Hypertension in pregnancy

  • Hypertension in pregnancy is the most common problem that can occur in a pregnancy. Approximately 8-10% of women in their first pregnancy and 3-6% in subsequent pregnancies develop hypertension. 
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  • How is hypertension in pregnancy defined?
  • It is defined as the unprecedented increase in blood pressure (systolic or high pressure of 140 mm Hg or greater), or diastolic (low pressure) of 90 mm Hg or greater, 2 measurements should be performed with a 4-hour distance between them, after the 20th week of gestation and not accompanied by proteinuria. The term "unprecedented" is used to distinguish hypertension from pre-existing hypertension (that was premature before pregnancy).
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  • What are the risk factors for the onset of hypertension in pregnancy?
  • First- time moms
  • A twin or multiple pregnancy
  • Mother’s age> 40 or <18 years
  • Family history of hypertension in pregnancy or pre-eclampsia
  • Predisposed hypertension
  • Chronic Kidney Disease
  • Diabetes mellitus
  • Obesity
  • Autoimmune disease (eg lupus)
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  • What are the dangers derived from gestational hypertension?
  • It may be the case that if it not diagnosed and not regulated, to cause problems in both the pregnant and the fetus. To the mother, high blood pressure may cause problems to the heart and kidneys (although this is the case with long-term hypertension - chronic). Gestational hypertension can progress to preeclampsia and even predispose to chronic hypertension at an older age. There may be also problems with the placenta and the development of the child (small fetus relative to his or her age), the child may be prematurely born and may cause the placenta to peel away. Of course, all the prementioned complications are "exceptions to the rule" and it is most likely that the pregnancy will continue without any problems.
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  • If I have one or more risk factors for gestational pregnancy, what should I do?
  • • The best way is to get informed and stay calm. Follow your gynecologist’s instructions and, if necessary, ask for advice from the nephrologist too.
  • • The gynecologist will create a follow-up plan tailored to the risk factors involved.
  • • Increase physical activity.
  • • Stop smoking and
  • • Start from the beginning of the pregnancy a systematic follow-up of the pregnancy with pressure measurements, weighing and data recording.
  • If gestational hypertension occurs, it will be very early detected and will be treated without any complications.
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  • How is gestational hypertension treated? Is there any cure?
  • Yes, it is treated. Its treatment depends on the stage of aging and the level of hypertension. The method of treatment will be selected by the gynecologist. The relationship between salt intake and hypertension in pregnancy is not as clear as arterial hypertension in the general population. That is why the salt directive is to consume as much as necessary for a pleasant food taste. There are several high blood pressure medicines that are completely safe for the fetus and the mother with long-term use. The efficacy of these drugs is high and with appropriate treatment, hypertension is well-adjusted, greatly reducing the chance of complications.
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Mesogeios Dialysis Centers Group Scientific Team

  • Βibliography 
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  • 2.Foo L, Tay J, Lees CC, McEniery CM, Wilkinson IB. Hypertension in pregnancy: natural history and treatment options. Curr Hypertens Rep. 2015 May;17(5):36.
  • 3.Kintiraki E, Papakatsika S, Kotronis G, Goulis DG, Kotsis V. Pregnancy-Induced hypertension. Hormones. 2015.Apr-Jun;14(2):211-23.
  • 4.Ali SM, Khalil RA. Genetic, immune and vasoactive factors in the vascular dysfunction associated with hypertension in pregnancy. Expert Opin Ther Targets. 2015;19(11):1495-515. doi: 10.1517/14728222.2015.1067684. Epub 2015 Aug 17. Review.
  • 5.Brown CM, Garovic VD. Drug treatment of hypertension in pregnancy. Drugs. 2014 Mar;74(3):283-96. doi: 10.1007/s40265-014-0187-7. Review. PubMed PMID: 24554373;
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  • 7.Zezza L, Ralli E, Conti E, Passerini J, Autore C, Caserta D. Hypertension in pregnancy: the most recent findings in pathophysiology, diagnosis and therapy. Minerva Ginecol. 2014 Feb;66(1):103-26. Review.
  • 8.Kattah AG, Garovic VD. The management of hypertension in pregnancy. Adv Chronic Kidney Dis. 2013 May;20(3):229-39. doi: 10.1053/j.ackd.2013.01.014. Review.
  • 9.Johnson W, Nguyen ML, Patel R. Hypertension crisis in the emergency department. Cardiol Clin. 2012 Nov;30(4):533-43. doi: 10.1016/j.ccl.2012.07.011. Epub 2012 Oct 2. Review.
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