Gestational hypertension is having high blood pressure during the second half of pregnancy in women who have never had high blood pressure before. This is diagnosed when blood pressure exceeds 140/90. Gestational hypertension normally resolves within about 6 weeks after delivery.
Preeclampsia is high blood pressure during pregnancy that damages other organs, usually the kidneys and liver. Preeclampsia can be a serious complication and is often characterized by swelling of the face and hands and protein in the urine.
Eclampsia results when preeclampsia is left undiagnosed or treated and can be fatal. Eclampsia is diagnosed when patients with preeclampsia begin having seizures. These seizures can occur, even if the patient does not have a history of them.
Gestational hypertension – The cause is generally unknown, but is more common in patients who have kidney disease or diabetes prior to pregnancy, or those who have had gestational hypertension in previous pregnancies. Other risk factors include being pregnant with twins (or triplets), maternal age younger than 20 years old or older than 40 years old and being African American.
Preeclampsia – The blood vessels within the placenta do not develop properly and are narrower than normal. This extra pressure within the blood vessels puts stress on the maternal liver and kidneys. Certain genetic factors, immune system response and damage to the blood vessels may contribute to this abnormal development. This complication can result in growth restriction of the fetus, placental abruption or even preterm birth.
Eclampsia – Eclampsia is basically severe preeclampsia that results in seizures. When preeclampsia becomes severe and is not treated, it can result in seizures and could be fatal to mother and fetus. This usually results in having to terminate the pregnancy and deliver the fetus, regardless of gestational age.
Patient will have controlled blood pressure at or below 140/90; patient will have optimal functioning of organ systems without chronic damage; patient will carry pregnancy to term
Monitor vital signs, particularly blood pressure
Blood pressure may fluctuate and spike quickly; monitor for changes and elevations
Assess for edema; note location and determine degree of pitting
Some swelling is normal in pregnancy, but pitting edema is different and can be a significant sign of decreased cardiac output.
Weigh patient regularly
Sudden increase in weight indicates fluid retention and may signify progression of disease and impaired renal function
Auscultate heart and lungs; note rate and rhythm; administer oxygen as necessary
Administer IV fluids and medications as appropriate
Monitor fetal heart rate
Observe for signs and symptoms of fetal distress due to maternal blood pressure, decreased placental blood flow and lack of oxygenation
Assess for vision disturbances and cognitive function
Monitor labs and diagnostic test results
Observe for proteinuria, blood glucose level, elevated liver enzymes and decreased renal function.
Provide nutrition and lifestyle education
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