Are you struggling with the daunting task of writing a thesis on hypertension in pregnancy?

You're
not alone. Crafting a well-researched and comprehensive thesis on such a complex medical topic
requires not only extensive knowledge but also impeccable writing skills and a significant amount of
time and effort.

Writing a thesis on hypertension in pregnancy entails delving deep into medical literature, analyzing
data, interpreting findings, and presenting coherent arguments backed by evidence. It involves
meticulous attention to detail, critical thinking, and the ability to synthesize information from various
sources.

Moreover, the pressure to produce original and impactful research can add to the already existing
challenges. As a result, many students find themselves overwhelmed and unsure where to begin.

That's where ⇒ HelpWriting.net ⇔ comes in. Our team of experienced academic writers
specializes in medical and healthcare-related topics, including hypertension in pregnancy. With their
expertise and dedication, they can assist you in crafting a high-quality thesis that meets the academic
standards and exceeds expectations.

By entrusting your thesis to ⇒ HelpWriting.net ⇔, you can alleviate the stress and uncertainty
associated with the writing process. Our professionals will work closely with you to understand your
requirements and objectives, ensuring that the final product is tailored to your specific needs.

Don't let the difficulty of writing a thesis on hypertension in pregnancy hold you back. Take
advantage of our services at ⇒ HelpWriting.net ⇔ and embark on your academic journey with
confidence. Reach out to us today to learn more about how we can help you succeed.
Initial evaluation includes 24-hour urine collection to confirm the absence of significant proteinuria
and serum laboratory evaluation to evaluate hepatic transaminases, creatinine, hematocrit, platelets,
and lactic acid dehydrogenase. Secondly, high levels of blood pressure in pregnant women have a
negative effect on the foetus: an increased risk for the placenta, the risk of endometrial bleeding,
and the onset of massive postpartum haemorrhage. Women with severe gestational hypertension,
however, are at increased risk of adverse outcomes, including preterm birth, intrauterine growth
restriction, and placental abruption. Factors that may contribute to the development of chronic
hypertension are derangements in sympathetic neural activity or angiotensin II activity. Blood
pressure should be measured in both arms with the patient in a sitting position and the arm at the
level of the heart, and multiple measurements should be obtained on different occasions. It has been
estimated that 10-15% of pregnancies will be complicated by hypertension. Hemolytic anemia may
occur in these patients and is an indication to stop the medication. Hypertension triggered by
pregnancy can lead to an array of complications. In support of this theory, cultured trophoblasts
exposed to a hypoxic environment release a variety of potentially vaso-active factors, including
thromboxane, interleukin-1, and tumor necrosis factor. Social Posts Create on-brand social posts and
Articles in minutes. By using this service, you agree that you will only keep content for personal use,
and will not openly distribute them via Dropbox, Google Drive or other file sharing services.
Considering her past obstetric track record, she tied the knot in 2011 when she was just 21 years old
and is currently experiencing her maiden pregnancy. No palmar erythema or peripheral cyanosis and
clubbing were present. The Magpie Trial: A randomized placebo-controlled trial. On the other hand it
does not produce liver damage and no thrombocytopenia (decreased platelet count). This protein
adheres to placental growth factor and vascular endothelial growth factor (VEGF), preventing their
interaction with endothelial receptors and causing endothelial dysfunction. The fetal back was
positioned on the mother's left side and the fetal head was not engaged. Had chronic high blood
pressure or chronic kidney disease before pregnancy ii. A decrease of 10 mm Hg in mean arterial
pressure was associated with a decrease of 145 g in mean. In addition, unique forms of hypertension,
gestational hypertension and preeclampsia, occur only during pregnancy. HELLP syndrome is a
group of physical changes including the breakdown of red blood cells, changes in the liver and low
platelets (cells found in the blood that are needed to help the blood to clot in order to control
bleeding ). It was found that a number of factors, like obesity, hypertension, abnormal insulin
resistance, inflammation, cardio-vascular risk factors (as measured by serum levels of triglycerides,
cholesterol, low density lipoprotein cholesterol, non-high density lipoprotein cholesterol, and blood
pressure), increased Homocysteine, presence of periodontal disease among others, were observed in
preeclamptic pregnancy. TABLE 2 shows the criteria for diagnosing preeclampsia with. If expectant
management is undertaken after 37 weeks, the patient should understand that the only known benefit
is a possible reduction in the rate of caesarean birth. More Features Connections Canva Create
professional content with Canva, including presentations, catalogs, and more. Had high blood
pressure or preeclampsia in a previous pregnancy iii. Optimal management requires an appreciation of
the complexity of the disease process and familiarity with its manifestations in multiple organ
systems. Maternal and fetal risks and benefits must be assessed thoroughly. Because the risks of the
regimen are few, some physicians may reasonably choose to use it. The fetal prognosis in eclampsia is
poor because of hypoxia and consequent fetal acidosis. Articles Get discovered by sharing your best
content as bite-sized articles.
