La Socodka DhiigKarka iyoUurkaagaDhiig Karka Xilliga Uurka

Dhiig karka caadiga ah waa uu u kala duwanaan karaadadka, iyadoo ay ku xiran tahay waxyaabaha la midka ahheerka jirdhiska qofka, iyo weliba waxa dhacaya markadhiig karka lagaa cabbirayo. Waa uu isbeddeli karaa xilligauurka.

Waxaynu filaynaa in aynu aragno in yar hoos u dhac ah intalagu guda jiro seddexda bilood ee labaad ee uurka (qiyaastiitoddobaadyada 14 illaa 22). Intaasi kaddib, dhiig karkaaguwaa in uu caadi ku soo noqdaa illaa iyo dhammaadkauurkaaga. Haddii uu dhakhtarkaagu uu ka walwal qabo inay kuugu yimaadiin dhibaatooyinka dhiig karka, isaga amaiyadu in lagaa qaado baaritaan qaas ah.

Cabbirka Wax Soo Saarka Wadnaha iyoDhiig Karkaaga

Waxaynu adeegsanaa mashiinka maqalka dhawaaqa (ultra-sound) ee cabbiraysa tirada dhiigga ee jidhkaaga loogudbiyo daqiiqad walba (wax soo saarka wadnaha).Baaritaanka waxaa laga qaadaa jidhkaaga dhibeddiisawaxaana uu qaadanayaa qiyaastii 15 daqiiqadood.

Dhiig karku waa isku dhafka wax soo saarka wadnaha iyotirada cadaadiska ee xididada (adkaysiga dibedda). Haddiiwax soo saarka wadnaha ama cadaadiska dibedda uuqiyaasta ka badan yahay, waxaa uu keeni karayaa in dhiigkarkaagu uu kor u kaco.

Qoraalkani waxaa uusharxayaa :

• Qaabka loogawarqabo dhiig karkainta uurka la leeyahay.

• Waxa uu yahaypreeclampsia (dhiigkarka), oo ay ku jirtowaxyaabaha khatartakeena, daweynta, iyowaxa la sameynkarayo sida khatartaloo dhimo.

• Sida loo baarocaafimaadkaubadkaaga.

• Waxyaabaha dhacamarka lala soconayodhiig karka xilligadhalmada iyo wixii kadambeeya marka uuubadka dhasho.

Wabarashada BukaankaBukaan Socod Eegtada Daryeelka Hooyada iyo Dhallaanka

Blood Pressure Management and Your Pregnancy – Somali

Bogga 2Bukaan Socod Eegtada Daryeelka Hooyada iyo UbadkaLa Socodka Dhiig Karka iyo Uurkaaga

Waa caadi in xilliga uurka uu socodka dhiiiga si aad ah uu isubeddelo si uu kaafiyo baahida korriinka ubadka (amadhallaanka). Caadiyan isbeddeladani waxaa ay billawdaanseddexda bilood ee hore ee uurka kaddibna caadi ku noqdaa wixiika dambeeya 14 illaa 16 asbuucood ee uurka. Marka aynusameyno cabbirka wax soo saarka wadnaha, waxaynu helaynaamacluumaadka waxa dhacaya maalintaasi ee uurkaaga.

Cabbirka wax soo saarka wadnahaaga waxaa lagu qorayaagaraafka socodka dhiiga uurka iyadoo lala barbar dhigayocabbirka la filayo xilliga uurka uu marayo. Natiijooyinka waxaauu adiga iyo dhakhtarradaadu idin siinayaa macluumaadka ahkhatarta in uu kuugu dhaco preeclampsia (dhiig karka) xilligadambe ee uurkaaga, iyo sida ugu habboon ee haatan loo daweynkarayo. Natiijooyinka waxaa uu ka saacidayaa dhakhtarka haddiidawooyinka loo baahan yahay, iyadoo uu u muujinayo midka uguwaxtarka badan xaaladdaasi taagan.

