check-ups include: edema assessment (may be normal during pregnancy), BP measurement, urinalysis, cell blood count, and kidney and liver function tests. The baby's growth and development must also be monitored, by assessing its size and movements, as well as by ultrasound examination of umbilical and uterine arteries and of fetal heartbeats. Delivery will need to be assisted by a medical team comprising specialists in obstetrics and gynecology, kidney disease, intensive care, and newborn care.
The treatment of PIH includes the following:
- Prolonged bed rest (preferably lying on the left-side);
- Termination of pregnancy whenever maternal or fetal complications arise;
- Low-dose mild tranquilizers;
- Salt intake restriction (to some six grams a day);
- Adequate water intake to avoid dehydration and placental ischaemia;
- BP-lowering medication only if diastolic BP is above 100 mm Hg or if there is target-organ (i.e. heart, brain or kidney) damage; BP has to be lowered slowly to avoid aggravation of uterine ischaemia;
- The safest BP-lowering (antihypertensive) drugs in pregnant women are centrally-acting (or sympathoplegic) agents (like methyldopa and clonidine), alpha-blockers (prazosine), and vasodilators (hydralazine); other common antihypertensive drugs like beta-blockers and diuretics are associated with certain fetal risks, whereas angiotensin-converting enzyme inhibitors are definitely contraindicated.
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