Renal failure and arterial hypertension in pregnancy
During the nine months of pregnancy, the expectant mother is subjected to a series of checks useful to assess her general state of health. Urine tests and blood pressure measurements are used, for example, to understand if kidney function is good and if blood pressure values are normal. L'renal failure and arterial hypertension in pregnancy they represent two disorders to be kept under control and, in case of anomalies, the doctor will indicate the most correct approach to minimize the risks.
Thanks to current treatments the repercussions of these two diseases in pregnancy are much better controlled and it is an exceptional fact that the health or life of the future mother is threatened. However, it remains true that such a pregnancy, which represents the typical high-risk pregnancy, must be particularly supervised in a specialized environment. In fact, accidents still remain frequent: abortion, fetal suffering, premature birth.
In case of renal insufficiency or arterial hypertension, for example, a higher incidence of pregnant tossie, otherwise called preeclampsia. A toxemia is the presence in the blood of large quantities of toxins coming from the outside (e.g. of vegetable, chemical, bacterial origin) or produced by the organism itself (e.g. in gestosis pregnancy).
Preeclampsia is also known clinically as gesturesi. It is generally accompanied by headache, fever and symptoms of the effect of the single toxin. Therapy is based on the use of drug suitable for the individual case (antibiotic, antitoxin, etc.). Toxaemia gravidarum is a condition in pregnant women, which manifests itself with increased blood pressure, swelling of the tissues and loss of large amounts of protein in the urine (proteinuria). Preeclampsia, which can evolve towardseclampsia, a serious complication of pregnancy that can also lead to seizures.
Kidney problems in pregnancy
Renal failure, that is, the reduced function of the kidneys, can occur in two different forms
- Chronicle: the kidneys are subject to a progressive reduction of their functions with compromise of the balance of water and electrolytes, of the balance between production and elimination of body acids, of the elimination of nitrogenous wastes from protein metabolism, of blood pressure control , of the metabolism of calcium and phosphorus, and of the synthesis, in the kidney, of erythropoietin, calcitriol and prostaglandins. The morphopathological equivalent of chronic renal failure is the evolution in sclerosis of a increasing number of nephrons (the elementary units of which the kidney is composed)
- Acute: the rapid decrease in renal function is visualized in the laboratory with the equally rapid decrease in the elimination (clearance) of creatinine, the reference substance deriving from muscle destruction (catabolism) and an index of the reduction in filtration at the level of the capillary (glomerular) microcirculation renal. The increased levels of creatinine and u in the blood, indicators of the retention of more complex nitrogenous waste, is frequently associated with pathological changes in urinary volume, first increased (polyuria) due to the functional inability of the kidneys to concentrate solutes in a reduced volume of urine, then decreased, conditions of oliguria, i.e. diuresis less than 500 ml / 24 hours, or anuria, i.e. diuresis less than 100 ml / 24 hours, up to the absence of urine production or the emission of a few ml of it during the 24 hours.
Renal failure symptoms
In case of abnormal kidney function, toxins accumulate in the body because the kidneys are unable to perform their function properly and to filter. The main symptoms of kidney failure are:
- swelling, especially in the ankles, legs, face;
- shortness of breath;
- weakness and lack of energy;
- pain in the rib cage
- reduction in the frequency of urination;
Hypertension in pregnancy symptoms
The term arterial hypertension defines an abnormal increase in blood pressure. Arterial pressure is the energy with which blood circulates in arterial vessels. It depends on the thrust given by the heart to the blood and on the elasticity of the arterial vessels: the more rigid they are, the higher the pressure. Blood pressure values vary with age, tending to increase with the passing of the years, and throughout the day, resulting higher upon awakening, tending to decrease during the day, increasing in the event of physical and emotional stress.
In any case, in the light of the studies carried out, a blood pressure with values lower than 140/90mmHg, where the first number (140) indicates the pressure systolic or "maximum" and the second number (90) indicates the pressure diastolic the "minimum".
In consideration of this fact, arterial hypertension is divided into read-moderate, when the diastolic pressure values reach up to 110 mmHg, and in gravi, when the values are higher. Out of 100 patients with arterial hypertension, only 3 or 4 have clearly identifiable and treatable diseases that have caused the increase in blood pressure. In all other cases it is not possible to identify an obvious cause: we are talking about essential hypertension, the most common form of arterial hypertension, towards which there is a family predisposition and which would be linked to alterations by the cells in the management of two substances: sodium and calcium.
Hypertension in pregnancy guidelines
We can talk about hypertension in pregnancy when systolic blood pressure values are greater than 140 mmHg / 90 mmHg, in at least two consecutive measurements at least six hours apart in a woman who has passed the twentieth week of gestation and who was normotensive.
Experts take thegestational hypertension when the values reach 160/110 mmHg and in this case the patient is treated in the same way as those who have severe preeclampsia.
Some rest and level patient management is generally advised outpatient with regular visits, but it is important to carefully follow the directions of your doctor.
Hypertension in pregnancy risks
Complications of severe gestational hypertension can be hypertensive crisis, eclampsia, placental abruption, however it is good to know that in case of mild or moderate hypertension and in the absence of other symptoms, complications are rare. It is important to follow the doctor's instructions and to undergo regular checks on the health of the mother and fetus.