Common Obstetric Problems

Haemorrhage (cont.)
Secondary PPH is more bleeding than expected, and is usually caused by infection in the womb. This can be treated with antibiotics. Occasionally a hysteroscopy evacuation is required (see Gynaesurgeon.co.uk - Hysteroscopy).

Hypertension - Raised blood pressure
We take two measurements when taking blood pressure, the systolic pressure is written on top and is when the pulse is first heard as the pressure in the cuff is reduced. The diastolic pressure is recorded as the pulse disappears again as the pressure in the cuff drops even further. Blood pressure greater than 140/90 mmHg is called hypertension or raised blood pressure. Hypertension in pregnancy accounts for about a third of all maternal deaths in pregnancy, so it is manged with great care. There are many reasons for a raised blood pressure, each with its own risks and problems. We generally classify hypertension in pregnancy into four groups:

1. Preexisting hypertension. This is where the women already has blood pressure (BP) problems before getting pregnant (she may not be aware of this). If it is possible to control the BP during pregnancy, the outcome is usually very good, but there are more small babies born ro mothers with hypertension. (continued next page.)