Other High Blood Pressure Disorders In Pregnancy
Preeclampsia is one of four blood pressure disorders in pregnant women. The other three are:
- Gestational hypertension. This is high blood pressure that starts after the 20th week of pregnancy but doesnât cause high amounts of protein in a womanâs urine. It usually goes away after delivery.
- Chronic hypertension. This is high blood pressure that starts before a woman gets pregnant or before the 20th week of pregnancy.
- Chronic hypertension with superimposed preeclampsia. This is chronic high blood pressure that gets worse as pregnancy goes on, causing more protein in urine and other complications.
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High Blood Pressure During Pregnancy
Some women have high blood pressure during pregnancy. This can put the mother and her baby at risk for problems during the pregnancy. High blood pressure can also cause problems during and after delivery.1,2 The good news is that high blood pressure is preventable and treatable.
High blood pressure, also called hypertension, is very common. In the United States, high blood pressure happens in 1 in every 12 to 17 pregnancies among women ages 20 to 44.3
High blood pressure in pregnancy has become more common. However, with good blood pressure control, you and your baby are more likely to stay healthy.
The most important thing to do is talk with your health care team about any blood pressure problems so you can get the right treatment and control your blood pressurebefore you get pregnant. Getting treatment for high blood pressure is important before, during, and after pregnancy.
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Why Is High Blood Pressure During Pregnancy A Problem
The main risk of having high blood pressure during pregnancy is developing pre-eclampsia. Pre-eclampsia is a serious condition and it can affect both you and your baby. Read more about pre-eclampsia.
If your blood pressure remains mildly to moderately raised and you dont develop pre-eclampsia, the risk of pregnancy complications is low. However, it is important that your blood pressure and urine are checked regularly throughout your pregnancy to check for signs of pre-eclampsia.
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Preventing High Blood Pressure During Pregnancy
Common risk factors for high blood pressure, such as obesity, can be minimized through diet and exercise.
During pregnancy, its normal to gain some weight. If youre concerned, talk to your doctor about a target weight gain and ways to stay within a range thats healthy for you.
Dietary guidelines for pregnant women vary from person to person. A nutritionist can help create a meal plan thats designed for your specific height and weight.
Avoid smoking and drinking alcohol. Both are known to raise blood pressure and to cause other complications during pregnancy.
Salt is important during pregnancy and its usually not necessary to limit salt intake, even for women with high blood pressure. Restricting salt too much is harmful for pregnant women and can impact fetal growth and development.
Pregnancy causes hormone shifts as well as psychological and physical changes. This can bring on stress, which can make high blood pressure harder to manage. Try stress reduction techniques such as yoga and meditation.
Some traditional blood pressure medications can cause problems in pregnant women.
These medications for lowering blood pressure are typically not recommended during pregnancy:
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Prevention And Treatment Of Gestational Hypertension
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How Hypertension During Pregnancy Is Diagnosed
Your blood pressure will be monitored during prenatal visits and you will undergo a few other tests and checks, including:
Testing your urine for excess protein
Taking a blood pressure reading along with your other vital signs like heart rate, respiratory rate, and temperature
Weighing you to determine if youre gaining weight at a normal rate
If your doctor detects high blood pressure, they will recommend more frequent visits to monitor both you and your baby. You will also undergo additional testing, including:
Fetal ultrasound to check your babys amniotic fluid, placenta, development, and growth
Electronic fetal heart monitoring to evaluate your babys heart rate and rhythm
Doppler ultrasound to determine if there is enough blood flow to the placenta
A blood test will be ordered to monitor your blood cells and liver and kidney function if you are diagnosed with preeclampsia.
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Who Is Most At Risk Of Pre
There are things that can increase your chances of developing pre-eclampsia, such as:
- having diabetes, high blood pressure or kidney disease before starting pregnancy
- having developed the condition during a previous pregnancy
Other things that can slightly increase your chances of developing pre-eclampsia include:
- having a family history of the condition
- being over 40 years old
- it having been at least 10 years since your last pregnancy
- expecting multiple babies
- having a body mass index of 35 or over
If you have two or more of these together, then your chances are higher.
Page last reviewed: 17 September 2018 Next review due: 17 September 2021
Hypertension Canada And Society Of Obstetricians And Gynaecologists Of Canada
Women should have their BP measured using a standardized protocol after a period of rest in a quiet environment and be in a sitting position with their arm at the level of the heart using an appropriately sized cuff .
The arm with higher BP values should be used for hypertension diagnosis and BP monitoring.
Nonsevere elevated BP should be remeasured at the same visit, with at least a gap of 15 minutes from the first measurement.
More than 50% of women with a first BP reading of 140/90 mm Hg have white-coat effect.
Hypertension in pregnancy is defined as an SBP 140 mm Hg and/or a DBP 90 mm Hg .
Severity of hypertension in pregnancy is considered on the basis of the presence of target organ involvement as well as the actual BP level.
BP levels between 140/90 mm Hg and < 160/110 mm Hg are considered nonsevere hypertension in pregnancy.
A BP level of 160/110 mm Hg is associated with increased risk of maternal stroke in pregnancy and is therefore considered the diagnostic threshold of severe hypertension in pregnancy.
Antihypertensive therapy is recommended for average SBP measurements of 140 mm Hg or DBP measurements of 90 mm Hg in pregnant women with chronic hypertension, gestational hypertension, or preeclampsia.
Initial antihypertensive therapy should be monotherapy from the following first-line drugs: oral labetalol, oral methyldopa, long-acting oral nifedipine, or other oral -blockers .
