Differential diagnosis of chronic pre-pregnancy hypertension and pregnancy-induced hypertension

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During pregnancy, a woman can have a number of diseases, including gestational hypertension. Gestational hypertension has many forms, with different clinical signs and treatments, especially chronic pre-pregnancy hypertension and pregnancy-induced hypertension that need to be differentiated. clearly to have the most appropriate treatment for the patient.

1. Gestational hypertension

Gestational hypertension is defined as the diastolic blood pressure of the mother is greater than 90 mmHg or the systolic blood pressure is over 140 mmHg when measuring blood pressure after resting the patient in place for about 10 minutes. Some clinical forms of gestational hypertension can be mentioned as chronic hypertension before pregnancy, pregnancy-induced hypertension, pre-eclampsia, eclampsia... with very diverse symptoms. form and have different treatment measures for each specific case. Gestational hypertension can have many negative effects on the health of both the mother and the fetus during this time, namely:
Decreased blood supply to the placenta: When the placenta is not supplied With enough blood needed to nourish the fetus, it will not have enough nutrients as well as oxygen needed for the fetus to develop in the best way, even causing fetal growth retardation, low birth weight and low birth weight. premature birth. Premature birth is very dangerous for babies because they often have respiratory problems, infections and a number of other problems because the organ systems are not yet complete, but the baby is born earlier. Placental abruption: In gestational hypertension, especially pre-eclampsia, it can cause the placenta to detach from the endometrium of the uterus before the time of delivery, if it is more severe, it can leave extremely dangerous complications. dangerous for both the mother and the fetus, typically severe anemia complications, diseases related to blood clotting disorders and more seriously, death of both mother and baby.

Fetal growth retardation Injury to some organ systems in the mother's body: High blood pressure during pregnancy puts some organs such as kidneys, liver, lungs or brain at risk of damage and destruction. a series of dangerous and life-threatening diseases of the patient. Premature birth: Because pregnant women suffer from gestational hypertension, it is extremely dangerous to life, so some cases are forced to give birth prematurely as a way of timely handling to save the mother's life. At this time, the baby was born because he was premature, so he encountered a number of health problems such as respiratory failure, neonatal infection and possibly death. In addition, some cardiovascular problems such as preeclampsia can predispose the mother to heart disease later in life.

2. Chronic hypertension before pregnancy

Chronic hypertension before pregnancy is a state of high blood pressure detected before the time of pregnancy or before 20 weeks of gestation with a systolic blood pressure greater than 140 mmHg or a blood pressure reading diastolic is more than 90 mmHg. In addition, chronic hypertension before pregnancy persists after 6 months after giving birth and can leave some complications during pregnancy such as graft preeclampsia, fetal growth retardation, placental abruption. abortion, premature delivery, or stillbirth, so a woman's high blood pressure should be closely monitored throughout pregnancy.
An extremely important and necessary thing for women with chronic hypertension before pregnancy is antenatal counseling and treatment for chronic hypertension. Some of the medications used to treat high blood pressure during pregnancy include ACE inhibitors, angiotensin antagonists, beta-blockers, and diuretics. Besides, finding out the cause of high blood pressure before pregnancy is also very helpful in examining and treating pregnant women. However, according to some studies, if taking a lot of drugs to control blood pressure during pregnancy, it will make fetal growth retardation in the uterus more occur because of decreased perfusion to the placenta. In addition, pregnant women should be tested for new proteinuria or increased proteinuria along with the progression of hypertension to diagnose preeclampsia or eclampsia as soon as possible. have effective treatment.

3. Hypertension due to pregnancy

Gestational hypertension is diagnosed when maternal hypertension is confirmed after the 20th week of pregnancy, and there are no additional signs of proteinuria or symptoms of prenatal disease. convulsions such as convulsions, stroke or pulmonary edema, and most importantly, the high blood pressure will stop and the mother's blood pressure will return to normal within 3 months of giving birth. Gestational hypertension often leaves complications during pregnancy, especially when hypertension occurs in the first months of pregnancy, with the potential to progress more seriously to hypertensive disease. severe with a blood pressure reading greater than 170/110 mmHg or pre-eclampsia.
Accordingly, pregnant women need to actively treat pregnancy-induced hypertension right from the mild and moderate stages to limit the risk of progression to severe hypertension as well as limit dangerous complications. occurs during pregnancy. Treatment of hypertension due to pregnancy requires antihypertensive drugs and monitoring of proteinuria as well as signs of preeclampsia for timely diagnosis. When the blood pressure readings return to the normal value within 3 months after giving birth, the mother will have an indication to stop taking antihypertensive drugs, otherwise if the hypertension persists, it is possible to stop taking antihypertensive drugs. will continue to monitor and consider the situation that the patient is suffering from chronic high blood pressure before becoming pregnant.
It is necessary to distinguish the symptoms of diseases in gestational hypertension, including chronic pre-pregnancy hypertension and pregnancy-induced hypertension so that the patient's health monitoring as well as the treatment treatment is most effective. When there are any signs of high blood pressure, pregnant women need to immediately go to medical facilities to be examined and diagnosed as soon as possible.

Before preparing to become a mother, people with a medical history, especially high blood pressure and heart disease, should learn carefully about medical knowledge, nutrition suitable for health conditions and diseases. own reason. In addition, it is necessary to regularly visit reputable medical facilities and hospitals for monitoring and advice. If there are unusual symptoms or the disease worsens, it is necessary to quickly go to the hospital for an active treatment regimen.
Not only is an address to provide knowledge and examination before planning to become a mother for women, now Vinmec International General Hospital offers a Package Maternity Care Program for pregnant women right away. from the beginning of pregnancy from the first months with a full range of antenatal check-ups, periodical 3D and 4D ultrasounds and routine tests to ensure that the mother is always healthy and the fetus develops comprehensively. In addition to regular check-ups, pregnant women will also be advised on nutrition and exercise so that the mother can gain weight reasonably while the fetus still absorbs nutrients well.
In particular, with the medical examination and treatment process at Vinmec performed by well-trained obstetricians both at home and abroad, it will soon detect obstetric diseases in the mother or abnormalities in the fetus for early examination and timely treatment.

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