HBP at 26 weeks of pregnancy

I am 26 weeks pregnant with a high blood pressure (BP) of 190/120. Doctors want to remove the baby. Should I allow them? -Chinwe, Lokoja

What is your urinalysis like, was the BP noticed to be high before the second half of the pregnancy, does the hospital have good neonatal services with facilities like incubators and neonatologist?

A BP of 190/120 is a severe Pregnancy Induced Hypertension (SPH), or if there is proteinuria, then it becomes preeclampsia. Also, if the BP predates the pregnancy or is noticed within the first 20 weeks, then it is chronic hypertension.

Twenty six weeks is close to our own age of viability and some babies have been known to survive even in our own environment after being delivered at that gestation age.

So let me state categorically that whatever will be done should be where there is the expertise of a neonatologist and neorealism services to give the baby a chance of survival.

The best person to assess is an obstetrician. I suggest you abide by his advice, but if not, transfer to a tertiary centre or where expertise is available.

Even at that, BP conservative management can still be done to give the baby a better chance of survival. Use of appropriate anti-hypertensives will help. If the BP is uncontrollable or is developing into severe preeclampsia, then delivery is advisable.