How to treat hypertensive disorders in pregnancy

  Hypertensive disorders of pregnancy include gestational hypertension, pre-eclampsia, eclampsia, chronic hypertension complicated by pre-eclampsia, and chronic hypertension combined with pregnancy. The treatment methods vary at different stages, but the overall treatment aims to control the disease, prolong the gestational weeks, and ensure the safety of mother and child.  The main symptoms of patients with hypertensive disorders in pregnancy are hypertension, proteinuria, edema, and in eclampsia, convulsions as well as confusion, irritability and irritability. Therefore, the basic principles of treatment are rest, sedation, antispasmodic, indicated hypotension and diuresis; meanwhile, the condition of mother and fetus should be closely monitored and pregnancy should be terminated at the right time.  Regardless of the severity of the disease, pregnant women with gestational hypertension need to go to the hospital for assessment of their condition. Patients with milder pre-eclampsia can be treated at home, pay attention to rest, ensure sufficient sleep, and rest in the lateral position, and take oral diazepam if necessary; patients with more severe pre-eclampsia and eclampsia need to be hospitalized.  For patients with indications for blood pressure lowering, patients need to take oral or intravenous antihypertensive drugs such as labetalol, nifedipine, nimodipine, phentolamine, nitroglycerin, sodium nitroprusside during treatment. The purpose of blood pressure lowering is to prevent serious complications such as eclampsia, cardiac and cerebral blood accidents and placental abruption. When the patient develops eclampsia, it can cause general convulsions, facial congestion, foaming at the mouth and even deep coma, which seriously threatens the safety of mother and child, so one of the keys to the treatment of hypertensive disorders of pregnancy is to prevent the occurrence of eclampsia, and the commonly used drug is magnesium sulfate. When eclampsia occurs, it requires good emergency treatment, as well as control of convulsions, control of blood pressure, correction of hypoxia and acidosis, and termination of pregnancy at the appropriate time.  If the patient has symptoms of nervousness, anxiety, and insomnia, sedative drugs such as diazepam, dormant drugs, and phenobarbital are needed. If the patient has generalized edema, pulmonary edema, cerebral edema, renal failure, or heart failure, diuretic therapy as well as mannitol to lower cranial pressure is needed in a timely manner. If the patient is <34 weeks gestational age, treatment to promote fetal lung maturation is required. If the patient's condition does not resolve or continues to progress despite aggressive treatment, termination of pregnancy is required. In patients with severe preeclampsia, postpartum magnesium sulfate is still required to prevent the development of postpartum eclampsia.