Treating High Blood Pressure In Pregnancy
Is treatment necessary?
Your healthcare provider wont always recommend medications for high blood pressure during pregnancy.
The American College of Obstetricians and Gynecologists recommends that pregnant women with severe high blood pressure take medication to lower their blood pressure. Severe high blood pressure is when the systolic blood pressure is 160 or higher and/or the diastolic BP is 110 or higher. Between 140-159 systolic, and 90-109 diastolic, the science is less clear. If you have symptoms like headache and blurred vision you might need treatment.
Are blood pressure medications safe during pregnancy?
This is the million dollar question. All blood pressure-lowering medications cross the placenta and get into your babys bloodstream. But, not treating high blood pressure in pregnancy can have harmful results for mom and baby.
The concern with treating high blood pressure in pregnancy is that lowering blood pressure too quickly, and the medications themselves, can cause low birth weight. But large studies have not shown consistently whether or not this is a real concern.
Healthcare professionals are also not sure whether treating high blood pressure in pregnancy actually lowers risk of birth complications, stroke, or preeclampsia. The results of the 2018 Cochrane review and the 2017 meta-analysis show that treating high blood pressure in pregnancy lowers the risk of severe high blood pressure, but does not lower the risk of birth complications or preeclampsia.
Treatment Options For High Blood Pressure In Pregnancy
It is important to keep blood pressure down during pregnancy because of the potential complications for both mom and baby. There are several ways to reduce blood pressure during pregnancy including:
- Attend all prenatal checkups
- Take medication regularly, if prescribed
- Eat a healthy diet
- Exercise regularly
- Avoid smoking, drinking and substance abuse
Stress can also be a factor on the body during pregnancy so it is important to avoid stressful situations, if possible, and be sure to get enough rest. Breathing exercises, prenatal yoga, baths and prenatal massages are all ways to help beat stress and take care of the body while pregnant.
How To Deal With Low Blood Pressure During Pregnancy
Keeping track of your blood pressure on a regular basis is a good way to see how healthy your pregnancy is. It also helps you monitor yourself, detecting potential complications such as preeclampsia. You should track your low blood pressure during pregnancy along with other data such as sleep, activity and nutrition. This will let you and your doctor draw patterns between behaviors that affect blood pressure or vice versa. Be sure to tell your doctor if your blood pressure remains consistently high.
Usually, this condition requires no treatment. If it shows some underlying causes, you can take some targeted methods. Intravenous fluids are required to relieve low blood pressure due to dehydration. Graduated compression stockings can help with low blood pressure caused by pooling blood. Sometimes eating a little more salt can improve it, but always talk to your doctor before trying this method.
You can also follow a few steps to help prevent low blood pressure during pregnancy.
What Others Have Experienced
“I had low blood pressure of 80/50 which led to a fainting spell. My doctor suggested drinking lots of water and eating hourly since my twins were stealing blood flow. It was annoying, but the suggestion helped.”
Salt Can Be One Option.
Low Blood Pressure and Cold Feeling
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Is There Anything You Can Do To Deal With Low Blood Pressure When Youre Pregnant
Although medication is not normally needed when this happens, there are some simple changes you can make that may reduce the likelihood of its happening.
Take it easy. Try to slow down, avoid making sudden movements, and dont stand up too quickly. If you do feel faint or dizzy, lie down on your left side, which may help to increase the blood flow to your heart.
Drink lots of water. As well as preventing dehydration, this increases your blood volume, and thus your blood pressure.
Eat a healthy diet. Your doctor may also recommend that you increase your salt intake, though its important not to overdo this.
Causes Of High Blood Pressure During Pregnancy
There are several potential causes of high blood pressure during pregnancy. For instance, unhealthy lifestyle choices may lead to hypertension while pregnant. Being overweight, obese, inactive, a regular drinker, or a smoker is thought to increase your risk.
If it is your first pregnancy, you are also more likely to experience hypertension. However, there is a lower chance of high blood pressure if you have multiple pregnancies with the same partner.
You can also be at risk if you are pregnant and over age 40, as well as when youâre carrying more than one child at the same time. Using assisted reproductive technology, like in vitro fertilization, can also increase your risk of high blood pressure during pregnancy.
Women who had hypertension before pregnancy are also at risk for high blood pressure complications during pregnancy.
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Dizziness In The Third Trimester
Many of the causes of dizziness in the first and second trimesters can cause the same symptom later in your pregnancy. Its important that you see your doctor regularly in the third trimester to monitor potentially dangerous conditions that can cause dizziness.
Watch for signs of feeling faint to avoid falling, especially during your third trimester. Stand up slowly and reach for support to avoid lightheadedness, and make sure to sit as often as you can to avoid long periods of standing.
There are some causes that may cause dizziness at any time during your pregnancy. These conditions arent tied to a specific trimester.
How Pregnancy Affects Blood Pressure
Your body goes through different changes during pregnancy. These changes can have a serious effect on your blood pressure. Due to an expansion in the circulatory system in your body, the blood pressure drops which is often considered normal. Its natural to notice a drop in your BP specifically during the initial 24 weeks of pregnancy.
