High Blood Pressure During Pregnancy

High Blood Pressure During Pregnancy

Although there have been several cases in which an expectant mother has high blood pressure and gives birth to a healthy baby, high blood pressure during pregnancy carries the risk of causing 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 pregnant – a condition known as gestational hypertension.

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

Understanding Blood Pressure

Our circulatory system would be nothing without blood pressure. Our heart, arteries, and veins need it to function properly. Blood pressure is created by a steady beating of the heart. When the heart contracts it pumps blood into the arteries. The arteries then transport the blood to the body’s organs, and veins then return blood from the organs back to the heart.

Normally your blood pressure fluctuates throughout the day and night. For example, it is low while you are resting or sleeping and high after exercising or becoming excited. Several things can contribute to the state of your blood pressure.

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 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 relaxed or 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 include but are not limited to:

Chronic Hypertension- When your blood pressure has been high for a long period of time, including before conception, it is known as chronic hypertension. For many women, the condition remains during and after pregnancy. 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 not safe to use while pregnant, so talk with your doctor or midwife about this if you plan to become or become pregnant. There are medications for this condition that are safe to use throughout the gestation period. You may need to switch your medication while you are pregnant or you may not need medications at all. Several women report not needing their medication because their blood pressure returns to normal while pregnant.

Gestational Hypertension- This condition is diagnosed by a timed blood pressure analysis. Most women do not develop gestational hypertension until the second half of pregnancy. Unlike chronic hypertension, high blood pressure returns to normal after child birth. Many women are encouraged to receive regular blood pressure testing during and after pregnancy to ensure levels are normal. Gestational hypertension can lead to preeclampsia, so diligent analysis of blood pressure is recommended.

Preeclampsia- Although there is no conclusive evidence, many experts believe this condition is caused by a toxin in a pregnant woman’s bloodstream. Many times there are high levels of protein found in the urine of an expectant mother 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 typically appears suddenly around the 20th week of gestation until one week after delivery. It can range from mild to severe, with mild symptoms including 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 not treated and controlled, seizures can occur and the mother could 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 health care provider may recommend plenty of rest; either at home or in the hospital. Rest is a great remedy for reducing ones blood pressure. If the blood pressure levels do not dangerously increase, you may be able to continue your pregnancy until labor naturally begins. If you are close to your due date, your doctor may recommend delivery. Severe cases of high blood pressure or preeclampsia require the delivery of your baby to cure the condition. Agreeing to delivery is based on several factors such as the risk to mother and whether the baby is at more risk of being inside the uterus or being in a special nursery. If you need to give birth, your health care provider will decide on whether to induce you or allow labor to naturally take place. In some cases, c-sections are required for delivery due to the health and/or well-being of mother and baby.

Treatment for high blood pressure does not need to begin after you have gotten pregnant, especially if you have suffered from the condition in the past. The best thing to do before conception, whether planning a pregnancy or just being sexually active, is to talk with your doctor or midwife. Lose weight and exercise before conceiving and talk with your health care provider about medications that are safe to use if you become pregnant.

If you do become pregnant see your doctor or midwife 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 health care provider as soon as you learn you are expecting. Your doctor or midwife may want you to check your blood pressure and weight at home on a regular basis, record the findings, and report them back to your health care provider during your next prenatal visit.

Complications of High Blood Pressure during Pregnancy

Normally, a baby will receive its nutrients and oxygen from its mother through the umbilical cord and receives its blood from the placenta. When blood pressure is high, it may cause complications for the mother including less blood flow to the placenta, which equals less oxygen and nutrients for the baby. Things like this can cause the growth of a baby to slow down. Additional complications high blood pressure may lead to if left untreated include but are not limited to:

  • 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 diagnosed with 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
  • If you had developed preeclampsia or high blood pressure during a previous pregnancy
[Page updated November 2013]