Potential Complication: Gestational Hypertension

Running Head: GESTATIONAL HYPERTENSION
Maternal/Newborn Health- Gestational Hypertension
Name of the Student
Name of the University
Author’s Note

1GESTATIONAL HYPERTENSION
Introduction
Pregnancy Induced Hypertension (PIH) or Gestational Hypertension is the onset of blood
pressure during pregnancy after 20 weeks of gestation. It can be detected even without the
presence of protein or the signs of preeclampsia. Blood pressure is diagnosed when the blood
pressure is more than 140/90 mm/Hg, twice during separate occasions after the interval of 6
hours (Magee et al., 2015). Family centered care is the approach to health care that is based on
the foundation of family care and the programs, policies, day to day interactions between
physicians, family members and patients, and facility design is related to the structure of a
family. The health care professionals involved in this care plan focuses on the significant role of
family settings in the wellbeing of a child including the family members of different ages. The
determinants of health is the factors and issues that influences the health of an individual or a
population. It could be a reason for the prevalence of gestational hypertension in pregnant
women, which is the determinants of health on an altered status. The application of nursing care
will be discussed in this paper that is related to the maternal and newborn health, which is
gestational hypertension.
Discussion
The alteration in the health status of a pregnant women or the newborn is due to several
complications during the gestational period and one of them is gestational hypertension because
it affects the wellbeing of the mother and the child. Gestational hypertension is caused in a
pregnant women due to the risk factors such as obesity, conceiving below 20 years of age or
above the age of 40, past medical history of hypertension, diabetes mellitus, and renal diseases,
pre-existing hypertension, thrombophilias, and during pregnancy if the mother has multiple

2GESTATIONAL HYPERTENSION
gestations including twins or triplets, placental abnormalities such as hyper-placentosis or
placental ischemia. Family history is another cause of complications in gestational period
(Guedes-Martins, 2016). Gestational hypertension is also known as preeclampsia that includes
proteinuria, but this paper will only focus on the issue of gestational hypertension. It affects the
health status of the newborn as well as the mother, which needs to be intervened through the help
of related nursing care plan and family centered care. There are no accurate treatment options
available for this complication because it needs to be monitored and kept under surveillance
through certain measures to keep the blood pressures at control (Kintiraki et al., 2015). Several
drug options are available for hypertension but during pregnancy, various complications have to
be considered because few antihypertensive drug can negatively affect the foetus. Some of the
medicines known as hydralazine, labetalol and methyldopa is used during severe hypertension in
pregnancy. This disease is not curable but it can be maintained with the help of controlled diet
and appropriate physical activities during pregnancy (Currie et al., 2014). The alteration in the
health status of the newborn and the pregnant women is crucial as it makes an impact on their
development and future life. High blood pressure in a pregnant woman can affect their wellbeing
such as its effect on the kidneys, low amount of blood flow to the placenta that leads to
insufficient nutrient, low birth weight or still birth of the child, leads to a future risk of
cardiovascular diseases or high blood pressure to the newborn or the mother. The complication
of hypertension during pregnancy also leads to preeclampsia, which is known as toxemia. It can
negatively affect the placenta including the kidneys, brain and liver. Preeclampsia is also the
cause of eclampsia, which is a condition of seizures and coma, sometimes death. A woman is at a
greater risk of gestational hypertension when she is going through her first pregnancy, has a
present condition of overweight of obesity, is more than the age of 40, comes from the African

3GESTATIONAL HYPERTENSION
American ethnic race or has a history of preeclampsia or PIH (Butalia et al., 2018). Women who
have twins or has the tendency of multiple gestations are more vulnerable to gestational
hypertension. In few cases, the women is asymptomatic to all the symptoms of hypertension,
which makes it difficult for the medical professionals to detect the disease.
The concept of family centered care has four core concepts that helps and guides the
nurse in interacting and communicating with different members of the family. It promotes
positive patient outcome and quality care in medical settings. The four concepts are participation,
information sharing, dignity and respect, and collaboration (Foster, 2015). All of them are major
aspects required in the profession of nursing and designing of any nursing care plan. To discuss
two of them it will be appropriate to choose participation and information sharing as it is a
necessary factor essential for the delivery of quality service, which is possible through a family
centered care model. ‘Information sharing’ guarantees effective communication between
professionals and the families involved in a healthcare. It is a system of clear communication
between patients, doctors, nurses and parents. The family of the patient needs to share adequate
information about the health condition of the patient for the accurate treatment and the doctors
need to explain the concerned people about the current health status of the patient as it will give
them a clear idea about the medical procedures required by the patient. During care process all
the parties involved such as the patient and the doctor should be given the timely reports and
updates about the whole medical management. This helps in enhancing transparency in a
healthcare organization and elevates the quality of service given to people through collaboration.
It is necessary to make the family members of the patient aware about the negative and positive
sides of the diagnosis and treatment, which is ethical and effective for the welfare of the patient
involved. ‘Participation’ is the core concept that encourages patient and medical professionals to

