According to statistics, hypertensive syndrome in pregnant women leads to complications and mortality during childbirth more often than any other diseases - per 100 births with complications in approximately 20-30 cases.
Hypertensive syndrome is the main cause of the risk of placental abruption and massive coagulopathic bleeding, and can impair cerebral circulation, retinal detachment, eclampsia and HELLP syndrome can also be a consequence of hypertension.
Please note that hypertension can be controlled at the very beginning and the woman will not feel any symptoms during pregnancy. discomfort associated with it, but usually treatment does not affect the outcome of the birth itself.
How to determine hypertensive syndrome
Firstly, hypertension can be indicated by an increase in blood pressure compared to blood pressure before pregnancy or blood pressure in the first trimester of pregnancy:
- systolic by 30 or more mmHg.
- diastolic by 15 or more mmHg.
Secondly, if hypertensive syndrome is suspected, it is necessary to systematically measure blood pressure in a pregnant woman within 6 hours. Blood pressure is above 140/90 mm. rt. Art., confirmed by several measurements in a row, will indicate that the pregnant woman still has hypertension.
Thirdly, by the calculation method, when the average blood pressure is equal to or more than 105 mm Hg, and jumps in diastolic blood pressure exceed 90 mm Hg. Art.
Feel
The sensations are the same as those with hypertension, only complicated by pregnancy. Some of the most unpleasant ones can be called:
Shortness of breath while walking
Flushing to the face, fever
Nocturnal surges in blood pressure cause stomach cramps similar to symptoms of hunger
Even sitting in a chair in front of the TV, you can feel how suddenly your heart, for no reason at all, loses its rhythm
Lying on your back, you feel short of breath
Occurs frequently headache, which, it seems, should not be provoked by anything
In later stages, the baby begins to beat too hard due to lack of oxygen and the mother’s condition itself.
Consequences for you
Depending on the form and severity of the hypertensive syndrome and the frequency of pressure surges, hypertension can lead to preeclampsia and eclampsia during childbirth. Also by the end of the period you may experience:
Hyperreflexia
Head sharp pain which does not go away after taking conventional analgesics
Visual impairment, double vision
Yellowness of the skin
Pulmonary edema
Decreased diuresis and sudden swelling of the extremities.
After delivery, hypertensive syndrome requires continued diagnosis and treatment so that hypertension does not become chronic disease for the mother. Having missed such a moment, the doctor will tug the woman at the risk of finding herself face to face with this unpleasant illness in subsequent births.
Consequences for the child
The main thing is premature birth, when the baby has not yet gained enough body weight and the lungs are not open enough. There is a high possibility of intrauterine death of the fetus, impaired blood supply to the brain, accelerated heartbeat, underdevelopment of the central nervous system, etc.
Therefore, it is best to diagnose hypertension early stages pregnancy and its moderate and severe forms are treated during subsequent trimesters. This will enable the baby to feel comfortable in the womb and avoid some serious consequences. of this syndrome, and will also allow you to prolong the pregnancy period to the required 38-40 weeks.
In the early stages, the doctor prescribes treatment depending on the severity of hypertension; in mild forms, it is enough to observe bed rest. With more severe forms, preeclampsia, magnesium therapy is prescribed (intravenously or intramuscularly), as well as antihypertensive drugs. In the last trimester - hospitalization with constant bed rest; choice of metaprolol, hydralazine, nifedipine, methyldopa - dopegite, labetalol or nitroprusside; reducing sodium intake; use of diuretics, etc.
Dopegit is usually prescribed as an antihypertensive drug, but a stronger drug may be prescribed at the discretion of the doctor.
In every special case obstetrician-gynecologist develops individual scheme combating hypertensive syndrome. The best treatment delivery is considered, but, nevertheless, the doctor should try to delay this moment as close as possible to the normal delivery date - 38-40 weeks.
To be or not to be?
