Simply put, gestational hypertension refers to the coexistence of pregnancy and hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg). In our country, about 5 out of every 100 pregnant women suffer from gestational hypertension. Moreover, the survey found that the prevalence of hypertension among Chinese women increases with age. In fact, the age of first childbirth for pregnant women in my country has been delayed to 26.2 years old (sixth census data). It can be speculated that the number of patients with pregnancy-induced hypertension in my country will continue to increase.
According to the definition of gestational hypertension, some patients already suffer from hypertension before pregnancy, while other patients have normal blood pressure before pregnancy and increase their blood pressure after pregnancy.
Why is this?
Pregnancy and childbirth are a special physiological period for women. As the baby gradually grows up, the pregnant woman's endocrine changes will also occur, and the demand for metabolism and blood volume will also increase, which will bring adverse effects to the body functions of the pregnant woman. A heavy burden.
The cause of pregnancy-induced hypertension is not yet clear, but it may be related to placental ischemia and placental dysfunction caused by low immunity in pregnant women. In addition, it may also be affected by family inheritance.
The diagnosis of pregnancy-induced hypertension only requires 2 tests
Some people may ask, isn't pregnancy-induced hypertension the diagnosis of pregnancy plus ordinary hypertension?
In fact, the diagnostic limit of gestational hypertension is the same as that of ordinary hypertension, which is 140/90 mmHg. However, pregnancy-induced hypertension does not need to look at the results of three measurements on different days. Pregnant women only need to re-measure their blood pressure 4 hours later. If the blood pressure in the two results is higher than 140/90 mmHg, it can be diagnosed as pregnancy-induced hypertension. If systolic blood pressure and are above 160 mmHg, or diastolic blood pressure is above 110 mmHg, it is considered severe hypertension. Retesting after a few minutes can make the diagnosis and immediate measures should be taken.
If " white coat hypertension ", masked hypertension or transient hypertension is suspected, 24-hour ambulatory blood pressure monitoring needs to be evaluated; if the blood pressure is lower than 140/90 mmHg, but is higher than the basic Although blood pressure increases by 30/15 mmHg, although it cannot be diagnosed as gestational hypertension, close observation is required to pay attention to changes in blood pressure.
If a pregnant woman finds that her blood pressure is elevated, she must receive formal treatment even if she has no symptoms in the early stages. If symptoms such as dizziness, headache, edema, vertigo, nausea, etc. occur, it may indicate that your blood pressure has been severely elevated, and you must go to the hospital for diagnosis and treatment as soon as possible and do not allow it to develop.
Pre-pregnancy assessment is indispensable
To prevent pregnancy-induced hypertension, you must take precautions. Pre-pregnancy blood pressure assessment should be performed when preparing for pregnancy.
If there is no history of hypertension, and the blood pressure and weight are normal, and there is no family history or contraindications to pregnancy, you can prepare for pregnancy normally; if there are uncorrectable risk factors, you should go to the obstetrics department for pre-pregnancy consultation; if BMI ≥ 24, or the blood pressure is at the critical value range (130 ~ 139/80 ~ 89 mmHg), you can consider preparing for pregnancy, but strict lifestyle intervention is required, such as salt restriction, weight loss, etc.
If there is a history of hypertension, further evaluation is required:
- If coronary heart disease and other heart, brain, kidney and other organ damage has occurred, you should go to a hypertension specialist for treatment;
- If there is no target organ damage, but blood pressure If the blood pressure is above 140/90 mmHg, you should improve your lifestyle or add drug intervention to reduce your blood pressure to 140/90. You can prepare for pregnancy only if the blood pressure is below 160/90 mmHg;
- If the blood pressure is above 160/90 mmHg, it is not recommended to prepare for pregnancy. The blood pressure should be controlled first and then re-evaluated after 3 to 6 months.
The content of this article comes from the book "Save the Heart"
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