What Causes High Blood Pressure In Pregnancy

Maternal Medical Risk Factors For Preeclampsia

The following are maternal medical risk factors for preeclampsia:

• Chronic hypertension, especially when secondary to such disorders as hypercortisolism, hyperaldosteronism, pheochromocytoma, or renal artery stenosis

• Preexisting diabetes , especially with microvascular disease

• Renal disease

• Use of selective serotonin uptake inhibitor antidepressants beyond the first trimester

How Do We Reduce The Risk

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.

What Is High Blood Pressure During Pregnancy

A small percentage of pregnant women in the U.S. have high blood pressure at some point during their pregnancy. Some cases are mild other cases are severe. Treatment varies depending on the type you have and how far along you are in your pregnancy.

There are three main types of high blood pressure during pregnancy:

In some cases, high blood pressure during pregnancy can cause harm to you and your baby.

• You may develop gestational diabetes.
• You may experience problems with your heart or kidneys. Youre also at greater risk for a stroke.
• High blood pressure may prevent the placenta from getting enough blood. If the placenta doesnt get enough blood, your baby doesnt get enough oxygen and food. This can cause low birth weight and premature birth.
• High blood pressure can lead to placental abruption. This is when the placenta becomes unattached to the uterus. This can be a life threatening situation to both you and your baby.

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What Are The Symptoms

High blood pressure doesn’t usually cause symptoms. You will probably feel fine, even if your blood pressure is too high.

Tell your doctor right away if you have any signs of very high blood pressure or pre-eclampsia, such as:

• A severe headache.
• Blurry vision.
• Pain in your upper belly.
• Rapid weight gainmore than 1 kg in a week or 3 kg in a month.

Signs Suggesting A Secondary Medical Cause Of Chronic Hypertension

Centripetal obesity, “buffalo hump,” and/or wide purple abdominal striae suggest glucocorticoid excess other clinical signs may demonstrate hyperthyroidism, hypothyroidism, or growth hormone excess. In addition, a systolic bruit heard over the abdomen or in the flanks suggests renal artery stenosis, whereas radio femoral delay or diminished pulses in the lower versus upper extremities suggests coarctation of the aorta.

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Blood Pressure Readings & Pregnancy

Pregnancy affects basically everything in the body, however, and blood pressure is no exception. âEveryoneâs baseline blood pressure is different and can change in pregnancy,â as Dr. Mitchell Kramer, Chair of OB/GYN at Huntington Hospital, tells Romper. This may affect your blood pressureâs safe ranges. âNormal blood pressure in pregnancy can vary from individual to individual, but it can vary from 90/60 to 130/80. Blood pressure 140/90 would be considered to be elevated and would require additional testing and/or treatment depending on the gestational age and other factors like age, weight, and medical history,â says Kramer. Itâs a lot to keep in mind, but here are some general guidelines for blood pressure during pregnancy provided by Dr. Alan Copperman, Medical Director at Progyny and co-founder of Reproductive Medicine Associates of NY.

• Normal: Less than 120/80 mm Hg
• Elevated blood pressure: Systolic between 120 and 129 mm Hg and diastolic less than 80 mm Hg
• Stage 1 hypertension: Systolic between 130 and 139 mm Hg or diastolic between 80 and 89 mm Hg
• Stage 2 hypertension: Systolic at least 140 mm Hg or diastolic at least 90 mm Hg or higher

Heart Disease High Blood Pressure And Menopause

While you may have had normal blood pressure most of your life, your chances of developing high blood pressure increase considerably after menopause.

Heart disease risk rises for everyone as they age, but for women symptoms can become more evident after the onset of menopause.

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Way Prevent High Blood Pressure In Pregnancy

The best way for pregnant women to prevent high blood pressure is by eating nutritious, high-quality nutrition every day, and engaging in regular exercise

To prevent the complications that high blood pressure can cause to the mother and the baby, pregnant women should control their blood pressure throughout the pregnancy.

They can do this by self-testing their blood pressure regularly and by eating more beneficial foods like fruits, vegetables, whole grains, and beans.

The good news is that Preeclampsia has a much better chance of being controlled if you eat nutritious food, live a healthy lifestyle, and limit the amount of alcohol you drink.

If you already have high blood pressure, there is a 25% risk that it will get worse if you do not get some prompt action taken.

Risks Of High Blood Pressure In Pregnancy

For mom

High blood pressure during pregnancy puts you at risk of:

• Stroke

• Heart attacks

• Breathing problems

• 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.

For baby

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.

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Causes Of High Blood Pressure During Pregnancy

There are several possible causes of high blood pressure or hypertension during pregnancy.

These include:

• A family history of pregnancy-related hypertension
• If you are carrying more than one child
• If your age is over 35
• Assistive reproductive technology
• If you Have diabetes or certain autoimmune diseases

What Are Possible Complications Of High Blood Pressure In Pregnancy

High blood pressure taxes the blood vessels, which in turn decreases blood flow to the liver, kidneys, brain, heart, lungs, uterus and placenta. When gestational hypertension isnt under control and the placenta isnt getting enough blood, fewer nutrients and oxygen make it to your baby, which can slow fetal growth.

