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What Are High Blood Pressure Complications During Pregnancy

Complications: Preeclampsia, HELLP Syndrome, Amniotic Fluid Abnormalities – Maternity – Pregnancy

Complications from high blood pressure for the mother and infant can include the following:

  • For the mother:preeclampsiaexternal icon, eclampsiaexternal icon, stroke, the need for labor induction , and placental abruption .1,4,5
  • For the baby:preterm delivery and low birth weight .1,6 The mothers high blood pressure makes it more difficult for the baby to get enough oxygen and nutrients to grow, so the mother may have to deliver the baby early.

Discuss blood pressure problems with your health care team before, during, and after pregnancy.

Learn what to do if you have high blood pressure before, during, or after pregnancy.

What Are The Signs And Symptoms Of Preeclampsia

Here are the warning signs of preeclampsia:

  • Swelling of face or hands
  • A headache that will not go away
  • Seeing spots or changes in eyesight
  • Pain in the upper abdomen or shoulder
  • Nausea and vomiting
  • Sudden weight gain
  • Difficulty breathing

If you have any of these symptoms, especially if they develop in the second half of pregnancy, contact your doctor right away.

What Is High Blood Pressure

Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body. Each time your heart beats, it pumps blood to the arteries. If the pressure in your arteries becomes too high, you have high blood pressure . High blood pressure can put extra stress on your organs. This can lead to heart attack, heart failure, stroke and kidney failure.

Some women have high blood pressure before they get pregnant. Others have high blood pressure for the first time during pregnancy. About 8 in 100 women have some kind of high blood pressure during pregnancy. If you have high blood pressure, talk to your health care provider. Managing your blood pressure can help you have a healthy pregnancy and a healthy baby.

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What Causes High Blood Pressure During Pregnancy

Its not clear whats behind every case of high blood pressure during pregnancy, but there are some risk factors, including a history of long-term high blood pressure or chronic kidney disease. You might also be more at risk if youre Black, youre carrying multiple babies, you have type 1 or 2 diabetes, youre younger than 20 years of age or older than 40, or youre obese.

Another cause of an above-normal blood pressure reading may be a case of “white-coat hypertension” a pretty common phenomenon , where blood pressure temporarily spikes because you get nervous or worried in medical settings.

Still, if your doctor notices your blood pressure is above 140/90 on two separate visits, whether youre just anxious when that cuff is placed on your arm or you have one of the above-mentioned risk factors, he’ll likely diagnose you with gestational hypertension.

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How Can I Reduce My Risk Of Getting Preeclampsia

For people with risk factors, there are some steps that can be taken prior to and during pregnancy to lower the chance of developing preeclampsia. These steps can include:

  • Losing weight if you have overweight/obesity .
  • Controlling your blood pressure and blood sugar .
  • Maintaining a regular exercise routine.
  • Getting enough sleep.
  • Eating healthy foods that are low in salt and avoiding caffeine.

How Is Postpartum Preeclampsia Diagnosed

Your doctor will check your blood pressure before you leave the hospital after giving birth. It will be checked again at your post-birth doctor visits. If your doctor suspects you have the condition, a blood test and urine test can provide more information. A blood test involves inserting a small needle connected to a syringe into the vein in your arm to collect a sample of blood. A urine test involves peeing into a cup at a lab or doctors office. If your blood pressure is too high, your doctor may send you to the hospital for overnight observation.

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What Complications Can Arise During Delivery

If you receive a preeclampsia diagnosis, your doctor may decide to induce your labor. Youll likely deliver vaginally, though the earlier you are in the pregnancy, the higher the chance you may need a cesarean delivery instead because your cervix wont be ready to dilate.

If your high blood pressure gets worse, it can lead to several life-threatening complications. Complications that could arise for the mother during a delivery include:

  • bleeding in the brain, or hemorrhagic stroke
  • HELLP syndrome, causing elevated liver enzyme levels and low platelets, which may lead to permanent damage to your nervous system, lungs, and kidneys

When preeclampsia causes seizures, its called eclampsia. Unborn babies can suffocate during a mothers seizure, and about one in every 14 of these babies may die. Additionally, mothers who experience a stroke due to preeclampsia may have permanent brain damage or even death.