Knowing in advance about the presence of hypertensive syndrome, it is difficult for a woman to make a decision about conception and a full-term pregnancy. Moreover, such a decision is difficult to make the second or third time, when the first attempt was not particularly successful - a difficult first birth, especially with eclampsia, leaves its mark. IN in this case Consultations with a specialist are required who can not only prescribe treatment and manage the pregnancy, but also support the woman morally during pregnancy, anticipating her fears.
Hypotensive syndrome occurs during pregnancy due to impaired cerebral vascular tone, decreased secretion of cerebrospinal fluid, or head injury. In this case, the woman develops severe headache, dizziness, nausea and fatigue. Pathology can be detected during a spinal puncture or using MRI.
The disease predominantly develops in young women during pregnancy.
Causes
Hypotension syndrome during pregnancy can be provoked by the impact on a woman’s body of factors such as:
- traumatic brain injuries;
- low intracranial pressure;
- history of dystonia;
- decrease in the secretory function of the choroid plexuses of the brain;
- exposure to medications;
- constant decrease in general pressure;
- dehydration of the body;
- prolonged vomiting;
- disturbance of vascular tone.
Manifestation
Hypotension syndrome in women causes such characteristic symptoms:
The pathology of pregnant women has characteristic features, one of which is vomiting, which does not bring relief. - headaches of a compressive nature;
- reduction of discomfort when changing body position;
- increased pain when the head is lowered;
- drowsiness;
- decreased performance;
- weakness;
- irritability;
- nausea and vomiting that does not bring relief.
This diagnosis is made mainly to women aged 25 to 30 years during pregnancy. The disease is caused by a persistent decrease, resulting in weakness, fatigue, lability nervous system and nausea followed by vomiting. A severe headache of a spasmodic nature also occurs, which intensifies when the head is lowered. This symptom complex significantly reduces the patient’s quality of life and requires treatment.
Diagnostics
A neurologist can identify hypotension syndrome after examining the patient and asking him about the symptoms that bother him. To confirm the diagnosis, it is recommended to take a general and biochemical analysis blood. A spinal puncture is also performed, which makes it possible to assess the pressure of the cerebrospinal fluid inside the spinal canal and detect possible infectious pathogens by inoculating biological material on nutrient media. Magnetic resonance imaging and CT scan brain.
Treatment methods
To combat the disease, the doctor will suggest changing your lifestyle and increasing physical activity. Therapy for hypotension syndrome should be comprehensive and include lifestyle changes with sufficient physical activity. Medications are also used to narrow the blood vessels in the brain and increase the production of cerebrospinal fluid. Means that improve the quality of microcirculation and nutrition of neurons are shown. If the measures taken are insufficiently effective, surgical intervention is recommended. Most often, the procedure consists of eliminating the dural defect and closing the cerebrospinal fluid fistula. With timely and sufficient treatment, therapy gives positive results.
Medicines
The use of medications, aimed at enhancing vascular tone and stimulating the secretion of cerebrospinal fluid. For this purpose, tonics are used. plant origin, such as tincture of ginseng, zamanikha or eleutherococcus, as well as alkaloids “Caffeine” and “Securin”. M-anticholinergics “Bellaspon” and “Atropine” will be useful. To normalize the amount of fluid in the body, isotonic solutions“Ringera” and “Trisol”, and “Piracetam” and “Lucetam” will help improve the nutrition of neurons. For symptomatic treatment, drugs that improve heart trophism “Riboxin” and “Aevit” are used, and in case of significant problems with cerebral microcirculation, “Cerebrolysin” and “Reopoliglucin” are used.
There are drugs that everyone, or almost all adults, know about and always have with them - as a last resort, in home medicine cabinet. No-shpa, or Drotaverine (this international name drug) is just one of these, in its popularity it is not inferior to Aspirin and Analgin.
No-spa is a fast-acting antispasmodic; most people take small yellow tablets for colic, flatulence, bloating, and pain in the pelvic organs. For some, they help with migraines, severe headaches or high blood pressure.
