HYPERTENSION is one of the common medical complications of PREGNANCY and contributes significantly to maternal and perinatal morbidity and mortality. Hypertension is a sign of an underlying pathology which may be pre-existing or appears for the first time during pregnancy.
Hypertension during pregnancy affects about 6-8% of pregnant women. Hypertension is responsible for more than 18% of total maternal deaths, occurring all over the world.
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Clinically, it may be –
• MILD :- Sustained rise of BP between 140/90 mm Hg and 160/100 mm Hg without Proteinuria.
• SEVERE :- Persistent systolic BP of > 160/110 mm Hg with Protein excretion of > 5gm/24hrs, Oliguria (<400ml/24hr), Platelet count <100,000/cubic mm, HELLP syndrome, Cerebral/visual disturbances, Severe epigastric pain, Pulmonary oedema, Retinal haemorrhages, etc.
The Different Types of Hypertension during Pregnancy are –
• Gestational Hypertension– Gestational hypertension, also referred to as Pregnancy Induced Hypertension (PIH) is a condition, characterized by high blood pressure during pregnancy. Gestational hypertension can lead to a serious condition called Preclampsia, also referred to as toxemia. The High blood pressure develops after week 20 in pregnancy and goes away after delivery. A sustained rise of blood pressure to 140/90 mm Hg or more on atleast two occasions 4 or more hours apart beyond the 20th week of pregnancy or during the first 24 hours after delivery in a previously normotensive woman is called Gestational Hypertension. It is associated with much higher incidence of Essential hypertension in later life than Pre-eclampsia. Majority of cases are > 37 weeks of Pregnancy. Pitting oedema over the ankles greater than 1+ after 12 hours in bed, Gain in weight of 2 kg or more in a week, Absence of Hypertension, oedema or renal infection, Orthostatic Proteinuria, Absence of other evidences of Pre-eclampsia.
• Preclampsia – Both chronic hypertension and gestational hypertension can lead to this severe condition after week 20 of pregnancy. Symptoms include High blood pressure and protein in the urine. Pre-eclampsia is a multi system disorder of unknown etiology characterised by development of hypertension to the extent of 140/90 mm Hg or more with Proteinuria after the 20th week in a previously normotensive and non-proteinuric woman. It frequently occurs in Primigravidae (70%).
• Essential hypertension is defined as the rise of blood pressure to the extent of 140/90 mm Hg or more during pregnancy prior to the 20th week. It occurs commonly in Multipara elderly woman, before the 20th week of pregnancy, persisting even after 3 months. May be suspected in case of Cardiac enlargement, Presence of medical disorders, Negative findings in Urine, Eye changes like silver wiring of the arterioles, Hypertensive Retinopathy. In about 20%, it is superimposed by pre-eclampsia evidenced by rise of BP to the extent of 30 mm Hg systolic and 15 mm Hg diastolic associated with oedema and/or Proteinuria.
• Chronic Hypertension – Women who have high blood pressure (over 140/90) before pregnancy, early in pregnancy (before 20 weeks), or continue to have it after delivery. Chronic hypertensive disease (CHD) is defined as the presence of hypertension of any cause antedating or before the 20th week of pregnancy and its presence beyond the 12 weeks after delivery. Overall incidence is 2-4% of which 90% are due to essential hypertension.
RISK FACTORS –
• First-time moms
• Women whose sisters and mothers had PIH
• Women carrying multiples
• Women younger than age 20 or older than age 40
• Women who had high blood pressure or kidney disease prior to pregnancy
ONSET – Insidious
COURSE – Slow
Dr. Yashika Arora
B.H.M.S. (N.H.M.C., D.U.) – Batch 2011-17, P.G. Scholar, D.K.M.M.H.M.C. (Aurangabad) – Batch 2017-18
Achiever of STSH (2015-16) Scholarship Programme organised by C.C.R.H. Achiever of Appreciation Award, Board of Homoeopathic system of medicine, Delhi & Delhi Homoeopathic Federation, 22 January, 2018.
Contact no. – 7827805347
Email ID – email@example.com
Address – House no. -86, 1st floor, Pocket – 9, Sector 21, Rohini, Delhi - 110085
SCOPE OF HOMOEOPATHY IN GESTATIONAL HYPERTENSION –
Homoeopathy treats the sick individual, not only his sickness as stated in Hahnemann’s writing “there is no disease, but sick people”. Thus, in case of primary/essential HTN, homoeopathy is concerned with the patient having high blood pressure rather than the hypertension itself. It is the sick man who has to restore to health, not his ti...