Preeclampsia, Toximia, HELLP Syndrome & Pregnancy-Induced Hypertension

Pregnancy-Induced Hypertension or PIH is a diagnosis which includes the complications of: toximia, preeclampsia, eclampsia (which indicates that a seizure has occured) and the HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome, which indicates blood and liver complications. The term PIH can be used to refer to any or all of the above complications.

Sustained high blood pressure or Hypertension can increase an expectant woman's risk of reduced placental blood flow to the baby, placental abruption, and possible internal organ damage to the mother. Blood pressure can vary according to activity level, emotional state and body position. If you are at rest and free of emotional stress, your blood pressure is more likely to be low, whereas if you are active and/or stressed your blood pressure is more likely to be elevated. Blood pressure readings can vary depending on the instrumentation used and the skill of the person taking the reading, so it's a good idea to request that the same person with the same equipment take your blood pressure reading each time you have it checked.

PIH can be prevented and/or reversed through a healthy diet. 80 to 100 milligrams of protein daily can reverse the symptoms of PIH. Good sources of protein include:

• Meat, poultry and fish
• Eggs
  
• Dried beans and peas
• Cheese (cottage cheese is especially high in protein)
  
• Milk
• Whole grains
• Peanut butter
• Nuts

For more information about a health pregnancy diet, please see my post about Staying Healthy and Low-Risk

Mild PIH consists of the following symptoms:

• Blood pressure over 140/90
  
• Edema (fluid retention and swelling)
• Protein in the urine

Mild PIH is generally treated with bed rest (the best position to rest is on your side), regular blood pressure checks, and close medical supervision to watch for signs of a more serious problem.

Severe PIH is characterized by any or all of the following symptoms:

• Blood pressure over 160/110
• Headaches
• Blurred vision
• Spots before the eyes
• Pain in the upper abdomen
• Decreased urine output
• Increased knee and ankle reflexes
• Changes in blood chemistry that indicate problems with the liver, kidney and blood platelet levels
• In the most severe cases, seizures or coma or death of the mother and baby can occur, which is why PIH is treated very aggressively

Severe PIH may be treated with hospitalization and medication such as magnesium sulfate to decrease the risk of seizures.

If signs of severe PIH persist after treatment, an induction of labor or cesarean section may be planned. Blood pressure generally normalizes within days or weeks after birth, and with early diagnosis and treatment, complications from PIH are usually minimal and a healthy outcome is achieved.

The causes of PIH are unknown, but it has been found to be more common in first time mothers, those pregnant with twins, teenagers, women over the age of 35, obese women, those with poor diets, and women in high stressful living conditions. Expectant mothers with a personal or family history of chronic hypertension, kidney or liver disease, diabetes mellitus, or a past pregnancy with PIH are also more likely to develop PIH.

Information paraphrased from Pregnancy, Childbirth and the Newborn by Simkin, Whalley & Keppler.