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Blood Pressure Readings May Change During Pregnancy
As a pregnancy progresses, blood pressure may change or return to pre-pregnancy levels. Why does this happen? Here are a few reasons behind blood pressure changes during pregnancy:
- Left ventricle becomes thicker and larger: The left ventricle is the left side of the heart, which is responsible for significant pumping. When the left ventricle temporarily becomes larger and thicker, it allows the heart to work harder when there is increased blood volume.
- Blood levels in a womanâs body increase: Research published in the journal Circulation in 2014 shows that a womanâs blood volume will increase by as much as 45% when pregnant. The heart must pump the extra blood throughout the body, and this leads to the higher blood pressure reading.
- Kidneys release hormone: The kidneys release increased amounts of a hormone called vasopressin, which leads to greater water retention and increased blood pressure and arterial pressure.
- After-birth BP: High blood pressure often immediately returns to normal after the baby is delivered. However, when high blood pressure remains, your doctor may offer treatment.
Symptoms Having To Do With Low Blood Pressure In Pregnancy
While hypotension is a physiological condition of pregnancy, some women experience bothersome symptoms from it. The intensity of these depends on many factors, among which are the usual blood pressure levels.
Among the most common clinical manifestations of hypotension in pregnancy, we can mention the following:
In general, none of these symptoms is serious, but the context may favor the appearance of pregnancy complications. For example, if the mother passes out in public and hits herself hard.
Likewise, the mothers basic condition is also a determining factor of risk. Sp, a mother who doesnt hydrate well and suffers from hyperemesis gravidarum may become dehydrated more easily and require hospitalization.
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What Are Types Of High Blood Pressure Conditions Before During And After Pregnancy
Your doctor or nurse should look for these conditions before, during, and after pregnancy:1,11
Chronic hypertension means having high blood pressure* before you get pregnant or before 20 weeks of pregnancy.1 Women who have chronic hypertension can also get preeclampsia in the second or third trimester of pregnancy.1
This condition happens when you only have high blood pressure* during pregnancy and do not have protein in your urine or other heart or kidney problems. It is typically diagnosed after 20 weeks of pregnancy or close to delivery. Gestational hypertension usually goes away after you give birth. However, some women with gestational hypertension have a higher risk of developing chronic hypertension in the future.1,12
Preeclampsia happens when a woman who previously had normal blood pressure suddenly develops high blood pressure* and protein in her urine or other problems after 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia.
Preeclampsia happens in about 1 in 25 pregnancies in the United States.1,13 Some women with preeclampsia can develop seizures. This is called eclampsia, which is a medical emergency.1,11
Symptoms of preeclampsia include:
Some women have no symptoms of preeclampsia, which is why it is important to visit your health care team regularly, especially during pregnancy.
You are more at risk for preeclampsia if:1
How To Handle Low Blood Pressure During Pregnancy
Theres no specific treatment for low BP, however, these self-care tips will go a long way in ensuring your safety:
- Relax! Take the time you need to wake up in the morning before starting your day. An ideal situation would be drinking a cup of warm tea in bed.
- Avoid standing up too fast when youre sitting or lying down.
- A well-balanced diet is super important when youre pregnant. Make sure you consume small meals throughout the day.
- Avoid bathing with extremely hot water.
- Increase your fluid intake by a lot. This also helps treat symptoms of morning sickness and vomiting. Seriously, double or even triple how much water/juice you drink every day.
- Wear loose clothes during the entire pregnancy.
- Drink salt and lemon water immediately if you feel like theres a drop in your blood pressure.
You do not need to overthink about the whole phenomenon. Low blood pressure during pregnancy is very common. Only when you feel like there are symptoms manifesting, seek medical advice.
Let me know if you guys know of any other natural tips to deal with low blood pressure in the comments below!
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High Blood Pressure Complications
While many women who have hypertension prior to pregnancy do very well, there are some potential complications to be aware of. You and your doctor will come up with a plan to manage your symptoms. Additionally, women who have chronic or gestational hypertension are at risk of developing preeclampsia in their second or third trimesters.
Physiologically, the effects of progesterone typically lower blood pressure during the first and second trimester of pregnancy, according to Robert Atlas, MD, an OB/GYN who specializes in high-risk pregnancy issues at Mercy Medical Center in Baltimore, MD. Blood pressure will return back to pre-pregnancy levels in the third trimester.
Additionally, he says the following are some of the more common complications associated with high blood pressure in pregnancy:
- 20% to 30% chance of developing superimposed preeclampsia, if you have hypertension prior to pregnancy
- Increased risk of preterm birth
- Increased risk of fetal growth problems, which may result in low birth weight
- Women who have underlying kidney problems have an even higher risk of blood pressure complications in pregnancy
Why Does Blood Pressure Increase During Pregnancy
Pregnant women are at an increased risk of hypertension. According to the CDC and American Pregnancy Association, high blood pressure affects up to eight percent of pregnant women, and that number is increasing. There are different types of high blood pressure women may suffer from during pregnancy, including:
- Gestational Hypertension, which develops twenty weeks into pregnancy
- Chronic hypertension, or high blood pressure occurring before pregnancy or at the twenty-week mark
- Chronic hypertension and superimposed preeclampsia, which occurs in women with high blood pressure before their pregnancy
- Preeclampsia, which is a pregnancy complication caused by high blood pressure and signs of damage to an additional organ system
Because high blood pressure during pregnancy puts additional stress on your heart and kidneys, your risk of heart and kidney disease and stroke increases, other complications may occur as well, including preterm delivery, placental abruption, fetal growth restriction, and others. Therefore, it is vital to monitor your blood pressure levels closely during your pregnancy.