Many hypertensive patients personal experience they know that No-Spa really quickly reduces blood pressure and can help out when there are no other antihypertensive drugs at hand. But can Drotaverine really be used to treat hypertension?
Indications for use of the drug
No-spa or Drotaverine is prescribed for pain caused by vasospasm; it is usually recommended for the following diseases and phenomena:
- Pathologies of the gallbladder and bile ducts accompanied by severe colic;
- Cystitis and others inflammatory processes Bladder;
- Kidney stones and various pyelitis;
- Gallstone disease;
- Any intestinal pathologies, including spasms caused by constipation;
- Inflammation of appendicitis;
- Ulcers of the esophagus and stomach;
- After surgical intervention on organs abdominal cavity or pelvis to relieve spasms and pain;
- Vascular spasms in the area of the heart or brain;
- Dilatation of the uterus during labor activity;
- Incessant hiccups.
Vascular spasms in the area of the heart or brain are very often observed with high blood pressure. Therefore, Drotaverine can be used as a drug with a moderate hypotensive effect in hypertension.
No-spa for high blood pressure - how it works
So, the main effect of this drug is relaxation of smooth muscles, primarily organs digestive system, genitourinary, and then vascular.
Without affecting the functioning of the heart muscle and the frequency of contractions, Drotaverine simply has a relaxing effect on the blood vessels. Thanks to this, the lumen in them increases, blood circulation improves, and if arterial pressure was elevated, the medicine lowers it.
No-Spa will also help with headaches, but only if it occurs due to high blood pressure and vasospasm. If the cause pain in another, this drug will be ineffective.
Usually, if blood pressure is high, No-spa is used as an auxiliary drug. In this case, the dosage must be strictly observed, since Drotaverine lowers blood pressure to a critical level. It is used in hypertensive crisis, when the pressure is very high, usually in the form of injections, but with great caution.
At the same time, blood pressure is constantly monitored; in case of overdose, arterial hypotension develops very quickly. It is for this reason that No-shpa is not used for permanent treatment hypertension - it reduces blood pressure too intensely to an unacceptable level.
When administering the drug intravenously, the patient must be in a lying position to prevent collapse.
Drotaverine begins to act already 2-3 minutes after administration, sometimes already during the injection. Maximum effectiveness is achieved after approximately 30 minutes.
Contraindications to the use of No-shpa
Drotaverine should not be taken by hypotensive patients whose blood pressure is already below normal - the medicine will lower it even more. In this case, it is better to use Papaverine as an analogue. This drug also effectively relieves pain and spasms, but lowers blood pressure much less.
Also contraindications are:
- Prostate adenoma.
- Atherosclerosis.
- Glaucoma.
- Acute cardiac or vascular failure.
- Pathologies of the liver and kidneys in severe or acute form.
- Individual intolerance to the drug.
Since this drug has a pronounced antispasmodic effect, that is, it quickly reduces muscle tone, it should not be taken uncontrollably without a doctor’s prescription, especially in case of certain pathologies and characteristics of the patient’s condition.
Also, you should not take No-shpa for headaches, pain in the heart or stomach until the ambulance arrives, as this medicine reduces pain syndrome very effective and long lasting, which can hide clinical picture pathology and complicate diagnosis.
Release form, composition, cost in pharmacies
This drug can be produced in three pharmacological forms:
- Capsules;
- Pills;
- Injection.
Regardless of the type of release, the active substance is always Drotaverine hydrochloride. Additional substances in tablets and capsules may include magnesium stearate, corn starch, lactose monohydrate, talc and povidone.
The tablets are pale yellow in color, small in size, round in shape, without a shell or bulges. The solution is a transparent liquid of pale yellow color with a greenish tint. Except active substance it contains purified water, ethanol, sodium metabisulfite, sodium disulfate.
This medicine is sold in pharmacies without a doctor's prescription. The price depends on the form of the drug, packaging and package size. A pack of 6 tablets costs from 50 to 60 rubles. The price of a package of tablets of 24 pieces is from 200 to 240 rubles. A package of 100 tablets will cost 25-270 rubles.