According to a 2005 report from the World Health Organization, 12 percent of maternal deaths worldwide related to pregnancy or childbirth were due to hypertensive disorders such as preeclampsia and eclampsia.

Preeclampsia can also affect your baby, especially during the stressful process of delivery. Complications that could arise for the baby during delivery include:

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Preeclampsia (Eclampsia) in Pregnancy Nursing Review: Pathophysiology, Symptoms, NCLEX

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Symptoms Of Postpartum Preeclampsia

The main sign of postpartum preeclampsia is high blood pressure . Normal blood pressure is 120/80 mm Hg. Other common symptoms include:

  • New or unusual headaches
  • A swollen face and limbs
  • Stomach pain near your ribs
  • Nausea and vomiting
  • Sudden weight gain

Serious complications can include:

  • Red blood cell damage

What Can You Do About High Blood Pressure Before Pregnancy

Heres what you can do:

  • Get a preconception checkup. This is a medical checkup you get before pregnancy to take care of health conditions that may affect your pregnancy.
  • Use birth control until your blood pressure is under control. Birth control is methods you can use to keep from getting pregnant. Condoms and birth control pills are examples of birth control.
  • Get to a healthy weight. Talk to your provider about the weight thats right for you.
  • Eat healthy foods.
  • Do something active every day.
  • Dont smoke. Smoking is dangerous for people with high blood pressure because it damages blood vessel walls.

Last reviewed: February, 2019

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How Can I Prevent Preeclampsia:

The exact cause of preeclampsia is not known. Its thought to be improper functioning of the placenta including insufficient blood flow to the placenta. Other factors that may increase risk include: high fat and poor nutrition immune function disorders genetic issues or a family history.

Currently, there is no sure way to prevent preeclampsia. Some contributing factors to high blood pressure can be controlled and some cant. Follow your doctors instruction about diet and exercise.

  • Use little or no added salt in your meals
  • Drink 6-8 glasses of water a day
  • Avoid fried foods and junk food
  • Get enough rest
  • Your doctor may suggest you take the prescribed medicine and additional supplements

How Do We Reduce The Risk

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Patient education and empowerment are cornerstones of our program. Women need to understand that any patient with a hypertensive disorder of pregnancy is at risk for developing severe hypertension in the postpartum period.

Two ways you can help reduce your risks include visiting the doctor prior to the six-week checkup and monitoring your blood pressure at home.

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Controlling Blood Pressure In Preeclampsia

Overview

Preeclampsia is a serious condition that can occur during pregnancy. The condition causes your blood pressure to become very high and can be life-threateningly. Preeclampsia can occur early in pregnancy or even postpartum, but often occurs after 20 weeks gestational age. An estimated 10 percent of women experience preeclampsia.

Doctors dont know exactly what causes preeclampsia. They think its possibly related to blood vessels in the placenta developing improperly. This can be due to family history, blood vessel damage, immune system disorders, or other unknown causes. Regardless of the cause, preeclampsia requires fast action to control blood pressure.

What Are The Treatments For Preeclampsia

Delivering the baby can often cure preeclampsia. When making a decision about treatment, your provider take into account several factors. They include how severe it is, how many weeks pregnant you are, and what the potential risks to you and your baby are:

  • If you are more than 37 weeks pregnant, your provider will likely want to deliver the baby.
  • If you are less than 37 weeks pregnant, your health care provider will closely monitor you and your baby. This includes blood and urine tests for you. Monitoring for the baby often involves ultrasound, heart rate monitoring, and checking on the baby’s growth. You may need to take medicines, to control your blood pressure and to prevent seizures. Some women also get steroid injections, to help the baby’s lungs mature faster. If the preeclampsia is severe, you provider may want you to deliver the baby early.