And if gestational hypertension morphs into preeclampsia, premature delivery or placental abruption can occur, which is the too-early separation of the placenta from the uterus. In the worst of cases, stillbirth and eclampsia are possible. Untreated very high blood pressure can also lead to stroke.

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Preventing Hbp In Pregnancy

Preventing high blood pressure before pregnancy will help lower the risk of high blood pressure when you do become pregnant. In fact, the healthier you are before becoming pregnant, the healthier and easier your pregnancy will be. Healthy habits to form before pregnancy include:

• Keeping alcohol intake within safe limits

Other medical conditions, like diabetes, can also increase your risk of high blood pressure. Healthy lifestyle practices and regular check-ups can lower this risk, but probably not forever.

Whether you have high blood pressure before you get pregnant or you develop it while pregnant, one thing is for sure: regular checkups throughout your pregnancy will keep you and your unborn baby healthy.

Are There Any Symptoms Of High Blood Pressure In Pregnancy

Symptoms can vary from person to person and at each pregnancy, but the main symptom of high blood pressure when youre expecting is a high reading in the second half of gestation, usually around week 20. Yet one of the tricky things about high blood pressure when youre pregnant is that some women feel completely normal and dont show any symptoms at all.

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Is It Safe To Take Blood Pressure Medication During Pregnancy

Any medication taken during pregnancy affects both the mother and the foetus. There are certain medications considered safe for use when treating high blood pressure in expectant mothers. Using any other over-the-counter medicines may harm the baby. Consult your doctor as soon as you are aware of your hypertension.

How Is Preeclampsia Diagnosed

Your health care provider will check your blood pressure and urine at each prenatal visit. If your blood pressure reading is high , especially after the 20th week of pregnancy, your provider will likely want to run some tests. They may include blood tests other lab tests to look for extra protein in the urine as well as other symptoms.

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Frequently Asked Questions Expand All

How often should blood pressure be checked during pregnancy?

Your obstetriciangynecologist should check your blood pressure at each prenatal care visit. Blood pressure changes often during the day. If you have one high reading, another reading may be taken later during your office visit.

What is chronic hypertension?

Chronic hypertension is high blood pressure that a woman has before getting pregnant or that develops in the first half of pregnancy . If you were taking blood pressure medication before you got pregnanteven if your blood pressure is currently normalyou have been diagnosed with chronic hypertension.

How does chronic hypertension affect a pregnant woman?

When a woman is pregnant, her body makes more blood to support the fetuss growth. If blood pressure goes up during pregnancy, it can place extra stress on her heart and kidneys. This can lead to heart disease, kidney disease, and stroke. High blood pressure during pregnancy also increases the risk of preeclampsia, preterm birth, placental abruption, and cesarean birth.

How does chronic hypertension affect a fetus?

High blood pressure may reduce blood flow to the placenta. As a result, the fetus may not get enough of the nutrients and oxygen needed to grow.

Will I need to deliver early if I have chronic hypertension?

If your condition remains stable, delivery 1 to 3 weeks before your due date generally is recommended. If you or the fetus develop complications, delivery may be needed even earlier.

High Blood Pressure Symptoms In Pregnancy

In some cases the symptoms of high blood pressure during pregnancy may be subtle or go unnoticed. Because many changes take place when pregnant, it is important to know the symptoms of high blood pressure.

A blood pressure during pregnancy of 140/90 is considered high during pregnancy and a diagnosis of gestational hypertension is given. Severe high blood pressure in pregnancy is 160/110. A typical blood pressure is around 120/80.

Some signs of high blood pressure in pregnancy include:

• Severe headaches
• Excess protein in urine
• Changes in vision
• Upper abdominal pain

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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.

What Are The Symptoms During Or After Delivery

High blood pressure often causes no noticeable symptoms, which is part of what makes the condition so dangerous. Go to the emergency room immediately if you experience any of these emergency symptoms, especially during pregnancy or after having a baby:

• Blood pressure of 160/110 or higher
• Seeing spots or sparkles
• Stomach pain, nausea, or vomiting
• Swelling in the hands or face
• Trouble breathing or shortness of breath

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High Blood Pressure During Pregnancy Treatment

If you have chronic hypertension, you may have been taking medicine for it before you became pregnant. Tell your doctor which medicine youre taking. He or she may say its okay to continue that medicine. But if the medicine isnt safe for your baby, you may need to switch to another medicine during your pregnancy. Like with all pregnancies, your doctor will check your blood pressure and urine during your regular appointments.

If you have gestational hypertension, your doctor will monitor your blood pressure and urine more closely. He or she will do this to watch for signs of preeclampsia. Your doctor may also monitor your baby. One way to do that is with an ultrasound. This is a painless test that lets your doctor see your baby inside your body.

Tracking Blood Pressure During Pregnancy

A blood pressure reading is a fraction: your systolic blood pressure over your diastolic blood pressure.

The top number is your systolic pressure, which is a measurement of the pressure on your arteries when the heart is beating or squeezing blood forward through your body.

The diastolic pressure, or the lower number, is a measurement of the blood pressure in your arteries when the heart is at rest.

To determine what your normal blood pressure is during pregnancy, your doctor will likely take a baseline blood pressure measurement at your first visit. Then they will measure your blood pressure at every visit that follows.

Normal blood pressure is anything less than 120/80 mm Hg.

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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:

• Blurred vision
• Nausea
• 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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