Gestational hypertension
Classification according to ICD-10 | |
---|---|
O13.- | Gestational hypertension [pregnancy-induced] without significant proteinuria |
O14.- | Gestational hypertension [pregnancy-induced] with significant proteinuria |
ICD-10 online (WHO version 2019) |
As a pregnancy-induced hypertension , gestational or gestational hypertension is defined as the occurrence of a significant increase in blood pressure during pregnancy .
to form
One differentiates:
- Gestational hypertension with no protein in the urine ( proteinuria )
- Gestational hypertension with proteinuria and possible edema formation = preeclampsia .
Preeclampsia can result in eclampsia and HELLP syndrome .
To be distinguished are one
- pre-existing arterial hypertension that causes problems (ICD-10: O10.-)
- pre-existing hypertension with newly developed proteinuria = graft preeclampsia (ICD-10: O11)
Pregnancy hypertension is one of the most common pregnancy complications, accounting for 30% of perinatal mortality ( infant mortality during childbirth) and 20% of maternal mortality .
Symptoms
Those affected have the typical symptoms of high blood pressure. These include headaches or pressure, visual disturbances, dizziness and nausea. Furthermore, increased urine excretion can occur due to the increased vascular pressure. The often mentioned edema formation is no longer seen as a characteristic symptom of a pregnancy disorder, as water retention occurs in almost all pregnancies. Gestational hypertension manifests itself from the beginning of the 20th week of pregnancy and should have resolved no later than 12 weeks after delivery.
Epidemiology
Gestational hypertension develops in about 25% of all pregnancies and occurs almost exclusively in primiparous women. Chronic high blood pressure develops in around 15% of affected mothers after pregnancy.
etiology
The main causes of gestational hypertension are the increase in blood in the maternal circulation of around 40% during pregnancy and the change in maternal metabolism. However, these causes have not yet been scientifically proven.
Diagnosis
The actual diagnosis is carried out through regular blood pressure checks as part of the gynecological prenatal care and through the self-observation of the pregnant woman. If symptoms occur or if blood pressure with values above 140/100 mmHg is measured continuously, gestational hypertension can be assumed. One speaks of a severe expression with blood pressure values of over 160/110 mmHg.
therapy
Gestational hypertension can only be treated symptomatically. Bed rest and physical rest, as well as a balanced diet geared towards pregnancy, are the means of first choice for mild hypertension. In severe cases or with persistent high blood pressure, drug therapy with methyldopa , beta blockers or dihydralazine can be initiated.
course
The course of a mild gestational hypertension is usually uncomplicated and does not pose any risk to the fetus. Dangers exist if further complications develop from simple high blood pressure, such as eclampsia .
forecast
With good monitoring and education of mothers, gestational hypertension rarely has serious effects on pregnancy and childbirth. The medical options also allow the blood pressure to be lowered early, so that the risk of premature birth or deficiency in the child due to insufficient nutrient intake is significantly reduced.
Web links
- AWMF guidelines: Hypertensive pregnancy diseases: diagnosis and therapy. Retrieved February 9, 2016 .