Applied to the theory under discussion, this suggests that some genetically determined paternal
antigens are less antigenic than others and therefore less likely to provoke an antibody response in an
exposed mother, decreasing maternal production of “blocking” antibodies and increasing the
likelihood of abnormal placental invasion and preeclampsia. Reasons for this induction are full-term
pregnancy and a necessity to reduce high blood pressure that can be caused by pregnancy.
Endothelial cell injury exposes subendothelial collagen and can trigger platelet aggregation,
activation, and release of platelet-derived thromboxane A 2 (TXA 2 ), a potent vasoconstrictor and
stimulator of platelet aggregation. These finding need not be considered as clinically serious with
respect to their inherent nature. Pain control is achieved with regional anesthesia or with
intramuscular or IV narcotic analgesics. All of these changes increase the workload on the heart and
blood vessels of pregnant women, which could lead to hypertension. Circulating angiogenic factors
and the risk of preeclampsia. Depending on disease severity, effects of previous therapy, and other
factors, preeclampsia has been described variously as a state of abnormally high cardiac output and
low systemic vascular resistance, a state of abnormally low cardiac output and high systemic vascular
resistance, or a state of high cardiac output and high systemic vascular resistance. Nephropathy,
Rennin Producing Tumors, Hydronephrosis, Polycystic Kidneys. This leads to the release of
antiangiogenic factors and inflammatory mediators. The National Institute of Child Health and
Human Development Network of Maternal-Fetal Units. Magpie Trial Collaboration Group. Lancet.
2002;359:1877-1890. Eclampsia is characterized by new-onset tonic-clonic, focal, or multi-focal.
Occasionally, authors may express opinions that represent their own viewpoint. Labetalol can be
given intravenously or Hydralazine IV or IM can be given. Pathophysiology and the effect of
hypertension on the placenta Hypertension and maternity diabetes are the pregnancy complications
that are known to be significantly reflected in the placenta both by using the microscope and without
using it. African-American citizen suffering from hypertension. She has not encountered inter-
menstrual bleeding or bleeding after intercourse. Decreased prostacyclin production by dysfunctional
endothelial cells and increased TXA 2 release by activated platelets and trophoblast may be
responsible for reversal of the normal ratio of prostacyclin and TXA 2 observed in preeclampsia.
Impact of high-dose corticosteroid therapy for patients with HELLP (hemolysis, elevated liver
enzymes, and low platelet count) syndrome. Have obesity v. Are over age 40 vi. Are pregnant with
more than one baby vii. Women destined to develop preeclampsia do not exhibit normal
refractoriness to endogenous vasopressors. Absent peripheral pulses suggest coarctation of the aorta.
With high blood pressure, there is an increase in the resistance of blood vessels. If this is the first time
you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Hypertension is one of the major risk factors for coronary heart disease, hemorrhagic. However, it's
important to recognize that there can be risks linked with inducing labor. Unfortunately, the benefit
of maternal blood pressure control appears to be limited to preventing maternal morbidities and does
not appear to extend to reducing the risk of these obstetric complications. These broad categories
have some value in estimating risk. As for her personal and social background, she lives with her
student husband in Taman Jalan Abdullah.
