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Features of pregnancy management in hypertension

pregnancy management in hypertensionPregnancy with hypertension is not contraindicated, even if a woman is constantly taking medications to maintain normal blood pressure levels. However, it must be borne in mind that a number of medications are unsafe during gestation, so they must be replaced at the stage of preparation for pregnancy.

In the case of good blood pressure control, the prognosis for pregnancy is favorable.

What examinations does a pregnant woman with hypertension undergo

For women with arterial hypertension, the basic examination protocol does not differ from the standard one.  Additional and mandatory are consultations with a cardiologist and daily monitoring of blood pressure.

The risks of pregnancy with elevated blood pressure

If there is a persistent increase in blood pressure before pregnancy, hypertension is diagnosed.

There are situations when the patient has never had problems with blood pressure before pregnancy, but during pregnancy the pressure begins to rise. An increase in blood pressure before the 20th week of pregnancy indicates the development of gestational hypertension. And if elevated blood pressure levels are detected after 20 weeks of pregnancy, additional tests should be performed to rule out preeclampsia.

Hypertension that exists before pregnancy or first appears during pregnancy is a risk factor for preeclampsia and premature birth. In this regard, additional preventive measures are recommended for pregnant women with an established diagnosis.

Regardless of the time of occurrence, safe and approved medications are used to normalize blood pressure.

Genera

Arterial hypertension is not a direct indication for caesarean section. In the absence of complications, a patient with elevated blood pressure can give birth through the natural birth canal, with mandatory pressure monitoring and with the use of epidural anesthesia.

If obstetric complications develop and blood pressure is not amenable or difficult to correct, a cesarean section is performed in the interests of the patient's health.

Special attention

The main criterion for arterial hypertension is an increase in blood pressure to 140\85 mmHg. However, during pregnancy, blood pressure normally decreases and already at numbers from 130\85 Mhg, hypertension can be expected to develop.

It is very important for a pregnant woman to self-monitor blood pressure in situations of worsening well-being: headaches, nausea, decreased visual acuity, dizziness, etc. In case of any deviations from the norm, it is necessary to consult your doctor.

General recommendations

The effectiveness of medical care largely depends on its timeliness.

If a woman suffers from hypertension and is planning pregnancy, she should consult a doctor before conception to determine the possibility and safety of pregnancy. At the stage of preliminary preparation, the doctor will draw up an individual examination plan, suggest preventive measures, select a safe antihypertensive drug and give advice on lifestyle and nutrition normalization. 

Advantages of contacting the EMC

  • An international team of doctors. Obstetricians and gynecologists who have worked in the best perinatal centers in Europe, the USA and Israel.
  • Specialists with 20-30 years of experience.
  • Pregnancy management and childbirth of any complexity.
  • The comfort and pleasure of your stay.
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I’ve had a tumor in the lower part of my right breast and a metastasis in the left lymph node removed in 2011. I then had a recurrence in the upper quadrant of the right breast. But the doctors didn’t immediately react to this, even though I told them that I was experiencing some discomfort. After this I had biopsies
under ultrasound guidance at several medical centers, but I keep getting a completely different diagnosis everywhere I go. I still haven’t received any treatment. Test results are good. The metastasis is not growing but just sitting there. They’ve suggested a mastectomy. What’s the point? I don’t want to undergo chemotherapy. I’m on a raw food diet. I don't know what to do. I wish at least one of the diagnoses was confirmed. I want to be sure that I’m getting the right treatment. Because it’s the doctors that have brought me to this situation, even though I’ve had regular screenings for the past 25 years.
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Before answering any questions regarding treatment, it is necessary to carry out a successful biopsy under ultrasound or X-ray guidance, to obtain multiple tissue samples (not cells) with subsequent histological and immunohistochemical analysis. Only then can we discuss a specific treatment plan! In any case, EMC
staff are always ready to provide advice and carry out the necessary diagnostic tests. Best regards, Irina Vassilieva — M.D, radiologist, Head of EMC Breast Clinic
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