Hypertension During Pregnancy

Hypertension is also called high blood pressure. It can occur at any time in life and during pregnancy. When you have hypertension, there is extra pressure inside your blood vessels that carry blood from the heart to the rest of your body (arteries). Hypertension during pregnancy can cause problems for you and your baby. Your baby might not weigh as much as it should at birth or might be born early (premature). Very bad cases of hypertension during pregnancy can be life-threatening.

There are different types of hypertension during pregnancy.

  • Chronic hypertension. This happens when a woman has hypertension before pregnancy and it continues during pregnancy.

  • Gestational hypertension. This is when hypertension develops during pregnancy.

  • Preeclampsia or toxemia of pregnancy. This is a very serious type of hypertension that develops only during pregnancy. It is a disease that affects the whole body (systemic) and can be very dangerous for both mother and baby.  

Gestational hypertension and preeclampsia usually go away after your baby is born. Blood pressure generally stabilizes within 6 weeks. Women who have hypertension during pregnancy have a greater chance of developing hypertension later in life or with future pregnancies.

UNDERSTANDING BLOOD PRESSURE

Blood pressure moves blood in your body. Sometimes, the force that moves the blood becomes too strong.

  • A blood pressure reading is given in 2 numbers and looks like a fraction.

  • The top number is called the systolic pressure. When your heart beats, it forces more blood to flow through the arteries. Pressure inside the arteries goes up.

  • The bottom number is the diastolic pressure. Pressure goes down between beats. That is when the heart is resting.

  • You may have hypertension if:

  • Your systolic blood pressure is above 140.

  • Your diastolic pressure is above 90.

RISK FACTORS

Some factors make you more likely to develop hypertension during pregnancy. Risk factors include:

  • Having hypertension before pregnancy.

  • Having hypertension during a previous pregnancy.

  • Being overweight.

  • Being older than 40.

  • Being pregnant with more than 1 baby (multiples).

  • Having diabetes or kidney problems.

SYMPTOMS

Chronic and gestational hypertension may not cause symptoms. Preeclampsia has symptoms, which may include:

  • Increased protein in your urine. Your caregiver will check for this at every prenatal visit.

  • Swelling of your hands and face.

  • Rapid weight gain.

  • Headaches.

  • Visual changes.

  • Being bothered by light.

  • Abdominal pain, especially in the right upper area.

  • Chest pain.

  • Shortness of breath.

  • Increased reflexes.

  • Seizures. Seizures occur with a more severe form of preeclampsia, called eclampsia.

DIAGNOSIS

  • You may be diagnosed with hypertension during pregnancy during a regular prenatal exam. At each visit, tests may include:

  • Blood pressure checks.

  • A urine test to check for protein in your urine.

  • The type of hypertension you are diagnosed with depends on when you developed it. It also depends on your specific blood pressure reading.

  • Developing hypertension before 20 weeks of pregnancy is consistent with chronic hypertension.

  • Developing hypertension after 20 weeks of pregnancy is consistent with gestational hypertension.

  • Hypertension with increased urinary protein is diagnosed as preeclampsia.

  • Blood pressure measurements that stay above 160 systolic or 110 diastolic are a sign of severe preeclampsia.

TREATMENT

Treatment for hypertension during pregnancy varies. Treatment depends on the type of hypertension and how serious it is.

  • If you take medicine for chronic hypertension, you may need to switch medicines.

  • Drugs called ACE inhibitors should not be taken during pregnancy.

  • Low-dose aspirin may be suggested for women who have risk factors for preeclampsia.

  • If you have gestational hypertension, you may need to take a blood pressure medicine that is safe during pregnancy. Your caregiver will recommend the appropriate medicine.

  • If you have severe preeclampsia, you may need to be in the hospital. Caregivers will watch you and the baby very closely. You also may need to take medicine (magnesium sulfate) to prevent seizures and lower blood pressure.

  • Sometimes an early delivery is needed. This may be the case if the condition worsens. It would be done to protect you and the baby. The only cure for preeclampsia is delivery.

HOME CARE INSTRUCTIONS

  • Schedule and keep all of your regular prenatal care.

  • Follow your caregiver's instructions for taking medicines. Tell your caregiver about all medicines you take. This includes over-the-counter medicines.

  • Eat as little salt as possible.

  • Get regular exercise.

  • Do not drink alcohol.

  • Do not use tobacco products.

  • Do not drink products with caffeine.

  • Lie on your left side when resting.

  • Tell your doctor if you have any preeclampsia symptoms.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe abdominal pain.

  • You have sudden swelling in the hands, ankles, or face.

  • You gain 4 pounds (1.8 kg) or more in 1 week.

  • You vomit repeatedly.

  • You have vaginal bleeding.

  • You do not feel the baby moving as much.

  • You have a headache.

  • You have blurred or double vision.

  • You have muscle twitching or spasms.

  • You have shortness of breath.

  • You have blue fingernails and lips.

  • You have blood in your urine.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well.