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High Blood Pressure During Pregnancy

Although many expectant mothers with high blood pressure give birth to healthy babies, high blood pressure during pregnancy carries the risk of problems for both mom and baby. Women with chronic high blood pressure before conception can almost always expect complications during the pregnancy. Some women develop high blood pressure while they are pregnant, a condition known as gestational hypertension.

High blood pressure symptoms can include problems with the mother’s kidneys, low birth weight, and premature birth. In the most severe cases, the mother may develop preeclampsia, a life-threatening condition for both mom and baby). But what is blood pressure and why is it so important?

Understanding Blood Pressure

Normally your blood pressure fluctuates throughout the day and night. It is low while you are resting or sleeping, and higher after exercising or when you become excited. Blood pressure readings have two distinct numbers, typically separated by a forward slash. For example, a normal reading may be less than 120/80. The first number represents what is known as your systolic pressure, the pressure in the arteries when the heart contracts. The second number is known as your diastolic pressure, the pressure in the arteries when the heart is not contracting. For pregnant women, systolic numbers above 140 and diastolic numbers above 90 indicate the blood pressure is too high.

Types of blood pressure conditions

Chronic Hypertension

Blood pressure that is always high is a condition known as chronic hypertension. This condition can lead to problems such as heart failure and stroke, and those diagnosed with it are encouraged to take special care of themselves. Chronic hypertension can also harm your developing baby. Some medications for this condition are safe to use while pregnant, and others are not, so talk with your doctor about this if you become pregnant. If you are taking medication for hypertension, you may need to switch your medication while you are pregnant. Some women report not needing their medication because their blood pressure returns to normal while they are pregnant.

Gestational Hypertension

This condition is diagnosed with a timed blood pressure analysis. Most women do not develop gestational hypertension until the second half of pregnancy. Unlike chronic hypertension, this type of high blood pressure returns to normal after childbirth. Many women are encouraged to undergo regular blood pressure testing during and after pregnancy to ensure that blood pressure levels are normal. Gestational hypertension can lead to preeclampsia, so diligent analysis of blood pressure is recommended.

Preeclampsia

Although there is no conclusive evidence, most experts believe this condition is caused by an inflammatory process in a pregnant woman’s bloodstream. Often high levels of protein are found in the urine of expectant mothers with preeclampsia. Poor diets, problems with the immune system, damage to the blood vessels, and insufficient blood flow to the uterus are also potential causes of this condition.

Preeclampsia is a serious problem for pregnant women. It can appear as early as the 20th week of gestation, but usually occurs after the 33rd week. Mild symptoms can include high blood pressure, swelling of the face, hands and feet, and excessive weight gain. Severe symptoms typically include blurred vision, headaches, abdominal pain, and a continued rise in blood pressure. If preeclampsia is not treated and controlled, seizures can occur, and the mother may even lapse into a coma. In most cases, this condition is treated with antihypertensive drugs for blood pressure and anticonvulsants to prevent seizures.

Treatment for High Blood Pressure during Pregnancy

If you are not close to your due date, your healthcare provider may recommend plenty of rest, either at home or in the hospital. Rest is a great way to reduce one’s blood pressure. If your blood pressure levels do not dangerously increase, you may be able to continue your pregnancy normally until labor naturally begins. If you have a severe case of high blood pressure, especially if you are close to your due date, your doctor may recommend inducing labor. Your doctor will determine which would be more dangerous — inducing labor and placing the baby in a nursery, or continuing the pregnancy with high blood pressure. In some cases, C-section deliveries are necessary for the health of the mother and baby.

You do not need to wait until after you have gotten pregnant to begin treatment for high blood pressure, especially if you have suffered from the condition in the past. The best thing to do is to talk with your doctor before conception. Lose weight and exercise before conceiving and talk with your healthcare provider about medications that are safe to use if you become pregnant.

If you do become pregnant, see your doctor on a regular basis. This way, changes in your blood pressure, weight, and urine can be detected early. If you have kidney disease or another type of medical condition, inform your healthcare provider as soon as you learn you are expecting. Your doctor may want you to check your blood pressure and weight at home on a regular basis, record the findings, and report them during your next prenatal visit.

Complications of High Blood Pressure during Pregnancy

A baby receives its nutrients, oxygen, and blood from the placenta. When blood pressure is high, it may cause complications for the mother, including reduced blood flow to the placenta, which means less oxygen and nutrients for the baby, which can slow the baby’s growth. Additional complications that can be caused by high blood pressure if it is left untreated include:

  • Heart attack
  • Stroke
  • Congestive heart failure
  • Kidney failure
  • Pulmonary edema (excess fluid in the lungs)

Risk Factors for High Blood Pressure during Pregnancy

Here is a look at factors that may increase your risk of developing high blood pressure while you are pregnant:

  • Previously diagnosis of chronic hypertension
  • Obesity prior to conception
  • Over the age of 40 or under the age of 20
  • Medical conditions such as diabetes, kidney disease, lupus, rheumatoid arthritis, or scleroderma
  • Pregnant with twins or multiples
  • Pregnant for the first time
  • African Americans are known to be at a higher risk for preeclampsia
  • Preeclampsia or high blood pressure during a previous pregnancy
[Page updated September 2014]