Dhiig Karka (Preeclampsia)

Preeclampsia waa dhibaatooyinka dhiig karka xilliga uurkakaasoo dhici kara xilli kasta wixii ka dambeeya 20 asbuuc uurkamarka uu yahay. Waxaa uu saameyn karayaa qaybo badan eejidhkaaga ka mid ah haddii aan la daweyn, oo ay ku jraankilyaha, beerka, iyo maskaxda.. Dhalmada ubadka waa muhiimhaddii preeclampsia ay gaarto heer ay khatar gelinaysocaafimaadka hooyada iyo ubadka. Tani waxaa ay keenaysaadhibaato badan haddii ay dhacdo ubadka oo aan korin, amadhalmada ka hor. Waxaynu isticmaalnaa dawooyin iyo nasasho siloo dib loogu dhigo horumarka ama loo dhimo horumarkiisa siubadka u dhasho xilliga ugu dhow dhalmada. Haweenka qabapreeclampsia sida ay u badan tahay waxaa ay qabayaan dhiig karsare, barootiin kaadida soo raaca, iyo isbeddelo kale ee kuyimaada dhiigeeda, kaasoo lagu cabbiro shaybaaro qaas ah.

Bogga 3Bukaan Socod Eegtada Daryeelka Hooyada iyo Ubadka

La Socodka Dhiig Karka iyo Uurkaaga

Calaamaadka Khatarta

Ujeedadeenu waa in la dhimo khatarta in uu kuugu dhacopreeclampsia intii la daweyn lahaa marka uu kugu dhaco kaddib.Haweenka qaba xaaladahani waxaa ay halis dheeraad ah ugu jiraan inuu xilliga uurka ku dhaco preeclampsia.

••••• Dhiig karka daba dheeraada.

••••• Xaalad jiritaan ah ee dhiig karka (qaasatan dhalmada ka hor).

••••• Macaanka.

••••• Cudurka kilyaha.

••••• Cudurka difaaca jidhka.

••••• Xuduudda dhiig karka horraanta uurka (ka badan 120/80).

••••• Dhiig karka aan hoos u dhicin seddexda bilood ee labaad.

••••• Uurka hore.

••••• Mataanada (laba, seddex, ama ka badan).

Calaamaadka Digniinta ee Preeclampsia

Haddii aad qabtid mid kastoo ka mid ah calaamaadka soo socda,waxaad sida ugu dhakhsiyaha badan u soo wacdaa dhakhtarkaaga (iskahubi in aad taqaanid lambarka taleefanka aad wacaysid haddii uuxafiiskooda xiran yahay):

••••• Madax xanuun, oo ka badan ama ka nooc ah sida caadiga ah,qaasatan haddii uu kaaga bogsan waayo marka aad qaadatidkaniinka Tylenol ama dawooyinka kale e lagu daweeyo.

••••• Bararb aan degaynin habeenkii ama marka aad nasatid ee dhaafacagahaaga iyo canqowga una gudba gacmahaaga iyo wejigaaga(iyo miisaan si dhakhsiya ah kuu kora kaasoo uu bararka la socdo).

••••• Dhibaatooyinka aragtida sida aragga xiddigaha, dhibicyo, ama iftiintooshka (sida waxa aad aragtid marka aad si dhakhsiyo ah uistaagtid).

••••• Xanuunka qaybta sare ee caloosha (Epigastric), sida laab dilaac,balse aad looga dareemo qaybtaada sare ee midig ee aan xiriir lalahayn marka aad wax cuntid. Noocan "laab dilaaca" ah kuma uubogsado kaniinka laab dilaaca (antacids). Ama, waxaa laga yaabaain lablabootid iyo/ama matagtid.

Bogga 4Bukaan Socod Eegtada Daryeelka Hooyada iyo UbadkaLa Socodka Dhiig Karka iyo Uurkaaga

Waxyaabaha Aad Sameyn KartidKuwani ayaa ah waxyaabaha qaarkood ee aad sameyn kartid siloo dhimo khatarta preeclampsia ama in aad inaga saacididtilmaanta dhibaatooyinka ee xilli hore si looga hortago dhalmadaxilligeeda ka hor:

••••• Sida ugu dhakhsiyaha badan u hel daryeelka dhalmada ka hor.

