Explain Hypertensive Disorders of Pregnancy?
Hypertension may have been existing before pregnancy. Alternatively, a mother may develop hypertension during pregnancy, a pregnancy-induced hypertension (PIH) which presents a serious complication. The cardinal symptoms are: hypertension, proteinuria and oedema, which usually occur after the 20th week of pregnancy. The onset of PIH may be signalled by unusual weight gain within a few days. Studies show that PIH incidence is higher in very young mothers (< 20 years) or older mothers (>35 years), mothers who are underweight and whose nutritional status is poor (including deficits in energy, protein, vitamins and minerals), in those who have pre-existing vascular disease e.g. essential hypertension, type I diabetes mellitus or a familial predisposition.
Several nutrients have been studied for their role in PIH. These include protein, sodium, calcium and zinc. Incidence of PIH is greater among underweight women who fail to gain weight normally during pregnancy. Research evidence therefore indicates that an optimal and regular pattern of weight gain is vital to support the pregnancy.
Of course, prevention is best. However, if PIH develops, we need to advise the mother to have a well-balanced nutritious diet with sufficient energy and protein. Sodium intake can be 2-3 g since dietary sodium intake should be moderate but sodium restriction does not cure the syndrome. Maintenance of good nutritional status is important. Mothers should be aware and careful since severe PIH can cause convulsions and can prove to be life-threatening. Next, let us review pregnancy and diabetes mellitus.