Hypertension in Pregnancy and Infertility as per IVF-Clinics in Delhi
Hypertensive Disorder is increasing at an alarming rate, among pregnant women, in recent times. 6 to 8% of all pregnancies are said to be affected by this disorder. Many factors are responsible, and a variety of treatments have been suggested to control it. Some of them will be further discussed in this article as per IVF Clinics in Delhi.
Types of Hypertensive Disorder
The problem of high blood pressure among pregnant women, causing hypertension, is known as Hypertensive Disorder or HD. The ailment is becoming a significant area of concern for gynecologists all over the world. Probably, because it not only negatively impacts the fetus but also causes infertility in the long run.
Hypertensive disorder of pregnancy is categorized into three types, based on the level of Blood Pressure (BP): Chronic Hypertension, Gestational Hypertension, and Pre-Eclampsia.
● Chronic Hypertension
BP of 140/90 mmHg or more, recorded before pregnancy and before 20 weeks of gestation is termed as Chronic Hypertension. It is more common in older women.
● Gestational Hypertension
When BP of 140/90 mmHg or more is recorded even after 20 weeks of gestation, it is known as gestational hypertension.
A systolic blood pressure of 140–159 mmHg or diastolic blood pressure of 90–99 mmHg causes pre-eclampsia. When the blood pressure rises above 170/110 mmHg, the risk of pre-eclampsia increases.
Side-effects of Hypertensive Disorder on Pregnancy
Hypertensive Disorder causes extreme complications during pregnancy, if not treated on time. Postponed childbirth, obesity in mothers, growth restriction of the fetus, and congenital heart disease in both baby and mother are the direct results of chronic hypertension. The disorder might also cause superimposed pre-eclampsia, caesarean delivery, pre-term delivery, low birth weight, neonatal intensive care, and even prenatal death.
Over 3% of pregnancies get complicated because of chronic hypertension. Pre-Eclampsia has even more severe consequences than chronic hypertension. Some of the significant side-effects include renal impairment, ECG changes, placental abruption, and repeated hospital admissions for blood-pressure control. Hepatic impairment is another major symptom of Hypertensive Disorder.
Effect of Hypertensive Disorder on Fertility
Obesity or insulin resistance, androgen excess, sympathetic nerve over activity, and chronic use of oral contraceptives are some of the primary causes of Hypertensive Disorder. They further lead towards polycystic ovaries and endometriosis, which causes infertility. These diseases are prominent in women who underwent infertility treatment because of old age or increased risk of multiple pregnancies.
Hypertensive Disorder causes poor egg quality which also negatively affects the fertility of women. Medicine used for the treatment of infertility such as letrozole, human chorionic gonadotropins, and dopamine agonists, and gonadotropin-releasing hormone agonists might cause Hypertensive Disorder among women in the future. These medicines release estrogen, which induces hypertension.
There are a variety of antihypertensive agents available, but none of them are considered completely safe. Methyldopa, a popular antihypertensive therapy since the 1960s, is still regarded as one of the successful therapeutic procedures. Severe hypertension can be treated by the regular dosage of another popular medicine and an alternative to Methyldopa, Labetalol.
Labetalol is a combination of alpha-blocker and beta-blocker and is easier to use than Methyldopa. Nifedipine, a calcium chain-blocker, is used to reduce the risk of premature labor. However, its usage to reduce the risk of placental hypoperfusion—causing sudden maternal hypotension and fetal distress—is highly discouraged.
Hypertensive Disorder is more psychological than physiological. The usage of supplementations such as calcium, antioxidants, and low-dose aspirin has always been a matter of debate among doctors and professionals. As suggested by IVF Clinics in Delhi women are encouraged to follow a healthy lifestyle rather than running behind medicines and chemical treatments. Regular exercise or yoga and a balanced diet tend to reduce the high blood pressure to a large extent.