Pregnancy-Induced Hypertension (PIH): Causes, Symptoms, and Treatment.
Pregnancy-Induced Hypertension (PIH): A Complete Guide from A to Z
Pregnancy-induced hypertension (PIH), also known as gestational hypertension, is a serious condition characterized by elevated blood pressure in pregnant women after the 20th week of gestation without prior history of hypertension.
Pregnancy-induced hypertension (PIH) occurs after 20 weeks of gestation and can lead to serious complications like preeclampsia, eclampsia, and fetal growth restriction. Early detection and management are vital.
📌 Definition of PIH
PIH is defined as systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg measured on two separate occasions at least 4–6 hours apart, occurring after the 20th week of pregnancy in a previously normotensive woman.
📊 Classification of Hypertensive Disorders in Pregnancy
| Type | Description |
|---|---|
| Chronic Hypertension | Pre-existing or diagnosed before 20 weeks of gestation |
| Gestational Hypertension (PIH) | Develops after 20 weeks without proteinuria |
| Preeclampsia | Hypertension with proteinuria and/or systemic features |
| Eclampsia | Preeclampsia with seizures |
🔍 Causes and Risk Factors
- First pregnancy (primigravida)
- Multiple gestation (twins, triplets)
- Family history of PIH or preeclampsia
- Obesity and diabetes
- Autoimmune disorders (e.g., lupus, antiphospholipid syndrome)
- Chronic kidney disease
- Advanced maternal age (>35 years)
🩺 Signs and Symptoms
- Persistent high blood pressure
- Swelling of hands, feet, or face
- Headache (often severe)
- Blurred vision or visual disturbances
- Upper abdominal pain
- Protein in urine (in case of preeclampsia)
🧪 Diagnosis
- Blood pressure monitoring (>140/90 mmHg after 20 weeks)
- Urinalysis for proteinuria
- Liver function tests (LFTs)
- Kidney function tests (creatinine, urea)
- Complete blood count (CBC)
- Fetal ultrasound for growth restriction
⚠️ Complications of PIH
- Preeclampsia and Eclampsia
- HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelet count)
- Placental abruption
- Intrauterine growth restriction (IUGR)
- Preterm labor
- Fetal distress or stillbirth
💊 Treatment and Management
Conservative Management (Mild PIH)
- Regular antenatal checkups
- Monitoring of BP and fetal well-being
- Low-sodium diet
- Rest and reduced physical activity
Medical Management
- Antihypertensives:
- Methyldopa – safe in pregnancy
- Labetalol – beta-blocker of choice
- Nifedipine – calcium channel blocker
- Magnesium sulfate for seizure prevention in severe cases
- Hospitalization if BP remains uncontrolled or complications arise
Delivery Decision
If PIH is worsening or fetal distress is evident, early delivery (preferably after 37 weeks) may be indicated. In severe cases, immediate delivery regardless of gestational age is recommended.
🧷 Prevention Tips
- Preconception counseling
- Weight management before pregnancy
- Healthy diet and regular exercise
- Early antenatal care for high-risk women
- Low-dose aspirin (75–150 mg/day) in high-risk pregnancies from 12 weeks
📘 Prognosis and Postpartum Care
- BP usually normalizes within 6–12 weeks postpartum
- Follow-up to detect chronic hypertension
- Monitor for signs of postpartum preeclampsia
🧠 FAQs About Pregnancy-Induced Hypertension
Q1. Can PIH harm the baby?
Yes, it can cause poor fetal growth, preterm birth, or even stillbirth if not managed properly.
Q2. Can PIH lead to long-term hypertension?
In some women, especially with severe cases, blood pressure may remain elevated even after delivery.
Q3. Is normal delivery possible with PIH?
Yes, if blood pressure is controlled and no complications occur. Otherwise, induction or cesarean may be needed: "Pregnancy-induced hypertension infographic showing symptoms, risks, and treatment"
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