High Blood Pressure in Pregnancy
Dr Sahana K P
Basaveshwaranagar, Bengaluru Jun 20, 2017
High blood pressure or Hypertension what is it?
The amount of force exerted by the blood against the walls of the arteries is called Blood pressure. A person's blood pressure is believed to be high when the readings are greater than 140 mm Hg systolic which is the top number in the blood pressure reading or 90 mm Hg diastolic which is the bottom number. In common, high blood pressure, or hypertension, plays a part in the occurrence of kidney disease, stroke, coronary heart disease and heart failure.
Impacts of high blood pressure in pregnancy?
High blood pressure can be threatening for both the mother and the fetus, although many pregnant women with high blood pressure have healthy babies without critical problems. Women with, chronic or pre-existing, high blood pressures are more liable to have specific complexities during pregnancy than those with normal blood pressure. However, a few women are liable to develop high blood pressure while they are pregnant (often called by the terms- gestational hypertension,pre-eclampsia.).
The impacts of high blood pressure differ from mild to severe. High blood pressure can be harmful to the mother's kidneys and other organs, and it can cause low birth weight and premature delivery. In the most critical cases, the mother develops preeclampsia - or "toxemia of pregnancy"--which can endanger the lives of both the mother and the fetus.
Related blood pressure conditions- during pregnancy
Chronic hypertension with superimposed preeclampsia
Causes of hypertension during pregnancy
Although the exact etiology of hypertension in pregnancy is not clearly understood, as per the (NHLBI) or National Heart, Lung, and Blood Institute, there are various possible factors that increase the risk of developing high blood pressure during pregnancy.
Lack of physical activity
Being overweight or obese
A family history of hypertension during pregnancy
Use of Assisted reproductive technology (such as IVF)
Carrying more than one baby eg. Twins, triplets
Age (over 40)
What is preeclampsia?
Preeclampsia is a disorder that generally commences after the twentieth week of pregnancy and is associated with loss of protein in the mother's urine plus high blood pressure. Preeclampsia impacts the placenta, and it can affect the mother's liver, brain and kidney. Preeclampsia is the second leading cause of maternal death. When preeclampsia causes seizures, the state is known as eclampsia. Preeclampsia is also a leading cause of fetal complications, which involve premature birth, stillbirth and low birth weight.
There is no rectified way to prevent preeclampsia. Many women who develop signs of preeclampsia, however, are closely observed to reduce or avoid associated problems. To deliver the baby is the only way to "cure" preeclampsia.
High blood pressure disorders occur in six percent to eight percent of all pregnancies in the U.S., about seventy percent of which are first-time pregnancies.
Although the percentage of pregnancies with gestational hypertension and eclampsia has stayed about the same in the U.S.A over the past years, the rate of preeclampsia has increased by about one-third. This rise is due in part to an increase in the numbers of multiple births and older mothers, where preeclampsia occurs more commonly.
Detection of preeclampsia
Sadly, there is no single test to forecast or identify preeclampsia. Key indications are increased blood pressure and presence of protein in the urine or proteinuria. Other symptoms that seem to happen with preeclampsia include constant headaches, blurry vision or sensitivity to light and abdominal pain.
All of these perceptions can be caused by other disorders; they can also happen in healthy pregnancies. Frequent visits with your physician help him or her to detect your blood pressure and level of protein in your urine, to order and study blood tests that detect signs of preeclampsia, and to observe fetal development more closely.
Pregnancy and prevention of high blood pressure
If you are planning about having a baby and you have high blood pressure, discuss about it with your doctor. Taking measures to manage your blood pressure before and during pregnancy - and getting frequent prenatal care - go a long way toward safeguarding your well-being and your baby's health.
Before becoming pregnant:
Make sure your blood pressure is under control. Lifestyle modifications such as limiting your salt intake, engaging in regular physical activity, and reducing weight if you are overweight can be helpful.
Discuss with your specialist how hypertension may impact you and your baby during pregnancy, and what you can do to check or lessen problems.
If you are under medication for your blood pressure, ask your physician whether you should change the amount you take or stop taking them during pregnancy. Specialists currently suggest avoiding angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II (AII) receptor antagonists during pregnancy; switch to safer blood pressure medications that may be fine for you to use. Do not, however, stop or modify your medicines unless your doctor tells you to do so.
While you are pregnant:
Acquire frequent prenatal medical care.
Avoid tobacco and alcohol.
Talk to your specialist about any un-prescribed medications you are taking or are planning about taking.
Learn about the warning signs of eclampsia and report to the hospital immediately if you experience such symptoms. Eg., headache, blurred vision, pain in the upper abdomen, excessive vomiting etc.
Long term effects
The effects of high blood pressure during pregnancy differ depending on the ailment and other factors. According to the National High Blood Pressure Education Program (NHBPEP), preeclampsia does not in general increase a woman's risk for developing chronic hypertension or other heart-related disorders. The NHBPEP also reports that in women with normal blood pressure who develop preeclampsia after the twentieth week of their first pregnancy, short-term complications--including high blood pressure--generally go away within about six weeks after delivery.
Few women, however, may be more prospective to develop high blood pressure or other heart disorders later in life. More study is needed to determine the long-term health effects of hypertensive disorders in pregnancy and to evolve better methods for identifying, detecting, and managing women at risk for these disorders.
Even though high blood pressure and related disorders during pregnancy can be critical, most women with hypertension and those who develop preeclampsia have efficient pregnancies. Obtaining early and frequent prenatal care is the most important thing you can do for you and your baby.
Medicines for high blood pressure during pregnancy
Some conventional blood pressure medicines can cause problems in pregnant women.
According to studies, these medications for lowering blood pressure should be avoided when you are pregnant:
Angiotensin receptor blockers
These drugs in specific will be passed through the bloodstream to the growing baby. They can adversely affect the fetal health. Talk to your specialist about how to manage your blood pressure if you develop hypertension during pregnancy.
How to manage high blood pressure during pregnancy
Common risk aspects for high blood pressure, such as obesity and a family record of high blood pressure, can be reduced through exercise and diet. It is suggested that pregnant women discuss with their doctor to determine a weight gain objective that is healthy for them.
Dietary suggestions for pregnant women differ from person to person. Discuss with a diet expert who will keep your particular height and weight in mind when creating a nutrition plan for you.
The NHLBI highlights that it’s crucial to take steps to reduce your risk of high blood pressure. You should usher clear of smoking and drinking alcohol, both of which have been known to increase blood pressure.
Pregnancy causes hormone repositions, as well as physical and psychological changes. This can bring on stress, which can make high blood pressure difficult to manage. Try stress reduction methods such as yoga and meditation.
It is essential that all pregnant women who develop hypertension in pregnancy be followed up 6 weeks after delivery for blood pressure measurements. Monitoring helps to identify those women who are prone for developing chronic hypertension later in life. It is important to educate such women regarding their risk for developing essential hypertension and measures to prevent and control it.