What Risks Exists To Mother & Baby Due To High Blood Pressure?
Her Weight is 110 kgs
Age - 28 years
Blood Group - O Negative
This is second pregnancy. 1st baby was delivered via C Section in December 2013.
She was diagnosed with Gestational Diabetes in March 2018. We do regular check up of Diabetes & mostly it is in range of 140 (fasting) & 200 (PP).
She was given Rhogam Shot at 29 weeks.
Now issue is She is having high Blood Pressure & it is fluctating very much. High blood pressure was first noted on 13.08.2018.
Blood pressure sometimes is 120/90, 130/90, 140/100, 150/100, 160/110, 160/120, 170/110 & 170/120.
Blood pressure readings are taken twice a day. Once in morning & another at night. But my wife feels normal all the time. She does not have any symptom of high blood pressure but readings keep fluctuating.
My Gynaec has given Blood Pressure medicine
Stamlo 2.5 mg. (Amlodipine)
Initially it was once a day in morning but from today she is given twice a day - one at morning & another at night.
I am worried. You are requested to inform the reason of high blood pressure. Is it just like gestational Diabetes (Gestational Hypertension)
So what should be our next step. Is it required to go for C section immediately (although my Gynaec haven't told me anything about that) or wait for some time.
What risks exists to mother & baby due to high blood pressure.
Kindly reply at earliest
Due to pregnancy induced hypertension.
Detailed Answer:
Hello,
I have gone through your query and understand your health concerns ,
The blood pressure readings of your wife are high in spite of taking the medicines regularly. This is due to pregnancy induced hypertension that happens just like GDM and the blood pressure returns to normal soon after the delivery.
The high records of BP reduces the placental blood circulation and can cause a reduced amniotic fluid around the baby and decrease the baby's movements. The chances of having a normal delivery are less than 20%. If the blood pressure levels remain raised then it can cause eclampsia causing convulsions in the mother and affecting the oxygen supply to baby also. It is best to get a cesarean section done if your gynecologist advises you so. After completing 37 weeks it is safe to have a cesarean delivery rather than to take further risk of increased blood pressure.
Regards.
Dr. Rakhi Tayal
Madam thanks for your answer. Her present gestational age as per last period is 35 weeks 4 days. But during last sonography the growth of baby was 5 days ahead of gestational age.
Growth of baby at present is estimated to be 36 weeks 2 days. My Gynaec has advised next USG on 28.08.2018.
I wanted to know what age of pregnancy should be considered 1) as per last LMP or 2) as per growth in sonography report.
Secondly i wanted to know whether my wife should remain active in household work or she takes bed rest. Which one is better for controlling BP.
Thirdly does fluctuation in BP has anything to do with her O Negative Blood group. Means if she is sensitized & due to that blood pressure is fluctuating.
Detail below.
Detailed Answer:
Hello.
Thanks for writing again.
In your wife's case, the growth of baby is ahead of dates calculated by LMP due to the effect of gestational diabetes. The date will be calculated as per LMP.
For controlling BP she needs at least eight hours rest at night and two hours rest in the afternoon in left lateral position and can have a moderate activity during the day. She can go for a walk for half an hour also.
The blood group does not affect the blood pressure levels.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.