Pregnancy-Induced Hypertension

Pregnancy-induced hypertension (PIH), which is also called toxemia or preeclampsia (say "pre-ee-clamp-see-ah"), is a problem that occurs in some women during pregnancy. It can happen during the second half of pregnancy. Your doctor will look for the following signs of PIH: high blood pressure, swelling that doesn't go away and large amounts of protein in your urine.

PIH is more common in a woman's first pregnancy and in women whose mothers or sisters had PIH. The risk of PIH is higher in women carrying multiple babies, in teenage mothers and in women older than age 40. Other women at risk include those who had high blood pressure or kidney disease before they became pregnant. The cause of PIH isn't known.

Not necessarily. If your doctor sees that your blood pressure is high, he or she will watch you closely for changes that could mean you have PIH. In addition to high blood pressure, women who have PIH also have excessive swelling. They may also have protein in their urine. Many women with high blood pressure during pregnancy don't have protein in their urine or extreme swelling, and don't get PIH.

Swelling alone doesn't necessarily mean you have PIH. Some swelling is normal during pregnancy. For example, your rings or shoes might become too tight. Swelling is more serious if it doesn't go away after resting, if it's very obvious in your face and hands, or if it's a rapid weight gain of more than 5 pounds in a week.

No one test diagnoses PIH. Your blood pressure will be checked during each doctor's visit. A big rise in your blood pressure can be an early sign that you might have PIH. A urine test can tell if there is protein in your urine. Your doctor may order certain blood tests, which may show if you have PIH. If you have signs of PIH, your doctor may want to see you at least once a week and possibly every day.

PIH can prevent the placenta (which gives air and food to your baby) from getting enough blood. If the placenta doesn't get enough blood, your baby gets less air and food. This can cause low birth weight and other problems for the baby.

Most women who have PIH still deliver healthy babies. A few develop a condition called eclampsia (PIH with seizures), which is very serious for the mother and baby, or other serious problems. Fortunately, PIH is usually detected early in women who get regular prenatal care, and most problems can be prevented.

If you have PIH, delivery of the baby is the best way to protect both you and your baby. This isn't always possible, because it may be too early for the baby to live outside of the womb.

If delivery isn't possible because it's too early in your pregnancy, steps can be taken to manage the PIH until the baby can be delivered. These steps include making your blood pressure drop, with bed-rest or medicines, and keeping a close eye on you and your baby. In some cases, hospitalization may be necessary.

One way to control high blood pressure when you're not pregnant is to cut the amount of salt you eat. This isn't a good idea if you have high blood pressure during pregnancy. Your body needs salt to keep up the flow of fluid in your body, so you need a normal intake of salt. Your doctor will tell you how much salt to eat each day and how much water you should drink each day.

Your doctor might tell you to take aspirin or extra calcium to prevent PIH. Your doctor might also tell you to lie on your left side while you are resting. This will improve blood flow and take weight off your large blood vessels. Many doctors give magnesium sulfate to their patients during labor and for a few days afterward to help prevent eclampsia. Talk to your doctor about these things.

This is up to your doctor and you. A cesarean section (an operation to deliver the baby) is more likely if your health or your baby's health is in danger. If things aren't this serious, your doctor may use medicine (such as oxytocin) to start your labor, and you can deliver your baby through a vaginal delivery.