Pregnancy induced hypertension is defined as elevated blood pressure during pregnancy. It includes preeclampsia, eclampsia, and transient hypertension (high blood pressure that occurs only during the pregnancy). Hypertension is usually defined as blood pressure readings of over 140/90, although this may vary depending on your baseline (normal) blood pressure. With preeclampsia, you may also have edema (swelling in the tissues, especially the hands and feet), and protein in the urine. Preeclampsia occurs in 3-6% of pregnancies in the U.S.

The causes of preeclampsia are not known. There may be genetic, immunologic (related to your immune system), hormonal, nutritional or infectious influences that produce the disease. Preeclampsia is also associated with the following:

• first pregnancy or more than 5 pregnancies
• age of mother under 20 or over 30
• pre-existing heart disease, diabetes mellitus, essential hypertension,
  kidney disease, autoimmune or collagen disease
• history of poor nutrition
• multiple pregnancy

Signs and symptoms include unusual or rapid weight gain and edema (swelling from increased fluids in your body), protein in the urine, increased blood pressure (especially the diastolic, or bottom number). There may also be changes in kidney and liver function, blurred vision, and increased reflexes. Your doctor may do several tests to see if you have this condition. These might include taking blood, checking your urine, or getting an EKG (an electrical reading of your heart). Your doctor may also do an ultrasound or other tests to see how the baby is doing.

The treatment you will receive depends on the severity of your preeclampsia. Delivery of the baby can cause blood pressure to return to normal. If the baby is immature, it may not be a good idea to induce delivery. You may be asked to rest in bed more often, possibly on your left side to prevent compression of the major blood vessel (vena cava) which brings blood back to the heart and improves blood flow. Your doctor may suggest that you do not add salt to your foods. There are medicines to help decrease your blood pressure. You may be treated as an outpatient and can stay at home, or your doctor may want to admit you to the hospital to better monitor your condition. If you are at 37 weeks or more, your doctor may choose to induce labor (starting labor before you start labor on your own). If your condition becomes severe, you may be treated with a medicine to prevent seizures). If you do have a seizure, your diagnosis will be called eclampsia, and it is highly likely that labor will be induced or a Cesarean Section will be done once your condition is stabilized.

For more information on these diagnoses, see Chism, D. (1997). The high-risk pregnancy sourcebook. Lowell House.