Elevated BP, protein in urine requires attention during pregnancy — Consultant


 A Consultant Obstetrics and Gynaecologist, Dr Ayodeji Adefemi, has advised expectant mothers to ensure that their blood pressure (BP) and urine are checked regularly to prevent pre-eclampsia.

Adefemi gave the advice in an interview with the press in Lagos.

According to him, elevated BP is one of the most common medical conditions in pregnancy with side effects experienced by both mother and baby.

“If the woman is already term, the pregnancy should be discontinued.

If the pregnancy is not yet term and the BP is, to the extent that she has not start manifesting eclampsia, I may even need to administer a drug to prevent convulsion.

If the BP is very high, I may have to discontinue the pregnancy depending on the safest routes.

I may want to go ahead and discontinue by doing a CS or ripening the cervix and offering the patient a vaginal birth.

However, if the BP is not bad; if the patient is still remote from term, I may want to try and give the patient some drugs that will help the lung maturity.

And also institute anti-hypertensives and surveillance in that patient,’’Adefemi said.

He said pre-eclampsia is a complication of pregnancy marked by high blood pressure and protein in the urine, adding that if Left untreated, pre-eclampsia can lead to eclampsia, a serious condition that can, in some cases, lead to death.

Adefemi explained that pre-eclampsia also affects blood flow to the placenta, often leading to growth-restricted or prematurely born babies.

He said avoiding this condition would bring substantial improvements to maternal and fetal health.

Adefemi noted that protein in the urine was an aftermath of preeclampsia and an indication that the kidney is destroyed, thereby causing leakage of protein into the kidney.

He explained that some of the complications to the mother include cerebral oedema (leakage of fluid into the brain) thus causing headaches, convulsion, heart failure, swollen legs, backs and fingers.

Other complications are liver dysfunction or rupture and acute kidney injury.

He also explained that apart from the maternal complications, preeclampsia could cause the amniotic fluid to dry up.

According to him, there can be intrauterine growth restriction, which can stop the baby from growing and the baby can die suddenly.

He said the BP could be so high causing the placenta to detach (placenta abruption).

Adefemi further explained that the pregnancy may be discontinued; through a Caesarean section (CS) or induction for vaginal delivery, if the BP was beyond control.

The doctor warned pregnant women to stop attending antenatal at places where their BP and urine are not checked regularly.

“When a patient presents at the antenatal clinic, the two most important things that we do is to check the BP and we check their urine.

You’re going to any hospital; they’re not checking your BP, they’re not checking your urine for protein and glucose, especially protein; it’s not a good hospital.

All these homes, all these clinics, all these maternity homes and sometimes, some mission homes, churches, mosques, traditional birth attendant homes – they don’t do all these things there.

So, how do you know that the BP is getting elevated, how do you know there is protein in the urine?’’ he said.

Adefemi advised women planning to get pregnant to ensure that their BP normalises first and should adopt healthier lifestyles by reducing their risks of hypertension.

“As soon as they’re pregnant and they have preeclampsia, most times, it’s medication and delivery that can be the solution, not lifestyle modification because the condition has already started,’’ Adeyemi said.

Other risks of the condition include diabetes mellitus, teenage, family history of preeclampsia, patients with multiple gestation obesity and patients with cardiovascular diseases.