Individualized treatment plans should be formulated and discussed with the patient, and she should
be encouraged to participate in major decisions regarding her care. Elliot, 2007). In other cases,
patients may have developed hypertension disease as a result. The National High Blood Pressure
Education Program Working Group stated that edema occurs too frequently in normal pregnant
women to be a useful marker in the diagnosis of preeclampsia. Decreased prostacyclin production by
dysfunctional endothelial cells and increased TXA 2 release by activated platelets and trophoblast
may be responsible for reversal of the normal ratio of prostacyclin and TXA 2 observed in
preeclampsia. Centrilobular necrosis may result from reduced perfusion. African-American citizen
suffering from hypertension. Labetalol can be given intravenously or Hydralazine IV or IM can be
given. This may hinder blood flow in many different organ systems in the expectant mother
including the liver, kidneys, brain, uterus, and placenta. A comprehensive check-up did not uncover
any considerable health issues, with no signs such as headache, nausea, vomiting or vision
disturbances that might be associated with hypertensive heart disease present. In the presence of
patellar reflexes, serum magnesium levels usually are unnecessary. The usual starting dose is 100 mg
twice per day (BID), and the dose can be increased weekly to a maximum of 2400 mg daily. This
early maturing occurs when blood vessels in placenta are damaged by the high blood pressure. In
fact, the majority of women tend to have successful pregnancies without too many complications.
However, the frequency distribution is bimodal, with a second peak occurring in multiparous women
greater than 35 years of age. Because the risks of the regimen are few, some physicians may
reasonably choose to use it. Delivery is indicated if the cervical status becomes favorable, antepartum
testing is abnormal, the gestational age reaches 40 weeks, or evidence of worsening preeclampsia is
seen. By using this service, you agree that you will only keep content for personal use, and will not
openly distribute them via Dropbox, Google Drive or other file sharing services. Unfortunately, the
benefit of maternal blood pressure control appears to be limited to preventing maternal morbidities
and does not appear to extend to reducing the risk of these obstetric complications. A sufficient
amount of blood is required to be circulated to the placenta. Changes in the prevalence of chronic
hypertension in pregnancy, United States, 1970 to. With eclampsia, the maternal mortality is high
from cause such as cerebral hemorrhage, circulatory collapse or renal failure. Therefore,
antihypertensive medication is not usually necessary. In addition, unique forms of hypertension,
gestational hypertension and preeclampsia, occur only during pregnancy. Some reports suggest that
endothelial damage in preeclampsia results in decreased endothelial production of prostaglandin I 2
(prostacyclin), a potent vasodilator and inhibitor of platelet aggregation. Sometimes the highly
undesirable degree of arterial hypertension requires the termination of pregnancy. Contemporary
concepts in the pathogenesis and management of preeclampsia. Cardiac output and renal blood flow
increase significantly. A comparison of magnesium sulfate with phenytoin for the prevention of
eclampsia. These finding need not be considered as clinically serious with respect to their inherent
nature. Resources Dive into our extensive resources on the topic that interests you.
According to the Mayo Clinic, high blood pressure decreases this amount of blood flow which
restricts the nutrients to travel through the placenta, and as a result foetal growth is limited and falls
back leading to possible low birth weight in a child. The resultant decrease in intravascular colloid
oncotic pressure contributes to further loss of intravascular fluid. As a result there is a decrease in the
arrival of food and oxygen to the baby that prevents adequate intrauterine growth, favors a decrease
in the volume of amniotic fluid, and in extreme cases can cause abruptio placenta, associated with
many risks in the baby's health. If possible, a 10- to 20-minute period of in utero resuscitation should
be permitted before delivery. Other studies have estimated that seventy per cent of the extra foetal
deaths in women with hypertension are as a result of large placental infarctions, noticeably small
placental size10. Importantly, these changes are attributed to abnormal endovascular trophoblastic
invasion during the second trimester of pregnancy, predisposing the fetus to suboptimal placental
perfusion early in gestation. Embed Host your publication on your website or blog with just a few
clicks. Norwitz, Louise C. Kenny and Philip N. Baker By Ian Crocker and Alexander Heazell Show
author details. The baby was a singleton with a longitudinal lie and cephalic presentation.
