Some weeks ago, we had an informative session on hypertension in pregnancy with our community on Instagram, the guest speaker was Adedoyin Ade-onojobi, an obstetrician and gynecologist practicing in Abeokuta, Nigeria. This article is an extract from the discussion and a continuation of the previous article on the same topic.
What happens if I develop severe pre-eclampsia?
If you develop severe pre-eclampsia, you will be cared for by your hospital specialist team,usually gynecologist,cardiologist or an endocrinologist.
Treatment includes medication (either tablets or via a drip) to lower and control your blood pressure. You
will also be given medication to prevent eclamptic fits if your baby is expected to be born within the next
24 hours or if you have experienced an eclamptic fit.
You will be closely monitored on the labour ward. In more serious cases, you may need to be admitted to
an intensive care or high dependency unit.
What happens after the birth?
Pre-eclampsia usually goes away after birth. However, if you have severe pre-eclampsia, complications may
still occur within the first few days and so you will continue to be monitored closely. You may need to
continue taking medication to lower your blood pressure.
If your baby has been born early or is smaller than expected, he or she may need to be monitored. There
is no reason why you should not breastfeed should you wish to do so.
You may need to stay in hospital for several days. When you go home, you will be advised on how often to
get your blood pressure checked and for how long to take your medication.
You should have a follow-up with your GP 6–8 weeks after birth for a final blood pressure and urine check.
If you had severe pre-eclampsia or eclampsia, you should have a postnatal appointment with your obstetrician
to discuss the condition and what happened. If you are still on medication to treat your blood pressure
6 weeks after the birth, or there is still protein in your urine on testing, you may be referred to a specialist.
Will I get pre-eclampsia in a future pregnancy?
Overall, one in six women who have had pre-eclampsia will get it again in a future pregnancy.
Of women who had severe pre-eclampsia, or eclampsia:
• one in two women will get pre-eclampsia in a future pregnancy if their baby needed to be born
before 28 weeks of pregnancy
• one in four women will get pre-eclampsia in a future pregnancy if their baby needed to be born
before 34 weeks of pregnancy
You should be given information about the chance, in your individual situation, of getting pre-eclampsia in a
future pregnancy and about any additional care that you may need. It is advisable to contact your midwife
as early as possible once you know you are pregnant again.
What if i have pre-existing medical conditions and i want to get pregnant?
You are advised to see your gynecologist to have a pre-conception consultation to advise on how you can have a safe pregnancy. The help to reduce the frequency of hospital admissions or complications during pregnancy
What are the likely pre-conception advice that may be given to a woman who had previously being diagnosed of pre-eclampsia?
First, your doctor may want to find out the influence of the condition on your previous pregnancies. For example, was the child born at term? what was the child’s weight at birth? what was the mode of the delivery for the past pregnancy? what were the drugs you were placed on?
The doctor may or may not recommend a change in diet for the patient. There are scientific reports that high protein diet and some vitamin supplements,can reduce the chances of developing hypertension in pregnancy. Also, the doctor may also want to conduct some other tests to ascertain the current state of health of the woman.
Does magnesium supplement reduce the risk of pre-eclampsia?
If a woman is diagnosed of low-magnesium, magnesium supplement may help to reduce the risk of pre-eclampsia in such women although, there are still various scientific studies that may not support this position.
Does gestational diabetics go away after birth?
Yes, gestational diabetics usually go away after birth that is why it is called gestational diabetics, meaning diabetics that was first diagnosed in pregnancy. However, women who have had gestational diabetics have a higher risk of developing diabetics later in life.
I am currently pregnant and i was told at the hospital that my blood pressure is high, then doctor gave me some drugs, after using the drugs for some days my blood pressure came down, can i discontinue using the drugs?
No, please do not discontinue any medication until you have sought prior advice of your doctor before doing so. The reason is because, hypertensive drugs are usually titrated against the patient’s blood pressure therefore as the blood pressure is going down, the doctor may want to reduce the dose of the anti-hypertensive given.
Can i take herbal liquids as opposed to anti-hypertensive drugs?
No,there are no scientific proof to support the use of herbal liquids as effective means of managing high blood pressure. Also, herbal liquids are not properly dosed and one may not know the active agents in the herbal liquids.
Can hormonal imbalance cause high blood pressure in pregnancy?
The type of hormonal imbalance that may cause high blood pressure in pregnancy is thyroid hormonal imbalance. You should see your doctor for proper care.
You can also watch the full video here.