Monthly Archives: Juni, 2019

Hypertension is a socially significant disease. 10% of pregnant women suffer from hypertension. High blood pressure is particularly dangerous during pregnancy, as it can affect both the mother and the fetus.

According to the World Health Organization (WHO), hypertension is blood pressure over 140/90mmHg.

FORMS OF HYPERTENSION IN PREGNANT WOMEN

The most severe forms of hypertension in pregnant women are eclampsia and preeclampsia. Preeclampsia is hypertension that occurs after 20 weeks of gestation with proteinuria (protein in the urine). Eclampsia is an emergency with hypertension and seizures. There are other forms of hypertension where there is no proteinuria.

Preeclampsia is thought to occur due to impaired blood flow to the placenta, resulting in multiple reactions from the mother’s body. The disease affects both the mother and the fetus. The mother could develop hemolysis (destruction of erythrocytes), liver damage and a low platelet count. Impaired blood flow to the fetus slows its growth and could lead to placental abruption and premature birth.

Obesity, first pregnancy and being under 18 or over 35 are all factors contributing to a higher risk of developing preeclampsia. Diabetes, kidney disease, some autoimmune diseases (lupus) also increase the likelihood as well. Women suffering from preeclampsia should give birth through a c-section.

PREVENTION

There is no 100% effective method of preventing hypertension during pregnancy. Proper nutrition (less salt), physical activity and achieving a healthy weight before conception has a positive effect though.

Do not miss your prenatal checkups and regularly measure your blood pressure at home. If you feel like you’re getting edema, dizziness, visual impairment, seek medical attention. Your obstetrician-gynecologist can prescribe you a blood pressure medicine that will not harm the fetus.

HYPERTENSION AND LACTATION

Breastfeeding does not increase the risk of hypertension in the mother. However, it lowers the likelihood of the child developing hypertension in the future – that’s another reason why you should choose to breastfeed.

Rhesus factor is the name of several proteins found on the erythrocyte membrane. The most important of these is the D-antigen, which determines whether our blood group is Rh (+) or Rh (-).

BLOOD TYPES AND PREGNANCY

One form of blood type incompatibility between the mother and the fetus is Rh incompatibility. It occurs when the Rh negative mother is pregnant with an Rh-positive fetus. To determine the probability of the fetus being Rh (+), the father’s blood gets tested. If he is Rh (-), there is no risk of immunological conflict between the mother and the fetus, as the fetus will also have Rh (-) blood.

During pregnancy, the mother’s blood doesn’t come into contact with the blood of the fetus. When this occurs (at birth, abortion, etc.), the mother’s body makes antibodies against the Rh antigen on the baby’s erythrocytes.

This isn’t dangerous to the baby if this is the first pregnancy. In subsequent pregnancies with an Rh (+) fetus, these antibodies can cross the placenta and start attacking the erythrocytes of the fetus. This can easily be prevented by injecting a drug called anti-D gamma globulin at 28 weeks. After birth, the baby’s blood has to be tested. If it’s Rh(+), the mother gets another dose of anti-D gammaglobulin.

It is important that prophylaxis with anti-D gammaglobulin is done even after an abortion, as it also leads to the formation of antibodies.

The second case of blood type incompatibility between mother and fetus is when the mother’s blood type is 0 and the fetus’s blood type is A, B or AB. Natural anti-A or anti-B antibodies from the mother’s blood may pass through the placenta only when their molecule is smaller (IgG class). Although rare, when it happens the baby is born with transient anemia and jaundice that are treatable.

HEMOLYTIC DISEASE OF THE NEWBORN

It develops when prophylaxis with anti-D gammaglobulin is not performed. In milder cases, babies are born with jaundice and hepatomegaly (enlarged liver). Serious forms are life-threatening, resulting in premature birth, anemia, oedema, and intense jaundice.

THE RAREST BLOOD TYPE

Those people don’t have any antigens of the Rh system on their red blood cells. This makes their blood compatible with any Rh phenotype. Only 44 people in the world are known to have the „golden“ blood.