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High Blood Pressure In Pregnancy
Arterial hypertension is considered to be pressure above 140/90 mm Hg. There may be a threat to the fetus with such indicators. There is strong vasoconstriction and blood circulation is disturbed. There is a lack of oxygen and nutrients that should be supplied to the child. This slows down its growth and development.
Blood pressure is one of the most important indicators of the circulatory system. It functions with a double load during pregnancy. The pressure rises with increased blood flow as the fetus grows.
What Are The Risks Of Chronic Hypertension
When not properly controlled, chronic hypertension increases the risk of:
- Problems with concentrating and thinking
Additional risks of chronic hypertension during pregnancy include:
- Placental abruption, where the placenta separates from the uterus
- Needing to undergo a C-section
- Low birth weight because the fetus doesnt receive enough blood through the placenta
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Can High Blood Pressure Affect The Baby
High blood pressure in pregnancy can prevent blood from flowing to the placenta. Because the baby doesnt get enough nutrients or oxygen, they are at higher risk of being low birth weight or being born prematurely.
For this reason, its very important that high blood pressure is picked up early and treated.
Abdominal And/or Shoulder Pain
This type of abdominal pain, often called epigastric pain or upper right quadrant pain, is usually under the ribs on the right side. It can be confused with heartburn, gallbladder problems, flu, indigestion or pain from the baby kicking. Shoulder pain is often called referred pain because it radiates from the liver under the right ribs. Lower back pain is different from muscle strain common to pregnancy, because it is usually more acute and specific. Shoulder pain can feel like someone is deeply pinching you along the bra strap or on your neck, or it can be painful to lie on your right side. All of these pain symptoms may be a sign of HELLP Syndrome or a related problem in the liver.
What you can do…
Pain in this area should be taken very seriously do not dismiss it and go to bed. Call your health professional immediately.
High Blood Pressure During Pregnancy: What You Need To Know
Around 510%¹ of pregnancies are affected by hypertension , either because the woman had chronic hypertension before becoming pregnant or developed the condition during pregnancy. High blood pressure during pregnancy is a serious health risk for mother and baby and can be life-threatening or fatal in some cases.
Hypertension before, during, and after pregnancy is preventable and treatable. You will be closely monitored throughout your pregnancy and birth to ensure you and your baby are safe and healthy, but the condition may impact your experiences, especially when it comes to giving birth. It helps to be aware of the steps you can take and the changes you can make to keep your blood pressure in check during your pregnancy and avoid serious complications.
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What Happens When You Have Preeclampsia
When you have preeclampsia, your blood pressure is elevated , and you may have high levels of protein in your urine. Preeclampsia puts stress on your heart and other organs and can cause serious complications. It can also affect the blood supply to your placenta, impair liver and kidney function or cause fluid to build up in your lungs. The protein in your urine is a sign of kidney dysfunction.
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When Will It End
The symptom should disappear after the 27th week of pregnancy. This occurs after the adaptation of the circulatory system to high loads. A single manifestation of high blood pressure cannot be considered hypertension. The symptoms end when the uteroplacental circulation is normalized. Hypertension can remain even after childbirth in case of health problems.
How High Blood Pressure Feels During Pregnancy
High blood pressure may not be accompanied by additional sensations. It is discovered by chance during a visit to the gynecologist. There will be an increased indicator on the tonometer, and the woman may not complain at all about the symptoms. Sensations are most often more vivid: headaches, pulsation of the temples, shortness of breath, swelling, etc.
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Reduced Blood Flow To The Placenta
As a result of the placentas insufficient blood deposition, the fetus receives less oxygen and nutrients.
This can lead to low birth weight, intrauterine growth restriction, and premature birth. Premature births can have repercussions, including respiratory problems, an increased risk of infection, and more.
What Not To Do
Dont put yourself at risk of complications from high blood pressure. It is necessary to exclude all factors provoking the symptom. For starters, dont self-medicate. You should always consult with your doctor at your next appointment. Do not use what is currently in your first aid kit. High-pressure prohibitions:
Do not lift heavy, do not overwork, and take a break from yoga, gymnastics, or swimming. Stay at rest until symptoms subside.
It is strictly forbidden for high blood pressure. Even being in a stuffy room can trigger an attack of hypertension.
Drink coffee, cola, and strong tea
These drinks worsen the condition at high pressure, creating an additional load on the vessels. Their use should be completely excluded.
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Types Of High Blood Pressure Disorders During And After Pregnancy
If you have high blood pressure before pregnancy, it will need to be managed during and after pregnancy.
In addition, some women who have a healthy blood pressure develop high blood pressure during or after pregnancy.
- Gestational hypertension is blood pressure greater than or equal to 140/90 that develops during pregnancy. Its typically diagnosed after 20 weeks of pregnancy or close to delivery.
- Preeclampsia is a combination of high blood pressure during pregnancy and signs that your organs are not working well, such as high protein levels in your urine. This can lead to life-threatening seizures or coma, a condition known as eclampsia. Women who have had preeclampsia have a higher risk of developing high blood pressure and heart disease later in life.
- HELLP syndrome is a more severe type of preeclampsia or eclampsia.
- High blood pressure disorders may continue after the baby is born. Some women may continue to have high blood pressure problems, including preeclampsia, eclampsia, or HELLP syndrome, after the birth of their child, or their high blood pressure may get worse.
- A sudden spike in blood pressure can also happen during pregnancy or after the baby is born. This is a medical emergency.