Final answer:
Fetal monitoring for chronic hypertension in pregnancy involves careful tracking of blood pressure to prevent complications like fetal renal failure. It also includes vigilance for fetal distress and growth issues like IUGR due to placental insufficiency. Avoidance of ACE inhibitors and management of increased blood volume are important considerations.
Step-by-step explanation:
Fetal monitoring in the context of chronic hypertension (HTN) associated with pregnancy is crucial for ensuring both maternal and fetal well-being. Chronic HTN is characterized by consistent blood pressure readings of 140/90 mm Hg or above. Pregnant individuals with chronic HTN should avoid angiotensin-converting enzyme (ACE) inhibitors due to the risk of causing fetal renal failure and oligohydramnios, which can lead to pulmonary hypoplasia and limb contracture, in addition to cranial bone abnormalities.
During pregnancy, blood volume and cardiac output increase to accommodate the developing fetus, which can exacerbate hypertension. Fetal monitoring in cases of maternal hypertension is vital to track the fetus's growth and detect conditions like intrauterine growth restriction (IUGR) which may occur in the setting of placental insufficiency.
Monitoring of fetal distress is also paramount, especially during labor, as contractions can reduce oxygenated blood flow to the fetus, necessitating a period of relaxation after each contraction. Any sustained decrease or increase in fetal heart rate can indicate fetal distress, potentially leading to an emergency birth scenario. Therefore, vigilant monitoring and management of maternal blood pressure and fetal health is essential in pregnancies affected by chronic hypertension.