Pregnancy-Induced Hypertension and Pre-Eclampsia

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Pregnancy Induced Hypertension (PIH) and Pre eclampsia
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 pre eclampsia are used interchangeable, but in pre eclampsia the woman also has protein in her urine indicating that there is renal involvement as well. The only know cure for pre eclampsia is delivery of the fetus. It is a relatively common problem of pregnancy and affects about 8% of all pregnancies. (Murray, p680) 2. Risk factors

There are many factors that increase a woman's risk. Those include women who are having their first baby, those under 17 years old, women who are obese, having diabetes mellitus, chronic hypertension, or pre-existing vascular disease and women with multi-fetal gestation. Also a woman is more likely to have pre eclampsia if the mother or sister has the disorder. (Murray, p681) 3. Etiology and Pathophysiology

Pre eclampsia is due to generalized vasospasm. In natural pregnancy, vascular volume and cardiac output increase significantly, but despite these increases, blood pressure does not rise in normal pregnancy. This is because pregnant women resistance to the effects of vasoconstrictors such as angiotension. However, in pre eclampsia, peripheral vascular resistance increase because some women are sensitive to angiotension Vasospasm decrease the diameter of blood vessels which results in endothelia cell damage, impeded blood flow and elevated blood pressure. As a result of this circulation to all body organs, including the kidneys, liver, brain and placenta, is decreased. This will cause many changes such as decreased venal perfusion, glomerular damage,...