/90, even if it's only one of the numbers, is considered to be hypertensive. Hypertension that is present before conception or diagnosed anytime before twenty weeks gestation is considered to be chronic hypertension, a separate disorder. Left untreated, PIH can have devastating effects on both mother and baby. Having pregnancy induced hypertension also puts a woman at increased risk for developing other serious pregnancy-related complications such as preterm birth and placental abruption. The exact cause of PIH has yet to be determined.

Pregnancy induced hypertension affects anywhere between five and ten percent of all pregnancies. Certain women are more likely to develop PIH. These include: first-time mothers, women whose mothers and/or sisters had PIH, women who had PIH in a previous pregnancy, women carrying multiples, teenage mothers, women over the age of forty, women with certain diseases, and women who are obese. Pregnancy induced hypertension can occur anytime after twenty weeks of gestation, however, it is most common after thirty weeks of gestation.

Symptoms of PIH can vary from woman to woman, but most women don't experience any symptoms at all unless the blood pressure is very high. If symptoms are present they can include headaches, vision problems, fatigue, and chest pain. Most of the time, pregnancy induced hypertension goes unnoticed until it is detected by the practitioner during a routine check-up.

If a woman is found to have pregnancy induced hypertension, prompt treatment is crucial. Treatment is highly individualized and can vary depending on when the hypertension is detected during the pregnancy and how severe the hypertension is. The only true treatment for PIH is delivery, however, delivery is not always an option especially when the disorder is detected earlier in pregnancy. Also, delivery may not always be the best option in cases where hypertension is controlled and not particularly severe. In milder cases, a wait-and-see approach may be used. This basically involves the mother taking it easy and being closely monitored. In more severe cases, the mother may need to take antihypertensive medication to lower the blood pressure. Bed rest may also be required. Severe cases need to be monitored much more closely. Along with checking the blood pressure, monitoring can also involve testing urine for protein, nonstress tests, ultrasounds, and blood work. Patients are also educated on what to look out for. This includes sudden weight gain, severe swelling especially of the face and hands, severe headaches, and severe abdominal pain. All of these are symptoms of preeclampsia, a very serious condition that can develop following PIH. Approximately one in four women who have PIH will develop preeclampsia and those chances double if the PIH was diagnosed before thirty weeks gestation.

The prognosis of pregnancy induced hypertension is very good. After birth, the mother will continued to be monitored to make sure the blood pressure does not get higher or the condition does not progress to preeclampsia or eclampsia, another serious complication. Assuming that the condition does not worsen, most women will see their blood pressure return to normal levels within one week of delivery. However, it can take up to six weeks following delivery for some women to see their blood pressure return to normal levels. Once blood pressure returns to normal levels, the vast majority of women will experience no more effects from the condition. Women who have PIH in one pregnancy are more likely to develop the condition in subsequent pregnancies. The long term effects of pregnancy induced hypertension have yet to be determined. While some research shows there is no long term effects, other research has found a link between PIH and heart disease later in life. More research is needed.

While pregnancy induced hypertension is a very serious condition, early detection, prompt treatment, and education are key.

Sources

University of Virginia HealthSystem

BabyCenter