Pregnancy-Induced Hypertension (PIH) and Preeclampsia Essay

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Pregnancy Induced Hypertension (PIH) and Preeclampsia

A. Discussion of disease/condition

1. Incidence

Pregnancy Induced Hypertension (PIH) is a multi-organ disease process that develops as a result of pregnancy and regresses in the postpartum period. It usually develops after 20 weeks of gestation in a woman who had normal blood pressure. It is defined as an elevation of systolic and diastolic pressures equal to or above 140/90 mm Hg. In clinical practice, the terms PIH and preeclampsia are used interchangeable, but in preeclampsia the woman also has protein in her urine indicating that there is renal involvement as well. The only know cure for preeclampsia is delivery of the fetus. It is a relatively common problem of
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This will cause many changes such as decreased venal perfusion, glomerular damage, impaired liver function, small cerebral hemorrhages, pulmonary edema, dyspnea and decreased placental circulation. Decrease placental circulation can result in infarctions that increase the risk for abruptio placentae. Also when maternal blood flows through the placenta is decreased, the fetus is likely to experience intrauterine growth restriction and persistent fetal hypoxemia and acidosis (Murray, p679-681)

4. Signs and Symptoms

Hypertension, generalized edema and proteinuria are the three classic signs of preeclampsia. The first sign is that a pregnant women may notice is edema and a rapid weight gain which are due to fluid retention.

Hypertension is defined as sustained blood pressure equal to or above 140/90. Blood pressure should be taken in the sitting position with the arm supported in a horizontal position at hear level.

Proteinuria usually develops later than hypertension an edema. The combination of proteinuria and hypertension indicates a worsening disease process.

Additional signs include vascular constriction and narrowing of small arteries (e.g. when the retina is examines). Deep tendon reflexes may be very brisk (hyperreflexia) and clonus may be present. This may suggest cerebral irritability.

Preeclampsia is dangerous for the woman and fetus for 2 reasons. The first

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