4GESTATIONAL HYPERTENSION
involve and indulge into activities that will promote positive patient outcome. It also makes the
family of the patient to participate in discussing about the treatment procedures of the patient
(Shields, 2015). The aspect of decision making is witnessed in this concept because participation
leads to the collaboration of different individuals, which ensures various ideas that leads to
efficient decision making. This encourages the patient and their family members to participate
with the healthcare organization to support a fast paced treatment. The philosophy of family
centered care model is designed according to the requirements of the medical profession and the
psychology of different age groups in a family. As a summary, family centered care model is
about the planning, delivery, and total evaluation of the concerned healthcare organization that is
based on the mutual relation between various medical professionals, families and patients. It is
an effective model of care because it focuses on all age groups, all levels of care present in all
types of healthcare settings. It prioritizes the preferences and demands of the family members
that includes different age groups and family dynamics (Perry et al., 2014).
The 12 determinants of health in Canada is income and social status, social support
networks, education and literacy, working conditions, physical environment, personal health
practices, healthy child development, biology and genetic endowment, health services, gender
and culture (Greenwood et al., 2015). The social determinant related to the topic of discussion is
healthy child development. According to the World Health Organization (WHO, early child
development is the most significant and essential development through the whole lifespan. It
includes social/emotional, physical and language or cognitive development of the child, which is
equally important for the wellbeing of the child. It affects the health status of their future life
such as mental health issues, obesity, cardiovascular disease and literacy competence. It also
includes criminality, numeracy, and economic participation during their whole lifespan. What

5GESTATIONAL HYPERTENSION
happens to a child during the prenatal period and childhood affects the course of their entire life
that involves their health status. The complication of gestational hypertension during pregnancy
affects the early childhood development during the prenatal stage, which is essential for the
wellbeing of the child. This determinant of health is related to this issue for the similar reason,
which is the alteration of health status of the newborn and the pregnant woman. The
development of a child also affects the future generation and the socioeconomic condition of the
country because their health status in the later life span will be a factor of prosperity in an
organization. To give a detailed explanation about the effect of the social determinant of health,
the three aspects are to be considered are known as social, political and cultural level. The daily
living conditions, the health of the family that influences the health status of the child are some
significant factors in early child hood development (Guhn et al., 2016). The prevalence of
hypertension in pregnant women is due to health negligence, unhealthy lifestyle and sometimes
family history. The issue of hypertension effects the development of the foetus and that
influences the condition of the new born. This will be a precursor to the health complications
during early childhood and that is the reason for several health complications in adulthood and
old age. The aspect of prenatal development has an impact on the early childhood development,
which dependent on the gestational care and condition of the mother during pregnancy.
Inaccessibility to healthcare services due to social inequities is the major concern for the
wellbeing of maternal and child health (Schoenaker, Soedamah-Muthu & Mishra, 2014). A
number of women are unable to attend their medical checkups due to unawareness or financial
constraints, which is caused due to other social determinants of health.

6GESTATIONAL HYPERTENSION
Conclusion
To conclude this essay, it can be said that gestational hypertension is a serious
complication that needs to be addressed to ensure a sound maternal and child health. This paper
summarizes the effect of determinants of health on the alteration of the health status and also the
concepts of family centered care model. The consecutive higher range of blood pressure during
pregnancy are the signs of gestational hypertension, which is caused due to several reasons such
as medical history or current condition of blood pressure or the family history. It cannot be cured
during pregnancy but it can be controlled as it gets cured after pregnancy. The development of
the foetus gets affected and it leads to more health complications after the child is born. The
family centered care model promotes maternal and child health with the help of information
sharing, participation, collaboration, dignity and respect. Whereas, the determinants of health
also influences the health of the child as well as the mother. Early childhood development gets
affected due to the complications in the prenatal stage, which is a significant factor towards the
wellbeing of the maternal and newborn health.

7GESTATIONAL HYPERTENSION
References
Butalia, S., Audibert, F., Côté, A. M., Firoz, T., Logan, A. G., Magee, L. A., ... & Nerenberg, K.
A. (2018). Hypertension Canada’s 2018 guidelines for the management of hypertension
in pregnancy. Canadian Journal of Cardiology, 34(5), 526-531.
Currie, L. M., Woolcott, C. G., Fell, D. B., Armson, B. A., & Dodds, L. (2014). The association
between physical activity and maternal and neonatal outcomes: a prospective
cohort. Maternal and child health journal, 18(8), 1823-1830.
Foster, M. (2015). A new model: the family and child centered care model. Nursing Praxis in
New Zealand, 31(3), 4-7.
Greenwood, M., De Leeuw, S., Lindsay, N. M., & Reading, C. (Eds.). (2015). Determinants of
Indigenous Peoples' Health. Canadian Scholars’ Press.
Guedes-Martins, L. (2016). Chronic hypertension and pregnancy. In Hypertension: from basic
research to clinical practice (pp. 395-407). Springer, Cham.
Guhn, M., Janus, M., Enns, J., Brownell, M., Forer, B., Duku, E., ... & Raos, R. (2016).
Examining the social determinants of children's developmental health: protocol for
building a pan-Canadian population-based monitoring system for early childhood
development. BMJ open, 6(4), e012020.
Kintiraki, E., Papakatsika, S., Kotronis, G., Goulis, D. G., & Kotsis, V. (2015). Pregnancy-
induced hypertension. Hormones, 14(2), 211-223.

8GESTATIONAL HYPERTENSION
Magee, L. A., von Dadelszen, P., Rey, E., Ross, S., Asztalos, E., Murphy, K. E., ... & Gruslin, A.
(2015). Less-tight versus tight control of hypertension in pregnancy. New England
Journal of Medicine, 372(5), 407-417.
Perry, S., Hockenberry, M., Lowdermilk, D., Wilson, D., Keenan-Lindsay, L., & Sams, C.
(2014). Maternal child nursing care in Canada (2nd ed.). Ontario: Elsevier.
Schoenaker, D. A., Soedamah-Muthu, S. S., & Mishra, G. D. (2014). The association between
dietary factors and gestational hypertension and pre-eclampsia: a systematic review and
meta-analysis of observational studies. BMC medicine, 12(1), 157.
Shields, L. (2015). What is “family-centred care”?. European Journal for Person Centered
Healthcare, 3(2), 139-144.