VOG| Pregnancy induced hypertension | ගර්භණි සමයේ අධි රුධිර පීඩනය | Episode 04
VOG| Pregnancy induced hypertension | ගර්භණි සමයේ අධි රුධිර පීඩනය | Episode 04
ලෝකයේ මවු මරණ වලට හේතු වශයෙන් ගත්කල ගර්භණි සමයේ අධි රුධිර පීඩනය තෙවන ස්ථානය ගන්නවා. බොහෝ දුරට මෙ පිලිබද දැනුමක් නැතිකම සහ නොදන්නා කමට සැලකිලිමත් නොවීම නිසා මේ තත්වය යටතේ නිකරුනේ ජීවිතයෙන් වන්දි ගෙවිමට සිදුවෙනවා. ඔබ පිරිමි උනත් ගැහැණු උනත්, ගර්භණී උනත් නැතත් ඒ පිලිබදව දැන සිටීම කොයි මොහොතක හෝ කාට හෝ පිහිට වීමට හැකි කරුණකි.
Content
41.147 -> Ayobowan! We’re back with our VOG discussion.
45.314 ->
Today also, we are going to talk about a topic on VOG.
52.941 -> As usual, Dr.Jagath N Herath, Obstetrician & Gynecologist Specialist from
57.272 -> Polonnaruwa General Hospital is joining with us to discuss more about this topic.
61.891 -> Ayubowan Doctor! Pregnancy Induced Hypertension.
68.176 -> Doctor, what do you mean by Pregnancy Induced Hypertension?
72.373 -> It is the high blood pressure detected during pregnancy. Normally the blood pressure
85.552 -> This is a special instance. We diagnose this after 5 months,
95.864 -> basically after 20 weeks of time
98.42 -> The foetus is there in the uterus for 40 weeks; 9 months.
102.899 -> So the high blood pressure which emerges after 5 months
106.28 -> is called Pregnancy Induced Hypertension.
108 -> Does this happen before 5 months of the foetus?
114.61 -> Yes, then we call her as a patient with hypertension.
119.075 -> She becomes pregnant while having high blood pressure.
122.954 -> Those are two different things.
124.379 -> So doctor, in which scenarios does this happen? What are the reasons?
128.64 -> So Chandu, we will be taking the pressure reading and if the pressure is higher than 140 – 90
137.811 -> we check it again after 4 hours.,
141.095 -> So if it is higher after then too, we identify this as Pregnancy Induced Hypertension.
145.004 -> If we take only one reading and if it is higher than 180 – 110,
149.414 -> then also we can diagnose it as Pregnancy Induced Hypertension
155.728 -> There are two kinds called systolic and diastolic.
158.451 -> Normal pressure is 120 – 80
161.722 -> the other is higher than 140 – 90. As I told you earlier
167.096 -> 30 per 100000 (hundred thousand) Sri Lankan mothers die during pregnancy
173.326 -> So out of those 30 deaths, Pregnancy Induced Hypertension would be the third or the fourth most contributing reason
180.304 -> Chandu, this is really important because, these deaths can be prevented
184.894 -> So the mothers need to be aware of this and have to be very responsible
188.744 -> That is why this programme is really important for the mothers
191.838 -> If a critical patient comes at the last moment, we won’t be able to save her life
198 -> Doctor, does this have an age barrier?
202.56 -> Yes, there is. We call them risk factors
211.247 -> As Chandu said, one reason is Age
213.188 -> If we divide this in to 3 categories, there’s a risk for the mothers
216.256 -> who are below 20 and above 40
222 -> Normally, 5% to 10 % of pregnant women can have this.
230.88 -> If she has other diseases such as Diabetes or if the mother is too fat the
241.918 -> risk of getting Pregnancy Induced Hypertension is high.
249.074 -> If we consider about pregnancy period and if there are twins or triplets in the uterus,
257.814 -> the risk of getting Pregnancy Induced Hypertension is also high.
283.52 -> What is the risk of death can be occurred due to this disease in Sri Lanka or in the world?
289.731 -> Initially, I told you about that. There are so many reasons where mothers die in Sri Lanka.
295.319 -> Pregnancy Induced Hypertension takes the 3rd or the 4th position in that. It takes the 2nd or the 3rd position in the world as well.
304.05 -> Doctor, now you stay in a rural province such as Polonnaruwa.
308.591 -> You may be getting different types of experience with those people. So,
310.591 -> what is the experience you’re getting regarding this disease
313.894 -> in the rural area?