••••• Waxaad timaadaa dhammaan booqashooyinka iyo balannadadhalmada ka hor.

••••• Waxaad bixisaa taariikhda caafimaadka oo dhammeystiran.

••••• Waxaad cuntaa cunno caafimaad leh – ka fogow cuntadacusbada ku badan sida bataatiga shiilan (chips), maraqagasacadaysa iyo khudradda, cuntada qabow, iyo cuntada uuku jiro suugada soy (soy sauce).

••••• Waxaad qaadata xilliyo nasiinno ah – la soco jidhkaaga oohaddii aad daalan tahay naso.

••••• Si caadi ah u qaado dawooyinka laguu qoro.

••••• Waxaad wacdaa dhakhtarkaaga si aad u soo wargelisidcalaamaadka digniinta iyo waxyaabaha kale aad ka walwalqabtid.

Xilliyada Nasashada Maalintii

Haweenka badankood waxaa ay ka faa’idaystaan nasiinadadheeraadka ah ee uurka xilligiisa dambe. Waxaad billawdaa inaad ka fakartid qaababka aad ku dhimi kartid hawlahaaga aqalka,shaqada, iyo xanaanada carruurta. Aad bay u fududaneysaa si aadu heshid waqti aad ku nasatid haddii aad saacidaad ka haysatiddadka kugu hareersan. Hore qorshooyin ula sameyso xubnahaqoyskaaga ka tirsa, dadka aad wada shaqeysaan, iyo asaxaabta siay tani u suuragasho.

Haddii lagaa codsado in aad nasiino dheeraad ah qaadatidmaalintii, waxaa aad kuu saacidaya in aad u kala qaadatid 2-diiillaa 3-dii saacadoodba. Ma aha in aad jiifsatid xilliyadaninasiinada ah, balse waxaa muhiim ah in aad gees u jiifsatid(aadan fadhiisan) islamarkaana aadan soo toosin ama fadhiisanxilligani nasiinada ah.

Xilliyada nasiinadani waxaa ay kaa saacidayaan in dhiigkarkaagu uu hoos joogo, socodka dhiigaagu uu kordho, kaasookaa saacidaya korriinka habboon ee ubadka, islamarkaanabararka hoos u dhigaya. La soco jidhkaaga hana is qasbin.

Bogga 5Bukaan Socod Eegtada Daryeelka Hooyada iyo Ubadka

La Socodka Dhiig Karka iyo Uurkaaga

DawooyinkaKuwani ayaa ah liiska dawooyinka ugu muhiimsan ee lagu daweeyodhiig karka xilliga uurka. Dhakhtarka waxaa uu kugula talinayaadawooyinka kugu habboon.

Atenolol

••••• Waxaa uu hoos u dhigayaa dhiig karka isagoo dhimaya garaacawadnaha iyo wax soo saarka wadnaha (kaasoo cadaadiska kayareynaya xididada dhiigga).

••••• Waxaa suuragal ah in uu dhimo madax xanuunka, garaaca wadnahadegdegga ah, ama neef yarida.

••••• Waxaa la qaataa isku xilli maalin kasta - mararka qaarkood waxaynuku talinaa in la qaato habeenkii maadaama uu daal ku dhaliyohaweenka qaarkood.

••••• Waxaa suuragal ah in uu dhimo korriinka ubadkaaga haddii uu hoosu dhaco socodka dhiigga – Taasi ayaa ka mid ah sababaha ugumuhiimsan in loogu soo noqdo booqashooyinka xiga (waxaynu lasocon karaynaa wax soo saarka wadnahaaga/socodka dhiiggaislamarkaana in isbeddel aynu ku sameyno dawooyinkaaga si looxaqiijiyo in uu aad hoos ugu dhicin).

Clonidine

••••• Dhiig karka ayuu hoos u dhigayaa isagoo dabcinaya xididada.

••••• Waxaa la qaataa 3 goor maalintii. Waxaa muhiim ah in dawadani laqaato sida ugu dhow ee 8-dii saacadoodba.

