Hipertensi gestasional

Adalah hipertensi tanpa proteinuria pertama kali pada kehamilan lebih dari 20 minggu. Dan hilang post partus.

 Menurut WHO :
Tekanan sistol 140 mmHg atau diastol 90 mmHg Kenaikan sistol 15 mmHg dibanding Td sebelum hamil atau trimester 1

Faktor resiko
Usia Ras Keturunan Faktor gen Diet Iklim Sosio ekonomi hiperplasentosis

 Penyebab utamanya belum jelas Namun hipotesisnya karena terjadi reaksi penolakan imunologik ibu terhadap kehamilan dimana janin dianggap hostile tissue graff

komplikasi
Merusak sistem vaskuler darah Mengganggu pertukaran nutrisi pada janin Oligohydromnion pada janin

ACUTE TREATMENT OF HYPERTENSION IN PREGNANCY

AGENT DOSAGE
5 mg iv bolus, then 10 mg every 20 to 30 minutes to a maximum of 25 mg, repeat in several hours as necessary 20 mg iv bolus, then 40 mg 10 minutes later, 80 mg every 10 minutes for 2 additional doses to a maximum of 220 mg 10 mg po, repeat every 20 minutes to a maximum of 30 mg Cautious use with magnesium sulfate, can see precipitous blood pressure drop Short acting nifedipine is not approved by FDA for managing hypertension 0.5 ug/kg/min to a maximum of 5 ug/kg/min Fetal cyanide poisoning may occur if used for more than 4 hour

Hydralazine (preferred) Labetalol (second line) Nifedipine (controversial)

Sodium nitroprusside (rarely when others fail)

penatalaksanaan
Dilakukan monitor his dan DJJ dan diberikan drip 5 IU oxytosin dalam RL 500ml . Direncanakan partus spontan