Interestingly, the clinical manifestations are observed most often in the third trimester, possibly due
to increasing fetal and placental oxygen demands with advancing gestation. Hypertension is
generally moderate, and no increase in uric acid levels. Women who have undergone multiple
pregnancies are more compromised with hypertension. With eclampsia, the maternal mortality is high
from cause such as cerebral hemorrhage, circulatory collapse or renal failure. In general, this disease
is characterized in that the patient knows their disease earlier, has several pregnancies and because
hypertension persists after delivery. Because the risks of the regimen are few, some physicians may
reasonably choose to use it. A woman has passed into this stage when cerebral edema is so acute that
seizure or coma occurs. The cardiovascular system of pregnant women undergoes changes. Women
with severe gestational hypertension, however, are at increased risk of adverse outcomes, including
preterm birth, intrauterine growth restriction, and placental abruption. Low-dose aspirin did not
reduce the incidence of preeclampsia in this high-risk population. Discussing her earlier
gynaecological history, she began menstruating at the age of 13 with cycles regularly lasting between
five to six days every four to five weeks interval. ACEIs and ARBs are contraindicated in pregnancy
due to their increased risk of fetopathy, a disease or disorder in the fetus. If a. In another subset of
patients, reduced placental oxygenation late in pregnancy may be the result of abnormal
endovascular trophoblast invasion early in pregnancy. Blood pressure should be measured after 10
minutes of rest, sitting with inflatable handle tensiometer at heart level. However, it can sometimes
cause severe health complications for both the mother and developing baby. Adobe Express Go from
Adobe Express creation to Issuu publication. To avoid progression of the disease to eclampsia,
hydralazine, nifedipine, and labetalol may be prescribed to reduce hypertension. Under such
conditions, babies require special care during the neonatal period14. Immunoglobulins, complement,
fibrin, and fibrin degradation products have been observed in the glomeruli, but their presence is
variable. CLASP: A randomized trial of low-dose aspirin for the prevention and treatment of pre-
eclampsia among 9364 pregnant women. The umbilicus was centrally located and flat, with no
dilated veins or surgical scars.
Calcium supplementation during pregnancy has been proposed as a means to prevent preeclampsia.
In her family, there's no record of twins or inborn disorders. The manifestations are the same
accompanied by seizures. Another reason is the gradual increase in weight of the pregnant woman.
This is usually indicative of pregnancy induced hypertension. The predominance of TXA 2 may
contribute to the vasoconstriction and hypertension that are central features of the disorder. Fever,
liver function abnormalities, granulocytopenia, and thrombocytopenia are rare side effects.
