OBSTETRIC CONDITIONS
High Blood Pressure
Elevated blood pressure during pregnancy falls into two categories :
• Chronic hypertension – high blood pressure that existed prior to pregnancy
• Gestational hypertension or pre-eclampsia – high blood pressure that presented during or after pregnancy
Both of these condition require special attention during pregnancy and increase the chances of complications for mother and baby . Both forms of hypertension require more laboratory evaluation , ultrasounds , and increased fetal testing . With close supervision , most pregnancies complicated by hypertension have excellent outcomes .
Gestational hypertension and pre-eclampsia occur in women who had normal blood pressure before pregnancy . The elevated blood pressure usually does not become apparent until the last few weeks of pregnancy . Warning signs that suggest gestational hypertension or pre-eclampsia include rapid weight gain , severe swelling in the hands and face , blurring of or spots in your vision , persistent headaches despite taking Tylenol , and pain in the upper abdomen . Untreated pre-eclampsia may progress to eclampsia , which is characterized by seizures .
Currently , the only treatment for pre-eclampsia is delivery . Gestational age directs the management plan concerning timing of delivery . Most women return to normal blood pressure within days to weeks of delivery , but some may require medication until blood pressure normalizes .
Placental Problems
The placenta is the organ that connects you to your baby . It provides nourishment and oxygen to baby , and removes waste products . In a small number of pregnancies a placental abnormality will be diagnosed , such as the following :
• Placenta previa – In this condition the placenta covers the cervix , which obstructs delivery . The most common symptom is painless vaginal bleeding . As the cervix dilates , the placenta tends to separate from the uterus , which compromises blood flow . Placenta previa requires a C-section at term or if significant vaginal bleeding occurs earlier in pregnancy .
• Placental abruption – This pregnancy complication occurs when the placenta separates from the uterus before the birth of the baby . It is usually associated with constant , severe abdominal pain and vaginal bleeding . The exact cause is often unknown , but high blood pressure , premature rupture of membranes , trauma , and substance abuse are all risk factors . This is an obstetric emergency and often requires an emergent C-section .
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