Dr Jaime Filho Gynecologist and Obstetrician, partner of Changing Diapers returns in yet another enlightening post about pregnancy and motherhood. See more about hypertension and pre eclampsia and ask your recurring questions. Welcome back Dr Jaime!
Changing Diapers: What can be the causes of hypertension in pregnancy?
Dr Jaime: The hypertension in pregnancy is a very frequent event in our population, and is responsible for much of the morbidity and maternal and child mortality. Because of this, its correct diagnosis and treatment are essential to avoid possible problems resulting from this pathology. Although the specific cause of pregnancy-specific hypertensive disease (DHEG) does not exist in the world literature today, there are some theories that try to explain it, such as changes in placental fixation (deficiency of the second wave of trophoblastic invasion) or maternal pathologies that may be involved, such as thrombophilia (ease in the formation of clots in the bloodstream).
Regardless of the etiology, DHEG occurs as follows (briefly): the placental vessels have increased resistance, that is, maternal blood has greater difficulty in reaching the placenta. This causes damage to the blood vessel wall, releasing factors in the circulation that cause vasoconstriction throughout the body, increasing the general resistance of the body, and therefore increasing blood pressure. As the circulation is compromised, the functioning of the organs may also be compromised, with kidney and liver failure, heart disease, etc. In addition, there is diffuse vascular injury as well, consuming the body’s clotting factors.
DHEG is a syndrome that can have some specific consequences, such as pre-eclampsia, which is characterized by increased blood pressure, loss of protein in the urine and edema, the HELLP syndrome, which means a drop in platelets, a breakdown of red blood cells and an increase in enzymes in the blood. liver, or eclampsia, characterized by all the findings of pre-eclampsia associated with seizure and coma. The severity of DHEG is directly linked to the correct control of blood pressure.
Changing Diapers: What are the main factors that indicate that the pregnant woman has hypertension and how can one have an accurate diagnosis for the problem?
Dr Jaime: Some signs and symptoms may indicate that the pregnant woman has a blood pressure increase. Symptoms such as headache, neck pain, blurred vision, dizziness and stomach pain,not pain in the lower abdomen, but in the stomach, they may indicate that pressure spikes are occurring. In addition, we have edema as an indirect sign of this pathology, which occurs due to the loss of protein in the urine typical of this pathology. However, edema can confuse the diagnosis since it can also be present in a pregnant woman with normal blood pressure levels, without DHEG, simply because the blood circulation is already compromised in the pregnant woman (due to the increase in intra-abdominal pressure, making it difficult for the patient to return). blood from the lower limbs to the heart). Another important sign is excessive weight gain in a short time.
Changing Diapers: What are the tests that can detect pre-eclampsia
Dr Jaime: As pre-eclampsia has as one of its characteristics the loss of protein in the urine, a primary test for its diagnosis is 24-hour proteinuria . Also part of the investigation of the severity of this pathology is the study of hepatic and renal functions, in addition to the investigation of the breakdown of red blood cells in the bloodstream. In addition to these tests, the evaluation of fetal well-being with ultrasound and doppler is also very important.
Changing Diapers: How to treat hypertension to prevent pre-eclampsia?
Dr Jaime: Correct blood pressure control is essential to avoid complications of DHEG. For this reason, prenatal care performed correctly, as well as the use of antihypertensive medications, carrying out the requested tests and a healthy diet, avoiding excesses, especially salt, are essential.
Changing Diapers: When menstrual delay can really mean pregnancy and when to take symptoms into account.
Dr Jaime: Menstrual delay must always be taken into account, but it does not always mean pregnancy.There are many causes of menstrual delay, such as hormonal changes, polycystic ovary syndrome, anovulatory cycles, etc. Some symptoms may appear with menstrual delay, such as pain in the lower abdomen like colic or hooked, nausea, increased number of urination, but these symptoms are also very nonspecific, they may or may not be associated with an early pregnancy. Therefore, if there was an unprotected relationship, that is, without the use of contraceptive methods, and if there is a menstrual delay, the ideal is to see your doctor for the beta-hCG test, which is already positive within the first week of pregnancy. .
You can find Dr Jaime Currently in the city of Santos, his homeland, in the office located at Avenida Ana Costa, 222 Conjunto 59 – Vila Mathias – Telephone: (13) 38777900 , and also in the hospitals Ana Costa, Santos Health House , and in other hospitals in the Baixada Santista region (Hospitals São José in São Vicente, Irmã Dulce in Praia Grande and Municipal de Bertioga).
My name is Dr. Alexis Hart I am 38 years old, I am the mother of 3 beautiful children! Different ages, different phases 16 years, 12 years and 7 years. In love with motherhood since always, I found it difficult to make my dreams come true, and also some more after I was already a mother.
Since I imagined myself as a mother, in my thoughts everything seemed to be much easier and simpler than it really was, I expected to get pregnant as soon as I wished, but it wasn’t that simple. The first pregnancy was smooth, but my daughter’s birth was very troubled. Joana was born in 2002 with a weight of 2930kg and 45cm, from a very peaceful cesarean delivery but she had already been born with congenital pneumonia due to a broken bag not treated with antibiotics even before delivery.