315.843 -> This is really important because we need to make the people aware of the danger in this disease.
323.64 -> Because, if a mother has Pregnancy Induced Hypertension, she can die at anytime.
331.992 -> There’s a huge risk, it’s not like a patient who has just high blood pressure.
335.025 -> Normally a patient with High Blood Pressure won’t die like that unless there are complications such as a stroke or something like that happens.
338.929 -> This Pregnancy Induced Hypertension is not like that.
341.894 -> It can be increased gradually and the mother and the baby both can die
345.807 -> That is very unfortunate.
348 -> If a mother has Pregnancy Induced Hypertension, we admit her in the hospital,
353.494 -> then we give anti hypertensive drugs,
355.891 -> then we check the passage of protein in urine,
359.267 -> then we control the high blood pressure giving anti hypertensive drugs and after that only we discharge the patient.
364.02 -> Then after two or three weeks we ask her to come to the clinic.
371.446 -> Meanwhile, we ask her to check her high blood pressure for 3 days in a week.
378.397 -> There’s no cost to measure high blood pressure. Doctors or the mid wives too can check that.
385.082 -> We give her a book to write the measures.
388.405 -> So if the pressure is higher than 140 – 90, we ask her to come to the hospital immediately.
393.308 -> What are the symptoms of Pregnancy Induced Hypertension?
397.179 -> That is a good question. That is the point I want to discuss next.
405.771 -> There are special symptoms. So the mothers should remember them. The first thing is,
412.994 -> you feel sick too often, and then you might get a headache with the increase of pressure.
418.514 -> A major symptom is double vision, which is, you see everything as double.
433.141 -> The other symptom is you see visual hallucinations, you get a vomitish feeling.
447.211 -> If you have these kinds of symptoms, it is better to consult a doctor.
456.322 -> Even though we advise, we can see that the people who live in rural areas hardly obey them.
463.884 -> If we ask them to consult a doctor as they have these kinds of symptoms, will they follow the advices regularly?
479.259 -> That is the main issue, that’s why mothers do die. The mother who refuses to comply will die.
496.055 -> Our health system is far better; there are so many dispensaries and hospitals in villages as well.
502.184 -> Mothers do not know the gravity of it.
504.925 -> If the pressure is high, they just take panadols and stay at home.
507.771 -> That happens if the husband has gone to the paddy fields and no one to take care of the baby at home,
515.779 -> or else till they find a vehicle, they stay
519.141 -> If the mother knows that she will die within one hour,
523.126 -> she should come to the hospital to check her blood pressure.
528.053 -> Sometimes, although we ask to admit after checking the blood pressure,
532.021 -> the mothers do not admit in the hospital.
536.694 -> When she goes to the village clinic and after the midwife says that the pressure is high and she should be admitted to the hospital,
541.685 -> So we don’t have anything to do after that.
545.406 -> If the pressure arises and if there’ll be any changes in the blood, no one can save her.
551.456 -> What are the causes for this disease?
554.371 -> There are several reasons. But we have not diagnosed the exact reasons in medical science.
560.448 -> I think one of the main reasons is an issue in the blood circulation of the placenta.
567.2 -> Another reason as I think happens is due to genes which come from hereditary.
572.191 -> If the mother has, it comes to the daughter etc.
575.753 -> Some argue if the salt intake is high,
578.362 -> there’s a chance of getting high blood pressure.
580.362 -> But it has not been proved yet. Likewise, there are many reasons.
583.035 -> Are there any treatments for this disease?
586.067 -> Yes Chandu, there are treatments.
588.57 -> That’s why we discuss about this a lot and make people aware of this and ask to act upon.
597.108 -> Let’s say we meet a high blood pressure patient in a clinic and we admit her.
602.523 -> Then there are few blood tests to be done because if the pressure goes high the platelet count drops down.
608.892 -> A mother can die after dropping the platelet count and bleeding internally.
616.795 -> We call this as a multi organ disease. Because of this disease, the kidneys and the liver can be damaged.
624.894 -> Ultimately we won’t be able to save the patient.
629.038 -> So initially, the treatment is delivering the baby.
635.75 -> Let’s say although the baby is not grown and the foetus is only 4 or 5 months,
640.158 -> we do a caesarian and take the baby out. The baby will die, but the mother will live.
647.135 -> It’s like this Chandu, in pregnancy the most important person is the mother.
