Hypertension and Pregnancy, what to know?Posted on Mar 24,2017
High blood pressure and Pregnancy doesn’t go well together! Hypertension in pregnancy, be it developed before conception or after conception is harmful to both baby and mother if not controlled well.
How does your doctor categorize your Hypertension?
Gestational Hypertension: Hypertension that develops during pregnancy, especially after 20 weeks of Pregnancy is called Gestational Hypertension. No organ damage or severe complications are encountered if the Hypertension is well controlled.
Chronic Hypertension: Chronic Hypertension develops before 20 weeks of Pregnancy, or it is present even before conception. It goes undetectable if the blood pressure is not measured at serial intervals as no specific symptoms or organ damage occurs.
Preeclampsia: Preeclampsia is a complication of pregnancy where Gestational Hypertension or Chronic Hypertension can lead to organ damage. Protein in urine and High blood pressure are classic signs of Preeclampsia. Protein in urine need not be present in all cases of Preeclampsia. This generally develops after 20 weeks of pregnancy. If not treated, Preeclampsia can turn fatal to mother and baby.
Chronic Hypertension with superimposed Preeclampsia: Few women will have chronic hypertension before pregnancy that lead to the development of Preeclampsia after 20 weeks of pregnancy. They may present with protein in urine and organ damage if left untreated.
Why should pregnant women be worried about High Blood Pressure?
- In Hypertension, the placental blood supply decreases, so the blood supply to the baby decreases which can lead to prematurity and abnormal growth of the fetus. There can be chances of Premature delivery as well.
- Gestational Hypertension/Preeclampsia patients have increased the risk of heart diseases in future, so it is important to maintain a healthy lifestyle and have regular health screening after delivery.
- Placental abruption is one condition where the placenta separates from the uterine wall before delivery and can be harm both mother and baby. This is a dangerous complication of Preeclampsia.
What are the symptoms of Preeclampsia?
Most of the times high blood pressure is of sudden onset, and there is no actual development of symptoms. It is important to measure blood pressure as a part of prenatal checkups regularly. Any reading greater than 140/90mmHg on two different occasions is considered as Hypertension.
Other symptoms and signs can be, headache, blurred vision, headache, nausea, vomiting, shortness of breath, edema of face and feet [not all times], protein in the urine, and a decrease in urine output, etc.
Treatment of Hypertension in Pregnancy:
Pregnancy is the period where you should be careful about any medication intake. Not all anti-hypertensive medications are suitable in pregnancy. Your healthcare provider will prescribe what is best in your case. Few drugs are contraindicated and can harm you and your baby, so be careful to take medications only under strict medical supervision.
Prevention of Complications:
It is not possible to avoid or prevent Hypertension in pregnancy as the right reasons are not always known for its development, but we can prevent complications if we monitor and control the blood pressure.
The pregnant women should make sure that her weight, blood pressure, baby’s growth is normal in every prenatal visit. Blood and Urine tests, Ultrasound abdomen, will be done at every trimester or as and when needed.
You should follow the scheduled prenatal visits to the doctor, take medications regularly, avoid alcohol, maintain minimum physical activity, and eat low sodium, maintaining a healthy diet is important.
Labor can be induced or a C-section only if there is an indication like preeclampsia in the previous delivery. Breastfeeding is encouraged. There may be a gap suggested between medication and Breastfeeding.
Take away message is, Hypertension in pregnancy is to be monitored and controlled well to avoid complications.
- Hypertension in pregnancy. Washington, D.C.: American College of Obstetricians and Gynecologists. 2013. http://www.acog.org/Resources_And_Publications/Task_Force_and_Work_Group_Reports/Hypertension_in_Pregnancy. Accessed May 27, 2014.
- Magloire L, et al. Gestational hypertension. http://www.uptodate.com/home. Accessed May 27, 2014.
- High blood pressure in pregnancy. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_preg.htm. Accessed May 27, 2014.