What is pregnancy-induced hypertension (PIH)? Pregnancy-induced hypertension (PIH) is a form of high blood pressure in pregnancy. It occurs in about 7 to 10 percent of all pregnancies. Another type of high blood pressure is chronic hypertension - high blood pressure that is present before pregnancy begins. Pregnancy-induced hypertension is also called toxemia or preeclampsia. It occurs most often in young women with a first pregnancy. It is more common in twin pregnancies, and in women who had PIH in a previous pregnancy. Usually, there are three primary characteristics of this condition, including the following:

• high blood pressure (a blood pressure reading higher than 140/90 mm Hg or a significant increase in one or both pressures)
• protein in the urine
• edema (swelling)

Eclampsia is a severe form of pregnancy-induced hypertension. Women with eclampsia have seizures resulting from the condition. Eclampsia occurs in about one in 1,600 pregnancies and develops near the end of pregnancy, in most cases. HELLP syndrome is a complication of severe preeclampsia or eclampsia. 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). What causes pregnancy-induced hypertension (PIH)? The cause of PIH is unknown. Some conditions may increase the risk of developing PIH, including the following:

• pre-existing hypertension (high blood pressure)
• kidney disease
• diabetes
• PIH with a previous pregnancy
• mother's age younger than 20 or older than 40
• multiple fetuses (twins, triplets)
• Why is pregnancy-induced hypertension a concern?
• With high blood pressure, there is an increase in the resistance of blood vessels. This may hinder blood flow in many different organ systems in the expectant mother including the liver, kidneys, brain, uterus, and placenta.

There are other problems that may develop as a result of PIH. Placental abruption (premature detachment of the placenta from the uterus) may occur in some pregnancies. PIH can also lead to fetal problems including intrauterine growth restriction (poor fetal growth) and stillbirth. If untreated, severe PIH may cause dangerous seizures and even death in the mother and fetus. Because of these risks, it may be necessary for the baby to be delivered early, before 37 weeks gestation. What are the symptoms of pregnancy-induced hypertension?

• Blurred Vision
• Fatigue
• Headache
• Nausea
• Swelling in Extremities
• Vomiting
• Weight Gain

How is pregnancy-induced hypertension diagnosed? Diagnosis is often based on the increase in blood pressure levels, but other symptoms may help establish PIH as the diagnosis. Tests for pregnancy-induced hypertension may include the following:

• blood pressure measurement
• urine testing
• assessment of edema
• frequent weight measurements
• eye examination to check for retinal changes
• liver and kidney function tests
• blood clotting tests

Treatment for pregnancy-induced hypertension: Specific treatment for pregnancy-induced hypertension will be determined by your physician based on:

• your pregnancy, overall health and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Can pregnancy-induced hypertension go away? It is typically diagnosed after 20 weeks of pregnancy or close to delivery. Gestational hypertension usually goes away after you give birth. However, some women with gestational hypertension have a higher risk of developing chronic hypertension in the future.