Sequelae of Hypertensive Disorders
Although these disorders form a spectrum, typically to diagnose conditions such as pre-eclampsia (PET) certain criteria must be met.
Namely hypertension in combination with proteinuria and oedema.
Within PET, the disorder can vary markedly patient to patient.
Some take on predominantly renal dysfunction, whilst others oedema and fluid overload take the forefront, in some difficult to control hypertension is the main concern.
Few women present the same, but for all the risks are consistent - eclamptic seizure prevention, and fetal concerns with poor placental perfusion.
Frequently there's a balance between getting the baby to a size that neonatal risks are minimised, but where the mother's well-being is not compromised. Fundamentally however, the mother is the priority.
Cardiomyopathy
Hypertension in pregnancy, whether it is essential, PIH, or as part of PET is a significant risk factor for developing perinatal cardiomyopathy.
Other risk factors include maternal age, multiple pregnancy, diabetes, severe anaemia, smoking, family history or personal history of cardiac disease.
Typically presents as heart failure, and requires urgent assessment and referral to on-call cardiologist. Often these women require transfer to coronary care, and a small percentage subsequently require heart transplant.