The symptoms usually go away within 6 weeks of delivery. In rare cases, symptoms may not go away, or they may not start until after delivery . This can be very serious, and it needs to be treated right away.

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Severe Preeclampsia Treated Safely With Nifedipine During Labor And Delivery

Research Highlights:

  • Pregnant women with severe preeclampsia who took a daily dose of extended-release nifedipine when labor was induced had better blood pressure control during labor and were less likely to need fast-acting medicine including intravenous medicine to lower very high blood pressure, compared to those who got a placebo.
  • Fast-acting medicines such as intravenous medicines administered during delivery for women with severe preeclampsia may lower blood pressure too quickly and lead to complications for the mother and/or the baby.
  • Researchers also observed trends toward fewer deliveries by Cesarean section and less neonatal intensive care needed for the newborns among the women started on nifedipine for high blood pressure during induction of labor.

Embargoed until 4 a.m. CT/5 a.m. ET Monday, Oct. 3, 2022

DALLAS, Oct. 3, 2022 Women with severe preeclampsia during pregnancy may be treated with extended-release nifedipine, a blood pressure-lowering medicine, daily during the labor and delivery process, according to new research published today in Hypertension, an American Heart Association journal. Women treated with the medicine were less likely to experience dangerously high blood pressure that would require treatment with fast-acting medicines including intravenous medications.

The study found:

The study was funded by The Ohio State University Department of Obstetrics and Gynecology.

Additional Resources:

Who Gets Preeclampsia

GHTN Preeclampsia | Doctor Explains High Blood Pressure in Pregnancy

Preeclampsia may be more common in first-time mothers. Healthcare providers are not entirely sure why some people develop preeclampsia. Some factors that may put you at a higher risk are:

  • Swelling in your hands and face .
  • Shortness of breath.

It’s essential to share all of your pregnancy symptoms with your healthcare provider. Many people are unaware they have preeclampsia until their blood pressure and urine are checked at a prenatal appointment.

Severe preeclampsia may include symptoms like:

  • Hypertensive emergency .
  • Fluid in the lungs.
  • Low blood platelet levels .

If your preeclampsia is severe, you may be admitted to the hospital for closer observation or need to deliver your baby as soon as possible. Your healthcare provider may give you medications for high blood pressure or to help your baby’s lungs develop before delivery.

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What Is Preeclampsia

Preeclampsia is a serious blood pressure condition that develops during pregnancy. People with preeclampsia often have high blood pressure and high levels of protein in their urine . Preeclampsia typically develops after the 20th week of pregnancy. It can also affect other organs in the body and be dangerous for both the mom and her developing fetus . Because of these risks, preeclampsia needs to be treated by a healthcare provider.

How Is It Diagnosed

Preeclampsia is often diagnosed during routine prenatal appointments when your healthcare provider checks your weight gain, blood pressure and urine.

If preeclampsia is suspected, your healthcare provider may:

  • Order additional blood tests to check kidney and liver functions.
  • Suggest a 24-hour urine collection to watch for proteinuria.
  • Perform an ultrasound and other fetal monitoring to look at the size of your baby and assess the amniotic fluid volume.

Preeclampsia can be categorized as mild or severe. You may be diagnosed with mild preeclampsia if you have high blood pressure plus high levels of protein in your urine.

You are diagnosed with severe preeclampsia if you have symptoms of mild preeclampsia plus:

  • Signs of kidney or liver damage .
  • Low platelet count
  • Visual impairment or seeing spots.

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What Are The Causes Of Preeclampsia

According to the Mayo Clinic, the exact cause of preeclampsia involves several factors. Experts believe it begins in the placenta the organ that nourishes the fetus throughout pregnancy. Early in pregnancy, new blood vessels develop and evolve to efficiently send blood to the placenta.

In women with preeclampsia, these blood vessels dont seem to develop or function properly. Theyre narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them.

Causes of this abnormal development may include:

  • Insufficient blood flow to the uterus
  • Damage to the blood vessels
  • A problem with the immune system

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