The price of injection ampoules per package of 25 pieces (the volume of one ampoule is 30 ml) is from 450 to 470 rubles. When purchasing, you should always pay attention to the dosage of the drug in tablets and capsules; this also affects its cost.
Instructions for use of the drug in different forms
Solution for injection is used 6 ampoules (240ml) for intramuscular injection and no more than 2 ampoules at intravenous administration per day. If No-spa is used together with antidepressants, the hypotensive effect may be reduced.
Tablets and capsules are taken 1-2 pieces up to three times a day. It is recommended to do this during meals. In case of overdose or hypersensitivity to the drug, the following side effects are possible:
- Arterial hypotension.
- Insomnia.
- Nausea and constipation.
- Hot flashes.
- Dizziness and headaches.
- Tachycardia, difficulty breathing.
- Skin rashes like urticaria.
In case of overdose, it is necessary to perform a gastric lavage, take an adsorbent and immediately go to the hospital. Because it may be necessary symptomatic treatment, the patient must be under constant medical supervision.
If you have high blood pressure and dry mouth, severe headaches or pain in the heart, you can actually take 1-2 tablets of No-shpa. But you should remember that the main indications for the use of this drug are different, and at the first opportunity, consult a doctor to select the optimal antihypertensive drug. The video in this article will serve as instructions for using the drug.
on
Hypotensive syndrome and pregnancy
- 1 Causes of the disease
- 2 Symptoms of hypotensive syndrome
- 3 Diagnosis of hypotensive syndrome during pregnancy
- 4 Features of treatment of the disease
- 4.1 Drug treatment
- 4.2 Features of surgical treatment
- 5 The danger of hypotensive syndrome
A symptom complex that reflects a persistent decrease intracranial pressure, called maternal hypotensive syndrome. It is characterized by a combination of severe, constricting headaches, fatigue, retching and mood lability. This diagnosis is given only to women. This syndrome occurs during pregnancy in women aged 25 to 29 years. The existence of this syndrome leads to a decrease in the quality of life, therefore, if such a symptom complex appears, you need to consult a doctor and begin treatment.
Causes of the disease
The syndrome has various reasons occurrence. The main ones:
- decreased intracranial pressure;
- head injuries;
- leakage of cerebrospinal fluid due to ruptures in the membranes of the brain and fractures of the skull bones;
- decrease in the secretory function of the choroid plexuses in the brain;
- severe drug-induced dehydration of patients;
- persistent decrease in pressure.
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Symptoms of hypotensive syndrome
The disease manifests itself with the following symptoms:
- the appearance of a strong, sudden, squeezing, “hoop” headache;
- increased pain in a sitting position and when raising the head;
- reduction of pain if you lower your head;
- the appearance of nausea and vomiting;
- labile mood;
- prostration;
- the appearance of drowsiness.
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Diagnosis of hypotensive syndrome during pregnancy
At the first symptoms of the disease, you should consult a doctor for help.
If the patient has the first manifestations of such a disease, you need to contact a neurologist, neurosurgeon and obstetrician-gynecologist. They will collect all complaints, conduct an objective examination, and also conduct differential diagnosis with other diseases and make a preliminary diagnosis. Diagnostic measures include:
- general analysis blood;
- general urine analysis;
- blood chemistry;
- spinal tap;
- X-ray of the skull;
- MRI of the brain.
Return to contents
Features of treatment of the disease
When the first symptoms of hypotensive syndrome appear in the mother, you cannot try to cure it yourself, but you need to contact a specialist. Doctors will take a medical history and examine the patient. They will also carry out diagnostic measures and prescribe special treatment. Treatment is prescribed with medication and surgical therapy.
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Drug treatment
Treatment of hypotensive syndrome is carried out using medications presented in the table:
Symptomatic treatment is carried out as follows:
- If there is a decrease in heart contraction, drugs are prescribed that improve heart trophism - “Riboxin”, “Aevit”.
- If there are pronounced microcirculation disorders, Reopoliglucin is used.
