Maternal Hypertension Classification

Definition and Classification

• Maternal hypertension is elevated blood pressure during pregnancy, typically defined as a blood pressure reading of 140/90 mmHg or higher.
• It's categorized into pre-existing hypertension (hypertension before pregnancy), gestational hypertension (onset after 20 weeks of gestation), and chronic hypertension with superimposed preeclampsia (pre-existing hypertension worsening during pregnancy).

Types of Maternal Hypertension

• Pre-existing hypertension: Hypertension present before pregnancy. Management focuses on careful blood pressure control and monitoring for complications.
• Gestational hypertension: Arises after 20 weeks of pregnancy and resolves postpartum. It's often associated with a higher risk of developing preeclampsia.
• Chronic hypertension with superimposed preeclampsia: Existing chronic hypertension that worsens during pregnancy, exhibiting features of preeclampsia.

Risk Factors

• Pre-existing medical conditions: Conditions like diabetes, kidney disease, and autoimmune disorders increase risk.
• Family history: A family history of hypertension or preeclampsia increases susceptibility.
• Obesity: Increased body mass index (BMI) is a significant risk factor.
• Multiple pregnancies: Carrying more than one baby increases the risk.
• Age: Younger women and women over 40 are at higher risk.

Complications

• Preeclampsia: A serious condition involving high blood pressure, protein in the urine, and potentially damages to organs such as the kidneys, liver, or brain.
• Eclampsia: A severe complication of preeclampsia characterized by seizures.
• Fetal growth restriction: Reduced fetal growth due to inadequate blood flow.
• Placental abruption: Premature separation of the placenta from the uterine wall.
• Preterm birth: Delivery before 37 weeks of gestation.
• Stillbirth: Loss of the fetus after 20 weeks of pregnancy.
• Maternal stroke or cardiovascular disease: Increased risk of future cardiovascular issues.

Diagnosis

• Blood pressure monitoring: Regular blood pressure measurements throughout pregnancy.
• Urine analysis: To detect proteinuria (protein in the urine), indicative of preeclampsia.
• Assessment of fetal well-being: Ultrasound examinations to monitor fetal growth and development.
• Laboratory tests: Blood tests to monitor for organ damage and other possible complications..

Management

• Medication: Antihypertensive medications are frequently prescribed to control blood pressure and prevent complications.
• Regular monitoring: Close monitoring of both mother and baby is crucial.
• Dietary modifications: Advice on dietary changes to manage blood pressure and overall health.
• Lifestyle recommendations: Encouragement of regular exercise and stress reduction strategies.
• Hospitalization: Possible hospitalization or close monitoring in cases of severe hypertension or complications.
• Delivery: Timing of delivery is crucial, balanced with maternal and fetal well-being. Considered a major risk factor for maternal mortality.

Prevention

• Healthy lifestyle: Maintaining a healthy weight, diet, and exercise regimen.
• Prenatal care: Regular visits to healthcare providers for early detection and management of risk factors.
• Early identification and treatment of pre-existing medical conditions: Effective management of underlying conditions can significantly reduce the risk.
• Management of stress: Reducing stress to maintain overall well-being.