Complication of Pregnancy: Pregnancy Induced Hypertension (PIH)

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Contents

Abstract
Instructor
Class
Teaching Plan
Handout
References

Abstract

Pregnant women are prone to complications, which threaten their lives and that of the infants. Pregnancy-induced hypertension is one of the complications that pregnant women experience. To prevent or manage complications, parents usually attend childbirth classes.

The childbirth class, which was held at Sibley Memorial Hospital taught parents how to handle experiences that they undergo during the first, second, and third trimesters. Despite the fact that the instructor covered extensive topics, she did not cover the topic of pregnancy-induced hypertension. Hence, the teaching plan focused on signs and symptoms, the nature of the complication, risk factors, and applicable interventions.

Instructor

On February 7, 2015, I attended a boot camp for childbirth class that was hosted at Sibley Memorial Hospital. The session of the childbirth class started at 9am and ended at 5pm. The instructors name was Rosemarie Antunes, a registered nurse with the experience of 30 years in obstetric, labor, and delivery nursing acquired from different hospitals in different states.

She obtained her licenses as a registered nurse (RN) from the Virginia Department of Health Professions in 2004 and State of Connecticut, Department of Public Health in 1980. She has also received professional certification from Prepared Childbirth Educators in 2006 and Certified Labor Doula in 2009. Rosemarie took her diploma education for RN at Saint Francis Hospital School in 1977-1980.

Currently, she works for Fauquier Health System, a family birthing center, since 2004. She also works for Labor and Delivery, Postpartum, and Normal Newborn as a certified childbirth educator with experience of 10 years in preparing expectant mothers and their partners for what is ahead of them. Rosemarie is a mother of six children with 10 grandchildren (R. Antunes, personal communication, February 7, 2015).

The instructor employed constructivism as a teaching philosophy because she aided the participants to understand experiences that they expect during pregnancy and delivery by using questions and demonstrations. To construct the foundation of teaching, the instructor told the participants to ask questions that they might have before she commences each session.

Moreover, the instructor informed the participants that she would stop at any time during presentation to allow them to ask questions. To enhance understanding among the participants, the instructor demonstrated her teachings using various methods. The teaching methods that the instructor employed in demonstrations are videos, PowerPoint presentation, handouts, dolls, and birth balls.

Class

The childbirth class took place on February 7, 2015 at Sibley Memorial Hospital in one of their lecture halls from 9am to 5pm. The childbirth class comprised of Caucasian couples, African couples, and Asians couples. Interestingly, during their introduction, all of them indicated that they were expecting their babies in March 2015.

From the introduction, it became apparent that half of the couples were married while the remaining couples were just partners. The participants were young adults between the ages of 20 to 30 years, who were expecting their babies for the first time. The couples were ready for the childbirth lessons as they brought with them pillows, birth balls, and blankets.

The topics covered in childbirth class aimed at enhancing the understanding of pregnancy (3^rd trimester), labor, Christina Birth story, comfort techniques, medical procedures, cesarean birth, newborn procedures, postpartum, and labor rehabilitation. The instructor covered anatomy and physiology of pregnancy from first trimester to the third trimester, and hormonal proliferations that happen during pregnancy.

To improve their health, the instructor encouraged the pregnant women to eat food high in fiber, drink water at all times, and call HCP whenever they experience pain during urination. The instructor also covered signs of labor and expected medical emergencies such as induction and cesarean births, which are essential in saving babies and mothers.

She taught the participants how to employ exercise, relaxation, massage, and music in improving the birth of the newborn in a natural way. The instructor also mentioned postpartum and gave healthcare instructions for newborn, such as safety and breastfeeding techniques.

Teaching Plan

Pregnancy-Induced Hypertension (PIH)

Although the instructor extensively covered diverse areas of childbirth, I noted that she did not delve deep into complications of pregnancy, and thus, she should have examined the topic of pregnancy-induced hypertension (PIH).

Pregnant women are susceptible to PIH or gestational hypertension owing to changes in their bodies. Essentially, PIH has medical importance because it threatens the lives of the baby and the mother. Therefore, I will explore the topic of PIH with a view of equipping the participants with the appropriate knowledge that is critical in prevention, treatment, and management of the complication.

Summary of Teaching

The first objective of teaching pregnant women is to enable them to identify signs and symptoms of PIH. As PIH requires early detection for treatment and management interventions to be effective, pregnant women need to understand how to identify the signs and symptoms of PIH very early.

Excessive swelling of hands and feet, dizziness, excessive nausea, rapid heartbeat, severe headaches, drowsiness, fever, blurred vision, and pain in the abdomen are some of the signs and symptoms of PIH, which pregnant women need to watch so that they can seek early medical attention.