659.135 -> If someone says to save the both,
660.844 -> we save the mother initially because she should be there for the existing children, if the mother lives, she can have another baby.
666.497 -> We never save the child before the mother.
668.709 -> If we keep the baby to grow, mother’s kidneys and the liver can be damaged,
677.538 -> the platelet count drops down and there can be an internal bleeding, and it can direct to the brain and the mother will die.
687.426 -> That is the most critical situation.
691.411 -> If the pressure goes up in a normal way, we give anti hypertensive drugs to the patient, control the high blood pressure and discharge the patient.
699.843 -> Can this disease be prevented, if so, what are the steps needed to be done?
707.772 -> First thing is they need to go to the maternity clinic, or they need to go to a consultant or to the MOH clinic.
716.575 -> They should do the regular check ups such as measuring the high blood pressure and the monthly urine tests.
724.24 -> That’s when you diagnose whether you have Pregnancy Induced Hypertension or not.
730.978 -> If we diagnose a patient like that, we regularly check the high blood pressure.
735.016 -> we admit the patient or we give anti hypertensive drugs and we control the high blood pressure
737.016 -> That is the first thing, and then we pay attention to the symptoms of the disease such as headache, tiresome, feeling of sick and sleepy.
752.436 -> Likewise, the double vision can also be a symptom.
757.268 -> So if you have these kinds of symptoms, you need to go to a hospital urgently
763.609 -> If we give anti hypertensive drugs and send the patient home, this again can be happened
767.885 -> So the mother should have a good understanding. At least if a doctor checks the high blood pressure that is more than enough.
776.158 -> This disease is developing in the body till the mother delivers the baby.
783.266 -> If the pressure goes high that cannot be cured. It won’t be cured even if we give anti hypertensive drugs too.
788.283 -> We give anti hypertensive drugs to control the high blood pressure, but it develops within the body
797.086 -> The kidneys and the liver will also be damaged.
799.086 -> Therefore, delivering the baby and removing the placenta is the ultimate solution. Because of that, this solely depends on the patient.
801.642 -> What is the responsibility of the husband or the guardian of such a patient?
824.435 -> There are good mid wives who have saved the lives of some mothers. For example,
829.21 -> a patient who had been diagnosed in a clinic as a Pregnancy Induced Hypertension patient
833.645 -> the midwife herself took her to the hospital. There are two instances like that
837.207 -> Some mothers were saved.
839.207 -> The midwife knows that the mother has other children and if she goes home she won’t come back to the hospital
848.38 -> That is the role of a midwife.
852 -> If the husband, brother, mother of her has paid good attention to her and if they have the knowledge
871.612 -> that she is not in a good state and has symptoms of Pregnancy Induced Hypertension, they also can save her life.
878.191 -> There are stubborn mothers who disobey and just neglect their disease and just wait at home
885.502 -> looking after the other children or waiting for the husband to come home or to cook for the other children and they delay it.
895.691 -> But that is an adverse situation because then we won’t be able to save her life.
899.704 -> Even there are so many facilities, even they live in Colombo or wherever in the world, we can’t save her at the last moment.
911.595 -> So we spoke about Pregnancy Induced Hypertension today.
915.342 -> This is a really important topic on VOG.
924.67 -> We believe the points we discussed today were important to your life
934.758 -> Before you may have had issues on this since you didn’t know anything, but now from the discussion we had today
943.111 -> it will be useful in future for your friend, brother or sister, mother or anyone and they can avoid the danger.
949.929 -> That will be an opportunity.
952.061 -> So, we are going to end the programme today. Thank you so much doctor for joining us to share the knowledge.
962.505 -> So Chandu I would like to say that after watching this programme,
967.593 -> if we can save at least one life that will be a great service. I wish this message will spread among people.
973.996 -> We also wish the same. Apparently, this is why we planned of doing something like this.
980.549 -> We’re also very happy that we could share this knowledge with you all.
986.149 -> So for today, we are going to end the programme and we hope to come back again with an important topic on VOG.
994.184 -> So we believe that the points we discussed today will be very useful to you.
1001.107 -> So if you feel that they are really important
1005.674 -> kindly like, comment and subscribe our channel and click the bell icon and you will be able to watch our new videos
1017.415 -> So we are going to meet you again with another topic on VOG. So we say good bye and wish you a healthy life.
Source: https://www.youtube.com/watch?v=e978y8nWTEo