Pregnancy Induced Hypertension

Mamas on Bedrest: Take a Look at the HealthTap App

June 5th, 2013

It’s Video Wednesday!

This week, I am taking a look at the HealthTap App. As you will recall from the last blog entry, HealthTap is a health information website that provides health information, tips and breaking health information. The site boasts some 40,000 physician experts from all 50 states and 128 specialties. HealthTap has just rolled out its new App and now consumers can have the convenience of health information at their fingertips.

The App is more than just an encyclopedia of health information. It is a way for consumers to store and track their own health information. This morning, I downloaded the app onto my iPad. The App then guided me through the registration process and enabled me to input personal information and preferences. I was able to “follow” doctors whose work I highly respect and often cite in my blogs and other educational information. I can contact my own gynecologist (who is a participating physician), ask questions of other physicians and get feedback on lab information, tests and other health inquiries.

I have to say that I barely scratched the surface of the HealthTap App. I am sure that it has many more functions that I have yet to discover. But I found it really easy to use, easy to read and easy to input and save my information. I think that this app may be a handy way for Mamas on Bedrest to chart their bed rest progress. In particular, when I think of mamas with cervical insufficiency, each time you go to the OB, you can chart your cervical measurements and keep track. If you have pregnancy induced hypertension or pre-eclampsia, you can track your blood pressures and/or urine proteins (if your OB has you doing urine dip sticks). And this tool is useful after your pregnancy as well; helping you to chart breastfeeding, weight loss, exercise, sleep, and other health indices.

Give it a shot. It’s free and fun (The Geek in Me was quite giddy playing with this!!).

 

Mamas on Bedrest: Pre-Eclampsia…More than Pregnancy Induced Hypertension

May 8th, 2013

Pre-Eclampsia is a leading cause for which women receive the bed rest prescription. Bedrest Coach Darline Turner shares the definition of pre-eclampsia, how it is diagnosed, how it is treated and what Mamas on Bedrest can do to care for themselves and partner in their health care if they are diagnosed with Pre-eclampsia. For more information, see our previous blog posts on Pre-Eclampsia or send e-mail us at info@mamasonbedrest.com.

May is National Pre-Eclampsia Awareness Month. Viacord, a cord blood bank company, is planning and supporting activities to benefit the Pre-Eclampsia Foundation.  The Campaign is called the “Aware Because I Care” Campaign and it is a month long initiative to raise funds for the Pre-Eclampsia Foundation. They are accepting donations of $10, collecting and donating up to $10,000. The funds will be used for Pre-Eclampsia patient education, medical research and direct support for women with the disorder. Learn more about the #awarebecauseicare campaign here.

Mamas on Bedrest: An Update on Pre-Eclampsia

November 26th, 2012

Pre-Eclampsia is one of the leading reasons that mamas are prescribed bed rest. Overall, hypertensive disorders (high blood pressure) during pregnancy account for 11% of pregnancy related deaths during pregnancy according to the US Centers for Disease Control and Prevention. Clearly, early recognition and treatment of pre-eclampsia are essential for the health and well being of both mamas and babies. Here, we give a review of pre-eclampsia and some of the latest information and treatments available.

Overview

Definition-Pre-Eclampsia is defined as blood pressure > 140/90 mmHg on at least 2 occasions 6 hours apart and protein in the urine (>300mg in a 24 hr period). Pre-Eclampsia is also associated with facial and extremity swelling and in severe cases, kidney failure and grand mal seizures.

Presentation-Pre-Clampsia typically presents after 20 weeks gestation and is often asymptomatic at diagnosis. It can occur in the new first time mother as well as in a “veteran” mama. It presents in singleton pregnancies as well as in multiple gestations. There is no particular presentation or no particular type of mama who will develop pre-eclampsia. What is known is that women with pre-existing conditions such as high blood pressure, cardiovascular disease, diabetes, kidney disease, or clotting/blood disorders are at increased risk of developing pre-eclampsia. Pre-eclampsia is also more common in women with multiple gestations (Twins or more) and older mamas. The wild card is obesity. Some studies have shown that mamas who enter pregnancy overweight or obese increase their risks of developing pre-eclampsia. Other studies have not been conclusive. Currently obesity is not considered an absolute risk factor for pre-eclampsia, but given its negative effects on other aspects of mama’s health and hence baby’s health, obese mamas should be watched closely.

Pre-Eclampsia is classified as mild or severe and treatment is guided depending on the severity. Mild pre-eclampsia is defined as hypertension (BP >140/90 mmHg) on two occasions at least 6 hours apart, but without evidence of end-organ damage (kidney disease inparticular). Severe pre-eclampsia may include an array of signs and symptoms and significant laboratory findings. At least one of the following signs or symptoms must be present with the indicators of pre-eclampsia for the condition to be regarded as severe. Severe Pre-Eclampsia is a medical emergency and must be treated immediately, typically by immediate delivery of the infant so as to save the life of both mama and infant.

Symptoms of Severe Pre-Eclampsia

Neurological: blurred vision, severe headache, altered mental status, stroke, seizures

Liver Damage: Right Upper Quadrant abdominal pain, elevated liver enzymes indicating liver damage (Precursors to HELLP Syndrome, Hemolysis, Elevated liver enzyme levels, low platelet count)

Kidney: Protein in the urine, decreased urine output, dark urine

Pulmonary Edema: Fluid in the lungs

Fetal: Intrauterine Growth Retardation

Blood Disorders: Increase in blood clotting, Low platelet count

Treatment of Pre-eclampsia

As previously stated, severe pre-eclampsia and pre-eclampsia that has progressed to organ damage or HELLP Syndrome is a medical emergency and must be treated aggressively in the hospital setting. Mild pre-eclampsia can be treated with bed rest and medication with close watch for development of symptoms indicating progression to a more severe form.

Medications

Magnesium Sulfate-Magnesium sulfate is considered first-line treatment for the prevention of primary and recurrent eclamptic seizures. It is also utilized for prophylactic treatment in all patients with severe preeclampsia.

Anti-Hypertensive (high Blood Pressure)Medications – Medications known to decrease blood pressure but found to be safe in pregnancy are Hydralazine, Labetalol, Nifedipine, Nicardipine and Sodium Nitroprusside.

Aspirin Therapy – Low dose aspirin therapy is controversial in the treatment of pre-eclampsia. While an individual study was unable to prove benefit for using low dose aspirin therapy as a preventive for pre-eclampsia, a meta-analysis of several studies found that using low dose aspirin starting before 16 weeks of gestation and continuing throughout pregnancy. Currently, low dose aspirin therapy is not recommended as a preventive treatment for pre-eclampsia. Physicians and researchers are still trying to determine which women are at greatest risk for developing pre-eclampsia and which women will benefit from low dose aspirin therapy.

References:

Pre-Eclampsia Revisited. Tammy D. Hart, BS, PharmD, Martha B. Harris, BS, PharmD. November 20, 2012.

US Pharmacist. 2012;37(9):48-53. © 2012  Jobson Publishing

Aspirin in the prevention of pre-eclampsia in high risk women: a randomised placebo controlled PREDO trial and a meta analysis of randomised trials. Villa, P., Kajantie, E., Räikkönen, K., Pesonen, A.-K., Hämäläinen, E., Vainio, M., Taipale, P., Laivuori, H. and on behalf of the PREDO Study group (2012).  BJOG: An International Journal of Obstetrics & Gynaecology. doi: 10.1111/j.1471-0528.2012.03493.x