According to Jwa et al. (2013), early detection of PIH is critical for fetal and maternal health because it enhances the effectiveness of treatment and management interventions. As teaching methods, I will employ PowerPoint presentation, brochures, handouts, and discussion.

In teaching about PIH, the second objective is to enable the participating couples to understand the nature of PIH. Given that pregnant women experience diverse forms of hypertension, PIH is a unique form of hypertension because it only happens after the 20th week of pregnancy and can be either transient or chronic (Sajith et al., 2014).

When blood pressure of a pregnant woman is higher than 140/90 in two different occasions, and her urine contains no proteins, the differential diagnosis indicates PIH. As a teaching method, I will demonstrate diagnosis of PIH by measuring blood pressure of the pregnant women and undertaking urinalysis to determine the presence of proteins in urine.

The third objective is to enable the participating couples to understand risks of PIH. The common risk factors for PIH are women with the first-time pregnancy, increased maternal age, family history, multiple gestations, proteinuria, hypertension, and diabetes mellitus (Jwa et al., 2013).

Moreover, nutrition also has other risk factors for PIH because an increased consumption of vitamin E and mono- and poly-unsaturated fatty acids increases the risk for PIH, while an increased consumption of magnesium, potassium, and vitamin C reduces the risk for PIH (Kazemian et al., 2012).

Sleep disturbance is also a possible risk factor for PHI because it correlates with hypertension (Haney, Buysse, & Okun, 2011). To expose these findings, I will employ PowerPoint presentation, brochures, handouts, and discussion.

The fourth objective of teaching is to enhance understanding of available treatment and management interventions of PIH. When pregnant women know the nature of available interventions, they can discuss with their doctors and choose the best intervention that fits them, hence, promote therapeutic adherence.

Sajith et al. (2014) state that both mono- and combined therapies of antihypertensive drugs are used in the treatment and management of PIH because they are safe for mothers and infants. Kazemian et al., (2012) recommends the application of nutrition in the prevention, treatment, and management of PIH.

Moreover, Haney, Buysse, and Okun (2011) recommend that alleviation of sleep disturbance reduces blood pressure, and hence, prevents the occurrence of PIH. The methods of teaching will comprise the use of the PowerPoint presentation, brochures, handouts, and discussion.

Handout

Pregnancy-Induced Hypertension

What is pregnancy-induced hypertension?

Pregnancy-induced hypertension refers to the high blood pressure, which women experience when they are pregnant.

Why is it important for pregnant women?

Pregnancy-induced hypertension affects pregnant women because their body changes during pregnancy. If doctors do not detect and treat pregnancy-induced hypertension, the mother and the baby will die. Therefore, pregnant women need to understand this disease so that they can seek medical attention whenever they experience signs and symptoms and save themselves and the unborn babies.

Signs and Symptoms

The common signs and symptoms of pregnancy-induced hypertension are excessive swelling of hands and feet, severe morning sickness, dizziness, fast heartbeat, severe headaches, drowsiness, high temperature, poor vision, and pain in the abdomen.

Nature of Pregnancy-Induced Hypertension

Pregnancy-induced hypertension is different from other types of hypertensions because it affects women only, occurs after 20 weeks of pregnancy, and there are no proteins in the urine. However, when not treated, it progresses into a disease called preeclampsia, which causes urine to appear in urine.

Risk Factors

The risk factors for pregnancy-induced hypertension are first-time pregnancy, age of the mother, bloodline with this disease, proteins in urine, many pregnancies, diabetes, nutrition, high blood pressure, and sleep disturbance.

Treatment and Management Interventions

Use medications that reduce high blood pressure (antihypertensive drugs).
Control food intake by reducing the amount of oils while increasing the amount of potassium, magnesium, and vitamin C.
Avoid disturbance during sleep and have peace of mind.

References

Haney, A., Buysse, D., & Okun, M. (2011). Sleep and pregnancy-induced hypertension: A possible target for intervention? Journal of Clinical Sleep Medicine, 9(12), 1349-1356.

Jwa, S., Arata, N., Sakamoto, N., Watanabe, N., Aoki, H., Kurauchi-Mito, A., Dongmei, Q., Ohya, Y., Ichihara, A., & Kitagawa. (2011). Prediction of pregnancy-induced hypertension by shift of blood pressure class according to the JSH 2009 guidelines. Hypertension Research, 34(1), 1203-1208.

Kazemian, E., Dorosti-Motiagh, A., Sotoudeh, G., Eshraghian, M., & Ansary, S. (2012). The nutritional status of women with gestational hypertension compared to normal pregnant women. Womens Health Care, 1(10), 1-6.

Sajith, M., Nimbargi, V., Modi, A., Sumariya, R., & Pawar, A. (2014). Incidence of pregnancy induced hypertension and prescription pattern of antihypertensive drugs in pregnancy. International Journal of Pharma Sciences and Research, 5(4), 163-170.

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