••••• Waxaa la qaataa isku xilli maalin kasta.

••••• Waxaa suuragal ah in lulmo uu keeno qaadashada hore.

Hydralazine

••••• Dhiig karka ayuu hoos u dhigayaa isagoo dabcinaya xididada.

••••• Waxaa uu kordhinayaa socodka dhiigga, kaasoo aad muhiim ugu ahkorriinka ubadka.

••••• Waxaa la qaataa 4 goor maalintii xilliyada quraacda, qadada,cashada, iyo jiifka ama 6-dii saacadoodba.

••••• Waxaa laga yaabaa in uu madaxa xanuun keeno - ma xuma in laqaato acetaminophen (Tylenol) si aad uga bogsatid, balse waxaadsoo wacdaa dhakhtarkaaga haddii Tylenol uu ku bogsan waayomadax xanuunka ama uu dhaafo 3 cishood.

Bogga 6Bukaan Socod Eegtada Daryeelka Hooyada iyo UbadkaLa Socodka Dhiig Karka iyo Uurkaaga

Lasix

••••• Waxaa uu hoos u dhigayaa dhiig karka isagoo kaadi kudhimaya biyaha jidhka ku jira.

••••• Waxaa la qaadan karayaa mar ama laba goor maalintii (haddiiaad habeenkii qaadatid waxaa uu keeni karyaa in aad kaadi usoo toostid).

••••• Waxaa suuragal ah in aad u baahatid qaadashada kaniinkabootaasiyumka (potassium) - kaadi dheeraad ah waxaa ayhoos u dhigaysaa bootaasiyumka dhiigga ku jira.

Caafimaadka Ubadkaaga

Waxaa jira dhowr waxyaabood aynu eegno xilliga uurka ee inoosheegaya in ubadku caafimaad qabo. Waxyaabaha ugumuhiimsan ayaa ah wax aad adigu la socon kartid.

Dhaqdhaqaaqa ubadka waxaa caadiyan ka gartaa 20 asbuucmarka uurku gaaro. La soco qaabka dhaqdhaqaaqa canuggaaga.Haddii la dareemo hoos u dhac ku yimaado dhaqdhaqaaqacanuggaaga, la socodsii dhakhtarkaaga. Xisaabinta dhaqdhaqaaqaubadka waxaa la billaabi karayaa qiyaastii marka uurku gaaro 28asbuuc.

Sida loo xisaabiyo dhaqdhaqaaqa ubadka:

••••• Waqti qabso marka caadiyan ubadkaagu uu dhaqdhaqaaqayo.Kaddibna ee inta ay qaadanayso in ubadkaagu dhaqdhaqaaqo10 goor.

••••• Haddii aad xisaabisid 10 dhaqdhaqaaq 2 saacadoodgudahood, waa ay fiican tahay. Waad joojin kartaa haddii uuubadkaagu dhaqdhaqaaq sameeyo 10 goor.

••••• Haddii aad xisaabisid 10 dhaqdhaqaaq ka yar 2 saacadoodgudahood, la socodsii dhakhtarkaaga.

Cabbirka korriinka ubadka waa qaab kale ee lagu ogaanayocaafimaadka ubadkaaga. Waxaa dheer qaab dhageysigadhawaaqa (ultrasound) in dhakhtarku amro in la eego dhismahajidhka ubadka, waxaynu ku talinaynaa in qaab dhageysigadhawaaqa (ultrasound) marka uurkaagu gaaro 28 asbuuc si looeego korriinka ubadka. Waxaa suuragal ah in sidani markale lasameeyo 32 illaa 34 asbuuc marka uurku gaaro.

Bogga 7Bukaan Socod Eegtada Daryeelka Hooyada iyo Ubadka

La Socodka Dhiig Karka iyo Uurkaaga

Xilliyada dambe ee uurka, caafimaadka ubadka ayaa lagu eegi doonaaiyadoo la adeegsanayo baaritaanka garaaca wadnaha (nonstress tests –NSTs). Baaritaanka cadaadiska aan lahayn wa baaritaan dibedda lagalasoconayo garaaca wadnaha ubadka iyo isbeddelada uu hawlaha kusameynayo. Isla xilligaas, waxaa lagaa eegi doonaa in uu isku sooaruurayo ilma geleenkaagu. NSTs waxaa caadiyan la billaaba 32asbuucood waxaana la sameeyaa mar ama laba goor toddobaadkii.