Derangements in any of these serum laboratories would be indicative of a diagnosis of preeclampsia
as opposed to gestational hypertension. African continent to have the highest level of hypertension
prevalence with over 46% of the. When high blood pressure is identified in pregnant women during
prenatal examinations, it's crucial to consider PIH as a potential cause. There appears to be a genetic
component in that hypertension is more common in individuals with a family history of
hypertension. During pregnancy a woman's body adjusts to the new conditions of functioning, which
include life support and development of the foetus. Treatment and prevention of hypertension during
pregnancy Treatment of hypertension during pregnancy is a difficult and responsible task. District I
ACOG Medical Student Education Module 2011. To avoid progression of the disease to eclampsia,
hydralazine, nifedipine, and labetalol may be prescribed to reduce hypertension. The decision to
proceed with immediate delivery versus expectant management is based on several factors, including
disease severity, fetal maturity, maternal and fetal condition, and cervical status. On one end of the
spectrum is the patient with hypertension that was present before pregnancy (or was recognized
during the first half of pregnancy), does not worsen appreciably during pregnancy, and persists after
delivery. Blood pressure normally decreases throughout the first half of pregnancy under the
influence of progesterone, reaching a nadir in midpregnancy and returning to prepregnancy levels by
the end of the third trimester. Thereafter, continued expansion of intravascular volume leads to a
gradual rise in the blood pressure to prepregnancy levels by term. She made it a point to attend all
scheduled prenatal appointments without any complications. Detailed discussion of these and other
possible etiologies of the entity of preeclampsia are beyond the scope of this chapter. Corticosteroids
are administered if the gestational age is. Published experience with these agents is limited, and they
should not supplant methyldopa, labetalol, or nifedipine as first-line agents in pregnancy. According
to the Mayo Clinic, high blood pressure decreases this amount of blood flow which restricts the
nutrients to travel through the placenta, and as a result foetal growth is limited and falls back
leading to possible low birth weight in a child. So foetal hypoxia is also result due to enate
vasospasm. If there are reasons to believe the fetus may not survive, then expectant management is
not advised and delivery should. Several small trials of low-dose aspirin reported significant
reductions in the incidence of preeclampsia in high-risk populations. Excellent gynaecologists can be
found at Kingsway Hospitals, Nagpur. Some studies of the present time have shown and
demonstrated the clear relationship between retarded foetal growth and the combined placental
mosaicism9. The highest risks are associated with preeclampsia or eclampsia.
Eclampsia is characterized by new-onset tonic-clonic, focal, or multi-focal. Considering her past
obstetric track record, she tied the knot in 2011 when she was just 21 years old and is currently
experiencing her maiden pregnancy. Obstet gynecol 2013,122:1122-31 The Executive summary is
concise and worth reading. These are just simple interventions but could create a dramatic effect
when applied properly. No palmar erythema or peripheral cyanosis and clubbing were present. Fall in
mean arterial pressure and fetal growth restriction in pregnancy hypertension: a. So foetal hypoxia is
also result due to enate vasospasm. A sufficient amount of blood is required to be circulated to the
placenta. Definition of hypertension in pregnancy Hypertension is a condition characterized by a
persistent increase in the level of blood pressure. Methyldopa has been studied extensively and is
recommended by many as the first-line antihypertensive agent in pregnancy. QR Codes Generate QR
Codes for your digital content. Prevention of preeclampsia with low-dose aspirin in health,
nulliparous pregnant women. She revealed no signs of discomfort or breathing problems. The
patient's body mass was average, and she displayed good hydration and nutritional status clinically.
These finding need not be considered as clinically serious with respect to their inherent nature. The
potential for labor induction is also being explored. Townsend, 2006). Thus, it is vital for the health
care providers to understand the culture. Transaminase levels are elevated, thrombocytopenia is
present, and DIC may be evident. Immunoglobulins, complement, fibrin, and fibrin degradation
products have been observed in the glomeruli, but their presence is variable. The patient denies
having any past episodes of primary hypertension and there are no instances of hypertension
documented in her familial lineage. Moreover, serum from preeclamptic women, when applied to
human endothelial cell cultures, alters the release of a variety of procoagulant, vasoactive, and
mitogenic factors, including endothelin, nitric oxide, and prostacyclin. This might be attributed to
the fact that the elevated blood pressure was relatively mild and only presented itself late in the
pregnancy, thereby reducing potential complications. Contemporary concepts in the pathogenesis and
management of preeclampsia. However, this approach may not be in the best interest of the fetus.
They may be disoriented and at times become unconscious. Elliot, 2007). In other cases, patients
may have developed hypertension disease as a result. It is mild or moderate, without proteinuria and
disappears after delivery. Have obesity v. Are over age 40 vi. Are pregnant with more than one baby
vii. This protein adheres to placental growth factor and vascular endothelial growth factor (VEGF),
preventing their interaction with endothelial receptors and causing endothelial dysfunction. These
divergent observations underscore the complexity of the disorder. In fact, when GA at birth is
considered, a high rate of SGA infants was found and then either premature birth or restriction of
growth within the womb or a combination thereof are responsible for the noticeably low birth weight.