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Treating High Blood Pressure
Similar to the treatment approaches for hypertension in non-pregnant patients, women who have high blood pressure prior to pregnancy can manage symptoms of hypertension through medication and lifestyle modifications. These are the same treatments used with preeclampsia as well.
Dr. Atlas says most mothers with elevated blood pressure will generally be treated with medications to lower the blood pressure. We use Labetalol and Nifedipine often for patients as they have generally been shown to be safe in pregnancy, he explains.
That said, Dr. Atlas does point out that some people may be on medications prescribed by internists or renal doctors that are not safe to take in pregnancy. “Medications such as ACE and ARB inhibitors can be potentially harmful to the developing fetus,” he explains.
In addition to medication, treating high blood pressure during pregnancy involves:
- Eating a healthy diet rich in fruits, vegetables, lean protein, and complex carbohydrates
- Limiting sodium
- If overweight, limiting weight gain
- Managing stress levels
- Avoiding alcohol
- Quitting smoking
If high blood pressure spikes too high and does not respond to medication and/or lifestyle accommodations, other possible treatments include bed rest and induction of labor. Particularly with preeclampsia, if a woman’s pressure is too high and her baby is viable , inducing labor will be considered.
Low Blood Pressure Complications
While many women who have low blood pressure prior and during pregnancy do not have any related issues, there are some complications to be aware of.
Some symptoms of low blood pressure include:
- Rapid or shallow breathing
One of the most concerning complications is dizziness because it can lead to fainting, falling, and injury, secondary to the fall. Additionally, research has shown a link between low blood pressure and increased symptoms of morning sickness.
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Risks Of High Blood Pressure In Pregnancy
High blood pressure during pregnancy puts you at risk of:
Fluid in other parts of your body It can also put you at risk of a serious complication called placental abruption and complications when giving birth.
High blood pressure can also affect your unborn babys growth and health. When the moms blood pressure runs high, this affects how much oxygen and nutrients are delivered to the growing baby. Unborn babies affected by high maternal blood pressure are more likely to be born preterm and underweight.
For the birth
Pregnancy-induced hypertension raises your risk of having an early delivery or a C-section.
How To Manage High Blood Pressure During Pregnancy
It is important to manage high blood pressure during pregnancy. Taking care of your body is the best way to benefit your developing baby.
Here are four key ways you can manage high blood pressure during pregnancy:
- Keep prenatal appointments: Be sure to visit your health care practitioner on a regular basis throughout your pregnancy. This will help you keep track of your blood pressure levels during each appointment. You can also purchase a blood pressure monitor, and pharmacies and grocery stores often carry machines that take blood pressure readings.
- Treat high blood pressure: Your doctor may prescribe antihypertensive drugs, such as beta blockers, ACE inhibitors, ARBs , direct renin inhibitors, diuretics, and calcium channel blockers. At the same time, you can use some of the natural blood pressure-lowering methods mentioned in the next section.
- Stay active and reduce stress: Aim to get at least 20 to 30 minutes of physical activity daily. Try to go for a walk and spend time in nature. Stress reduction is also a great way to lower blood pressure, and prenatal yoga classes, meditation, and deep breathing are excellent natural stress relievers.
- Eat a healthy diet: The Mediterranean and DASH diets are considered two of the best diets to manage blood pressure. Both are high in fiber, potassium, and omega-3 fatty acids, and lower in salt. Include items such as coconut water, avocados, flaxseeds, chia seeds, and wild-caught salmon.
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Low Blood Pressure During Pregnancy: Should You Be Worried
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Hypotension or low blood pressure is often a commonly occurring phenomenon in pregnant women, however, it becomes a cause for concern only when it fluctuates unnaturally. Typically, you do not need a structured treatment for low blood pressure but in certain scenarios, very low BP can be devastating for the baby and mommy both!
Ways To Lower Blood Pressure During Pregnancy
No medications needed, just a couple of lifestyle changes.
ByAnita Mirchandani June 7, 2017
@iripetrakova / Twenty20
You may think of high blood pressure as a problem you’ll have to deal with when you are older, but it turns out, many pregnant women deal with it too. Hypertension affects up to 8 percent of expecting women and can lead to complicationsfrom preeclampsia to low birth weight to higher risk of placenta abruption to kidney problems. So if you were diagnosed with gestational hypertension or are at risk of developing it during pregnancy, you should find a way to keep your blood pressure under control and since a lot of medications are big no-nos during pregnancy, the key to doing so is making a few lifestyle changes.
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