Hypertension in pregnancy is generally defined as hypertension that is present either before the pregnancy or hypertension that is diagnosed before the 20th week of gestation.
Hypertension which is diagnosed prior to pregnancy is sometimes called “chronic hypertension.” Hypertension which occurs prior to the 20th week of gestation is also sometimes called “pregnancy induced hypertension.”
Hypertension is generally defined as a blood pressure greater than 140 mm Hg systolic or 90 mm Hg diastolic. This distinction is very important, since many patients may exhibit elevations in only their systolic or diastolic readings and mistakenly conclude that they do not have hypertension. If either the systolic or diastolic readings are elevated, as confirmed by repeat blood pressure assessments, prompt medical attention should be obtained.
Once hypertension in pregnancy is diagnosed, a safe and careful obstetrician or obstetrical nurse will typically take serial blood pressure measurements throughout the course of the pregnancy. In more severe cases, additional testing will be performed, including blood and urine analyses, which aid in the determination of the severity of the hypertension.
In those cases in which hypertension in pregnancy is moderate to severe, a safe and careful obstetrician may prescribe antihypertensive therapy using various types of blood pressure medications. Many obstetricians also prescribe diuretics, medications intended to reduce fluid retention by increasing the secretion of urine.
In addition to carefully monitoring and treating a patient with hypertension in pregnancy, safe and careful obstetricians will typically initiate a regimen of fetal surveillance in patients who have hypertension in pregnancy.
Such fetal surveillance may consist of ultrasonography, serial nonstress testing or biophysical profile testing.
It has long been recognized that undiagnosed or untreated hypertension in pregnancy is associated with potentially severe outcomes for both mother and baby.
In particular, untreated or uncontrolled hypertension in pregnancy is associated with maternal pre-eclampsia and placental abruption.
Undiagnosed or untreated hypertension in pregnancy is also associated with an increased risk of preterm fetal delivery, low birth weight babies or babies who suffer from intrauterine growth restriction (IUGR).
It is generally recognized that the incidence and degree of these adverse maternal and fetal outcomes is directly related to the extent and duration of the hypertension during pregnancy.
Because of the risks associated with moderate to severe hypertension in pregnancy, many safe and careful obstetricians will deliver their patients prior to term.
The Law Firm of Dugan, Babij, Tolley & Kohler, LLC has extensive experience in representing families whose loved ones have died or been injured as a result of medical malpractice associated with the management of patients with hypertension in pregnancy.