Xilliga Foosha iyo Dhalmada

Dhiig karkaagu ayaa la eegi doonaa xilliga foosha iyo dhalmadaadu.Waxaad hore u soo qaadataa dawooyinkaaga marka aad cusbitalkaimaanaysid. Waxaa muhiim ah in dhakhaatiirtaadu ay og yihiin waxaaad qaadato iyo inta aad ka qaadato. Sida ay u badan tahay waxaad siiqaadan doontaa dawooyinkaaga dhiig karka inta aad cusbitalka ku jirtid.

Haddii uu dhakhtarkaagu uu kuu sheego in aad qabtid dhiig karka(preeclampsia), waxaa suuragal ah in lagu siiyo dawo aad xididka kaqaadanaysid ee loogu yeedho magnesium sulfate inta aad foolanaysidiyo dhalmaadada. Dawadani waxaa loo adeegsadaa si looga hortagoqalalka ee dhici karaya marka aan dhiig karka (preclampsia) aan ladaweyn. Dhakhtarkaagu iyo kalkaaliyeyaasha cusbitalka waa ay kaalahadli doonaan dawooyinkan haddii ay ogaadaan in aad u baahanaysid.

Dhalmada Ubadkaaga Kaddib

Kaddib marka uu ubadkaaga dhasho, dhiigga ku hareersanaamandheerta waxaa uu dib ugu laabanayaa mariinnada dhiigaaga.Maadaama dheecaanadan dheeraadka ah ee uurkaaga sito uu dib ugusoo laabanayo wareegga dhiigaaga, waxaa ay keeni karayaan in dhiigkarkaagu sare u kaco. Waxaa suuragal ah in ay noqoto in aad qaadatidkaniinka kaadida badiya ee lagu magacaabo lasix ama furosemide sidheecaan dheeraad ah jidhkaaga si dhakhsi ah looga saaro. Miisaanbadan ayaa kaadi awadeed kaaga dhici kara maalmaha horedhalmadaada kaddib.

Waxaa weli muhiim ah in aad la socotid calaamadka digniinta ah eedhiig karka preeclampsia asbuuca hore ee dhalmadaada. Waxaadwacdaa dhakhtarkaaga haddii aad dareentid mid ka mid ah calaamdkaiyo/ama cabbirka aqalka kuu yaal oo ka bata 140/90 asbuuc gudihiiskaddib marka cusbitaalka lagaa saaro.

© University of Washington Medical CenterBlood Pressure Management and Your Pregnancy

Somali10/2003 Rev 04/2006

Reprints: Health Online

Maternal and Infant Care ClinicObstetrical Hypertension Consult Clinic

Box 3561591959 N.E. Pacific St. Seattle, WA 98195

206-598-2689

Bukaan Socod Eegtada Daryeelka Hooyada iyo UbadkaLa Socodka Dhiig Karka iyo Uurkaaga

Inkastoo dhakhtarkaagu uu dhimi karo tirada dawooyinka ah inaad qaadatid, waxaa ay u badan tahay in aad sii qaadanaysiddawooyinkaaga dhiig karka dhowr asbuucood kaddib markubadku dhasho. Caadiyan waa muhiim maadaama ay qaadanayso6 illaa 8 asbuuc in jidhkaagu uu caadi ugu soo noqdo. Waadqaadan kartaa dawada dhiig karka inta aa naas nuujinaysid.

Mar haddii 6-da asbuuc ee hore la dhaafo, dhiigga iska cabbirugu yaraan laba goor sanadkiiba. Ogsoonow cabbirka dhiiggacaadiga ah iyo garaaca wadnaha jidhkaaga. La socodsii cabbirkadhiigaaga dhakhtarkaaga haddii uu kor u dhaafo 140/90.

