Hypertension During Pregnancy is Common, Treat it Well
Hypertension/high blood pressure is defined as blood pressure that’s 140/90 or higher on two or more occasions. If either number is higher than those stated, even if the other number is normal, it indicates high blood pressure.
High blood pressure during pregnancy can reduce blood flow to the placenta, which restricts oxygen and nutrient delivery to the baby. If left untreated, high blood pressure can lead to serious health complications to the mother, her infant, or both. High blood pressure can increase the risk of poor birth outcomes, such as preterm delivery, growth retardation, and infant death.
In most cases, however, hypertension is preventable and treatable. If hypertension is controlled and monitored during prenatal care, chances for a healthy pregnancy and baby are great.
Hypertension is the most common medical problem encountered during pregnancy and can be categorized as follows:
- Chronic hypertension: it is defined as hypertension present before pregnancy or developed in the first half or before the 20th week of gestation. The mother may or may not need to take medication to normalize her blood pressure, depending on whether her condition is mild, moderate or severe.
- Gestational hypertension: (Pregnancy-induced hypertension or PIH) is high blood pressure that first occurs during the second half of pregnancy or after the first 20 weeks of pregnancy. It usually returns to normal after birth. In some cases however, the blood pressure will remain elevated after the pregnancy, resulting in chronic hypertension. It might be treated with medication, bed rest or simply be monitored. Whenever blood pressure rises during pregnancy, further investigations are needed to make sure the woman isn’t developing pre-eclampsia or eclampsia.
- Preeclampsia/Eclampsia: Preeclampsia is a serious medical condition affecting all organs of the body. It usually occurs in the third trimester. It rarely occurs after delivery, but it is possible. Approximately 5–8% of all pregnant women develop preeclampsia. High blood pressure is one of its most common signs. Because preeclampsia causes stress on the kidneys and reduces their ability to filter urine, protein in the urine is another significant indicator. Women may also have changes in liver function.If the woman also develops seizures she is then diagnosed with eclampsia. Sometimes seizures are the first and only symptom a woman develops, though usually preeclampsia/eclampsia are accompanied by other symptoms, including:
- Nausea, vomiting
- Visual problems
- Rapid weight gain
- Swelling of the hands, feet and face
- Upper abdominal pain
Risk factors for pre eclampsia include:
- Pregnancy for the first time
- Pre-eclampsia in a previous pregnancy
- Chronic hypertension
- 35 years or old
- Carrying more than one fetus
- Diabetes or kidney disease
- Immune disorders, like lupus, or blood diseases
The only way to treat pre-eclampsia is to deliver the baby urgently though hypertension may persist for a few days, even a few weeks. That decision is made based on the severity of the mother’s condition, how well she responds to treatment.
About 10–20% of women with severe preeclampsia/eclampsia develop a condition called HELLP Syndrome, which stands for Hemolysis (breakdown of red blood cells), Elevated Liver enzymes, Low Platelet count. This can cause hemorrhage, pulmonary edema, heart failure, kidney failure and placental abruption. The main treatment is immediate delivery, even if the baby is premature. The mother may also need blood transfusions.
- Preeclampsia superimposed on chronic hypertension: occurs in women with chronic hypertension before pregnancy who then develop worsening high blood pressure and protein in the urine during pregnancy. It’s estimated that 25% of women with chronic hypertension may go on to develop preeclampsia. When chronic hypertension is medically managed and the pregnancy is well monitored, however, women and their babies do well.
High blood pressure, or hypertension, during pregnancy can be life-threatening to a woman in some cases. If left untreated, it can cause harm to both the mother and her infant. Hypertension in pregnancy should be closely monitored to prevent potentially life-threatening health complications. It is important that women attend regular prenatal evaluations and report any abnormal symptoms to ensure their own health and that of their infant.