- In case of severe impairment of cerebral circulation, Cinnarizine is prescribed.
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Features of surgical treatment
Surgical treatment is used when drug therapy is ineffective, as well as to close a cerebrospinal fluid fistula in the presence of a defect in the dura mater of the brain. This surgical intervention is performed by a neurosurgeon. Apply surgical treatment the resulting defect in the dura mater of the brain, after which the wound is hermetically sutured.
Hypotensive syndrome in the mother is a state of dysregulation of vascular tone, in which there is a decrease in blood pressure to 100/60 mmHg. and below.
The incidence rate ranges from 1.8 to 29%.
Hypotensive syndrome most often occurs in the 1st trimester of pregnancy, and, as a rule, worsens as pregnancy progresses. In the development of pathology, anatomical and physiological changes in the body of a pregnant woman are important, primarily the occurrence of uteroplacental circulation, as well as changes in the interaction of parts of the autonomic nervous system and a decrease in the function of the adrenal cortex.
It is customary to divide arterial hypotension into primary, which occurred in a woman during the pregestational period, and secondary, first identified during pregnancy. Regardless of the type of hypotension, the condition has bad influence on the health of mother and child.
Risk factors for the development of hypotension syndrome are asthenic physique, endocrine pathologies, liver diseases, infections, pathologies of the autonomic nervous system, prolonged bed rest, and nutritional deficiency.
Some sources classify hypotensive syndrome in pregnant women as gestosis.
Causes
In the pathogenesis of the development of hypotensive syndrome during gestation, the following factors are important:
- BCC deficiency as a result of the occurrence of uteroplacental circulation and conditions caused by it (decreased venous return to the heart, increased minute volume of blood, etc.)
- The placenta produces hormones that affect the functioning of the pituitary gland, resulting in a decrease in the blood of pressor substances that maintain vascular tone.
- An increase in the tone of the parasympathetic nervous system, the predominance of parasympathetic activity, and, as a result, a decrease in the tone of smooth muscles, incl. vascular wall.
- Decreased ovarian hormone production.
- Production by the maternal body of antibodies to antigens of the fetus and placenta.
Taking some medicines can also cause arterial hypotension.
In late pregnancy, arterial hypotension is often postural in nature and is caused by compression of the inferior vena cava by the uterus in the woman’s supine position.
Low blood pressure contributes to the development of hemodynamic disorders in all organs and systems, causing greater variability clinical symptoms.
Symptoms
Arterial hypotension may be asymptomatic. Fatigue and weakness, irritability and tearfulness that occur with a decrease in blood pressure are often attributed to normal course pregnancy.
Dizziness and headache, darkening of the eyes, weakness, “spots” before the eyes when changing body position from horizontal to vertical, fainting, feeling of lack of air, chest pain, and palpitations may occur.
Skin cold, pale or bluish, characterized by sweating. A systolic murmur is heard at the apex of the heart, and the pulse rate is reduced.
In severe cases of the disease, there may be hypotensive crises. They manifest themselves as collapse, severe weakness, tinnitus, sticky cold sweat, tachycardia, and nausea.
Important! Hypotonic crisis in a pregnant woman is a condition life-threatening child and requires immediate assistance.
During childbirth, arterial hypotension contributes to the development of labor anomalies and increased blood loss.
Diagnostics
Hypotensive syndrome in the mother is diagnosed on the basis of life history and disease, objective examination data and additional research methods.
Important! A pregnant woman with an asymptomatic course of the disease may have no complaints.
When clarifying the anamnesis, attention is paid to the presence of hypotension in a woman before pregnancy, the presence of pathologies of the endocrine and nervous system, and the peculiarities of the course of this pregnancy (presence of anemia, gestosis, hypoglycemia, etc.). The drug history is ascertained.
Pulse measurement, percussion and auscultation of the heart, examination and palpation are carried out thyroid gland, temperature measurement.
To confirm the diagnosis, blood pressure measurements are prescribed during the day (2-3 times a day).