Dhakhtarkaagu waxaa laga yaabaa in uu kugula taliyo siiqaadashada dawooyinka dhiig karka. Dawooyinka waxaa ay sidhakhsiyo ah caadi ugu soo celin karayaan cabbirka dhiiga.

Isbeddelka qaab nololeedkaaga sida cuntada caafimaadka leh,miisaankaaga oo aad ilaalisid, iyo jirdhiska joogtada ah eecaafimaadkaaga guud, balse waqti ayeey qaadanaysaa in cabbirkadhiigaagu hoos u dhaco. Isbeddel oo aad qaab nololeedkaagu kusamaysid, waxaa laga yaabaa in aad hoos u dhigtid tiradadawooyinka aad u baahan tahay si dhiigaagu uu hoos uga dhaco120/80.

Waa u muhiim in ilaalinta cabbirka dhiiggaaaga caafimaadka fogee wadnahaaga, kilyaha iyo xididada. La socodka fiican ee dhiigkarka ayaa sidoo kale muhiim ah haddii aad qorshaynaysid in aaduur kale qaadid.

Su’aalo?

Su’aalahaagu waamuhiim. Waxaad wacdaadhakhtarkaaga haddiiaad su’aalo ama waxdareen ah qabtid.Shaqaalaha BukaanSocod Eegtada UWMCayaad xilli kasta helikaraysaa.

Bukaan Socod EegtadaDhiig Karka Haweenka(Obstetrical Hyperten-sion Consult Clinic):206-598-2689

Patient EducationMaternal and Infant Care Clinic

Blood Pressure Management and Your Pregnancy

This handout explains:

• How your blood pressure is checked during pregnancy.

• What preeclampsia is, including risk factors, treatments, and what can be done to lower risk.

• How your baby’s well-being is checked.

• What happens to manage blood pressure during labor and delivery and after the baby is born.

Blood Pressure During Pregnancy Normal blood pressure can vary from person to person, depending on such factors as your fitness level, and even what is happening when your blood pressure is being taken. It can change a great deal during pregnancy.

We expect to see a slight decrease during the second trimester of pregnancy (around 14 to 22 weeks). After that, your blood pressure should stabilize until the end of your pregnancy. If your provider were concerned that you might develop blood pressure related problems, he or she would ask for specialized testing to be performed.

Cardiac Output Measurement and Your Blood Pressure We use a specialized ultrasound machine that measures the amount of blood that is pumped through your body each minute (cardiac output). The test is done on the outside of your body and takes about 15 minutes.

Blood pressure is a combination of cardiac output and the amount of constriction or tightness in your blood vessels (peripheral resistance). If either your cardiac output or peripheral resistance is higher than average, it can cause your blood pressure to go up.

Page 2 Maternal and Infant Care Clinic Blood Pressure Management and Your Pregnancy

It is normal for a woman’s blood flow to change dramatically throughout pregnancy to meet the demands of a growing baby (or babies). Usually these changes start in the first trimester of pregnancy and stabilize after 14 to 16 weeks of pregnancy. When we do your cardiac output measurement, we obtain information about what is happening on that day during your pregnancy.

Your cardiac output measurement will be plotted on a pregnancy blood flow graph and compared with the expected values for that point in pregnancy. The results will give you and your providers more information about your risk for developing preeclampsia later in pregnancy, and how to best treat you now. The results will help the doctor decide if medications are needed, and show which one(s) would be most effective in your situation.

About Preeclampsia Preeclampsia is a high blood pressure complication of pregnancy that can happen any time after the 20th week of pregnancy. It can affect many systems of the body if left untreated, including the kidneys, liver, and brain. Delivery of the baby is necessary if preeclampsia has advanced to a stage where it threatens the health of the mother and baby. This can be a major problem if it occurs when the baby is not mature, or preterm. We use medications and rest to delay its development or slow its progression so that baby can be delivered as close to term as possible. A woman with preeclampsia will likely have increased blood pressure, protein in her urine, and other changes in her blood, measured through specific lab tests.