A general blood test, a general urinalysis, a biochemical blood test, determination of the level of thyroid hormones, ultrasound of the kidneys and adrenal glands, and an ECG are prescribed.
Differential diagnosis is carried out with diseases of the thyroid gland and adrenal glands, infectious diseases, hypotensive syndrome when taking certain medications, peptic ulcer stomach.
Complications
Arterial hypotension, regardless of its course, affects both the health of the mother and the health of the fetus.
Complications on the maternal side may include:
- Development of late gestosis.
- Spontaneous termination of pregnancy, both early and late later gestation.
- Anemia.
- Discoordination of labor, protracted labor(in 75% of cases).
- Increased blood loss during childbirth.
- Decreased activity of the adrenal cortex.
Complications from the child include conditions associated with impaired fetoplacental blood flow. Intrauterine hypoxia may develop, increasing the risk birth trauma, encephalopathy, the risk of perinatal death increases.
Forecast
In arterial hypotension syndrome, the prognosis depends on the severity of the disease and the adequacy of the prescribed treatment.
With secondary hypotension, first detected during pregnancy, the prognosis is less favorable, since the course of the disease is more severe and is more often accompanied by crises.
A large number of hypotensive crises indicate decompensation and are an unfavorable prognostic criterion.
In postpartum women with arterial hypotension twice the risk of developing postpartum infections.
Prevention of the development of hypotensive syndrome in pregnant women is the elimination of overwork, normalization of sleep patterns, gymnastics, cold and hot shower, correction (if necessary) of diet, massage.
During childbirth, women in labor with arterial hypotension must undergo additional prevention bleeding.
The symptom complex that reflects a persistent decrease in intracranial pressure is called maternal hypotensive syndrome. It is characterized by a combination of severe, constricting headaches, fatigue, retching and mood lability. This diagnosis is given only to women. This syndrome occurs during pregnancy in women aged 25 to 29 years. The existence of this syndrome leads to a decrease in the quality of life, therefore, if such a symptom complex appears, you need to consult a doctor and begin treatment.
Causes of the disease
The syndrome has various causes. The main ones:
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- decreased intracranial pressure;
- head injuries;
- leakage of cerebrospinal fluid due to ruptures in the membranes of the brain and fractures of the skull bones;
- decrease in the secretory function of the choroid plexuses in the brain;
- severe drug-induced dehydration of patients;
- persistent decrease in pressure.
Symptoms of hypotensive syndrome
The disease manifests itself with the following symptoms:
- the appearance of a strong, sudden, squeezing, “hoop” headache;
- increased pain in a sitting position and when raising the head;
- reduction of pain if you lower your head;
- the appearance of nausea and vomiting;
- labile mood;
- prostration;
- the appearance of drowsiness.
Diagnosis of hypotensive syndrome during pregnancy
At the first symptoms of the disease, you should consult a doctor for help. If the patient has the first manifestations of such a disease, you need to contact a neurologist, neurosurgeon and obstetrician-gynecologist. They will collect all complaints, conduct an objective examination, and also carry out differential diagnostics with other diseases and make a preliminary diagnosis. Diagnostic measures include:
- general blood analysis;
- general urine analysis;
- blood chemistry;
- spinal tap;
- X-ray of the skull;
- MRI of the brain.
Features of treatment of the disease
When the first symptoms of hypotensive syndrome appear in the mother, you cannot try to cure it yourself, but you need to contact a specialist. Doctors will take a medical history and examine the patient. They will also carry out diagnostic measures and prescribe special treatment. Drug and surgical therapy are prescribed as treatment.
Drug treatment
Treatment of hypotensive syndrome is carried out using medications presented in the table:
Symptomatic treatment is carried out as follows:
- If there is a decrease in heart contraction, drugs are prescribed that improve heart trophism - “Riboxin”, “Aevit”.
- If there are pronounced microcirculation disorders, Reopoliglucin is used.
- In case of severe impairment of cerebral circulation, Cinnarizine is prescribed.