Page 3 Maternal and Infant Care Clinic

Blood Pressure Management and Your Pregnancy

Risk Factors Our goal is to decrease your risk for developing preeclampsia instead of treating it after it has developed. Women who have these conditions are at a higher risk of developing preeclampsia during pregnancy:

• Chronic hypertension.

• A history of preeclampsia (especially preterm).

• Diabetes.

• Kidney disease.

• An autoimmune disease.

• Borderline blood pressures early in pregnancy (most often greater than 120/80).

• Blood pressures that don’t decrease in the second trimester.

• A first pregnancy.

• Multiple gestation (twins, triplets, or more).

Warning Signs of Preeclampsia If you have any of these symptoms, call your doctor or provider right away (be sure you know the phone number to call if their office is closed):

• Headaches, which are more frequent or different than are usual for you, especially if they don’t go away with Tylenol or other recommended treatment.

• Swelling that doesn’t resolve overnight or with rest and goes past your feet and ankles to your hands and face (and the rapid weight gain that happens with swelling).

• Visual problems such as seeing stars, spots, or flashing lights (much like what you may see when you stand up too fast).

• Epigastric pain, which is like heartburn, but felt more on your upper right side and not related to what or when you eat. This type of “heartburn” does not get better with antacids. Or, you may have nausea and/or vomiting.

Page 4 Maternal and Infant Care Clinic Blood Pressure Management and Your Pregnancy

Things That You Can Do These are some things that you can do to help lower your risk for preeclampsia or to help us identify problems early so you can avoid a preterm delivery:

• Get prenatal care as early as possible.

• Come to all of your scheduled prenatal and consult visits.

• Give a complete medical history.

• Eat healthy foods – avoid salty foods such as chips, canned soups and vegetables, frozen entrees, and soy sauce-based dishes.

• Take rest breaks – listen to your body and rest when you’re tired.

• Take your prescribed medicines regularly.

• Call your provider to report warning signs and other concerns.

Daytime Rest Breaks Most women benefit from increased rest late in pregnancy. Begin thinking about ways to lighten your load at home, work, and with childcare. It will be easier to find time for the rest breaks if you have help from the people around you. Make plans in advance with family members, coworkers, and friends to make this possible.

If you are asked to get some additional rest during the day, it is most helpful if you take it in blocks of 2 to 3 hours. You don’t have to sleep during these breaks, but it is important to lie down on your side (not sit) and to not get up and down during the rest break.

These rest breaks help to keep your blood pressure down, increase your blood flow, which can help baby to grow well, and can help reduce your swelling. Listen to your body and don’t push yourself.

Page 5 Maternal and Infant Care Clinic

Blood Pressure Management and Your Pregnancy

Medications Here is a list of the main blood pressure medicines used to treat high blood pressure in pregnancy. The doctor will recommend the medicine(s) that is best for you.

Atenolol • Lowers blood pressure by slowing your heart rate and

decreasing your cardiac output (putting less stress on your blood vessels).

• May decrease headaches, racing heart, or shortness of breath.• Is taken at the same time every day – we sometimes suggest

taking it at night since it makes some women feel a little tired.

• Can slow your baby’s growth if blood flow becomes too low – that’s one of the reasons that it’s important to come back for follow-up visits (we can monitor your blood flow/cardiac output and make changes in your treatment to ensure that it does not become too low).

Clonidine

• Lowers blood pressure by relaxing blood vessels.

• Is taken 3 times per day. It is important to take this medicine as close to every 8 hours as possible.

• Is taken at the same time every day.

• May cause drowsiness after the first dose.

Hydralazine • Lowers blood pressure by relaxing blood vessels.

• Increases blood flow, which is important in maintaining baby’s growth.

• Is taken 4 times a day either at breakfast, lunch, dinner, and bedtime or every 6 hours.

• May cause headaches – it is fine to take acetaminophen (Tylenol) for relief, but call your health care provider if headache pain is not relieved by Tylenol or lasts longer than 3 days.

Page 6 Maternal and Infant Care Clinic Blood Pressure Management and Your Pregnancy

Lasix • Lowers blood pressure by reducing extra body fluids

through increased urine output.

• May be taken once or twice a day (taking it in the evening may cause you to wake up to urinate during the night).

• May require potassium supplements (take with the morning meal) – increased urine output can lower potassium in the blood.

Your Baby’s Well-Being There are several things we look at during your pregnancy to tell us that baby is doing well. One of the most important ones is something that you can keep track of yourself.

Baby movements are usually noticed by 20 weeks of pregnancy. Get to know your baby’s activity pattern. If there’s a noticeable decrease in your baby’s movement, notify your provider. Fetal movement counting can start when you are about 28 weeks.

How to do fetal movement counting:

• Pick a time when your baby is usually active. Then see how long it takes baby to move 10 times.

• If you count 10 movements within 2 hours, it is OK. You can stop counting when baby moves 10 times.

• If you count fewer than 10 movements over a 2-hour period, notify your prenatal provider.

Measuring baby’s growth is another way to determine baby’s well-being. In addition to the routine ultrasound your doctor may order at 20 weeks to look at baby’s anatomy, we will recommend you have an ultrasound at 28 weeks to look at how baby is growing. This may be repeated around 32 to 34 weeks.

Page 7 Maternal and Infant Care Clinic

Blood Pressure Management and Your Pregnancy

Later in pregnancy, baby’s well-being will also be watched with nonstress tests (NSTs). A nonstress test is an external fetal monitoring test that tracks your baby’s heart rate and how it changes with activity. At the same time, you will be monitored to see if you are having any uterine contractions. NSTs are usually started around 32 weeks and done once or twice a week.

During Labor and Delivery Your blood pressure will be checked often during your labor and delivery. Bring your medicines with you when you come to the hospital. It is important that your providers know both what you are taking and in what doses. You will most likely be kept on your blood pressure medications throughout your hospitalization.

If your provider says that you have preeclampsia, you may receive an intravenous medication called magnesium sulfate during your time in labor and delivery. This medication is used to prevent seizures that can occur when preeclampsia is not treated. Your provider and the nurses at the hospital will talk with you about this medication if they think that it is something that you will need.

After Your Baby Is Born After your baby is born, the blood that was circulated to the placenta is returned back into your own bloodstream. As these extra body fluids from pregnancy come back into your circulation, they can cause your blood pressure to go up. You may need to take a diuretic (water pill) called lasix or furosemide to get the extra fluid out of your body more quickly. You can lose a lot of weight in the first few days after delivery through urinating.

It is still important to watch for the warning signs of preeclampsia for the first week after you deliver. Call your provider if you experience any of those symptoms and/or a home blood pressure measurement greater than 140/90 within the first week after discharge from the hospital.

Maternal and Infant Care Clinic High Blood Pressure Management and Your Pregnancy

Although your provider may decrease the amount of medication that you need to take, you will probably need to continue your blood pressure medicines for several weeks after your baby is born. This is often necessary since it takes 6 to 8 weeks for your body to get back to normal. It is safe to breastfeed while taking blood pressure medicines.

Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. UWMC Clinic staff are also available to help at any time.

Once the first 6 weeks are over, have your blood pressure checked at least twice a year. Get to know what the normal blood pressure and pulse is for your body. Report your blood pressure to your primary care provider if it is greater than 140/90. Obstetrical

Hypertension Consult Clinic: Your provider may recommend continuing blood pressure

medications. Medications can bring your blood pressure into a normal range quickly.

206-598-2689

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Making lifestyle changes such as eating a healthy diet, maintaining or reaching a normal weight, and exercising regularly are important for your overall health, but they take time to lower blood pressure. By making these lifestyle changes, you may be able to gradually lower the amount of medications needed to maintain a blood pressure of less than 120/80.

It is key to control your blood pressure for the long-term health of your heart, kidneys and blood vessels. Good blood pressure control is also important if you plan on becoming pregnant again.

Maternal and Infant Care Clinic Obstetrical Hypertension Consult Clinic

Box 356159 1959 N.E. Pacific Street, Seattle, WA 98195

206-598-2689

© University of Washington Medical Center 10/2003 Rev. 04/2006 Reprints: Health Online