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Hypertension in Pregnancy: What You Need to Know

Post written by BFH Staff Writer on June 13, 2024
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Hypertension, or high blood pressure, is a significant concern during pregnancy, affecting both the mother’s and the baby’s health. Understanding the risks, symptoms, and management strategies for hypertension in pregnancy is crucial for a healthy pregnancy journey.

What is Hypertension in Pregnancy

Hypertension in pregnancy is when a pregnant woman has high blood pressure, which can be dangerous for both her and her baby. This condition can show up in different ways, such as chronic hypertension (existing before pregnancy or before 20 weeks), gestational hypertension (starting after 20 weeks), preeclampsia (high blood pressure with organ damage), and eclampsia (seizures due to preeclampsia).

Managing low blood pressure during pregnancy is very important because, if left untreated, it can lead to serious problems like organ damage, premature birth, and even death for the mother and baby.

Types of Hypertension in Pregnancy

There are different types of hypertension you should look out for that can affect your pregnancy, which include the following:

1. Chronic Hypertension

Chronic hypertension refers to a type of high blood pressure that either existed before pregnancy or is diagnosed before the 20th week of gestation. A high heart rate during pregnancy may indicate something is wrong. Hence, women with chronic hypertension need careful monitoring throughout their pregnancy as they are at a higher risk for complications like the occurrence of preeclampsia and premature birth. Managing chronic hypertension in pregnancy typically involves lifestyle changes and possibly medication with a healthcare provider.

2. Gestational Hypertension

Gestational hypertension happens when high blood pressure develops after the 20th week of pregnancy without protein in the patient’s urine or other signs of preeclampsia. While it generally resolves after delivery, gestational hypertension can elevate the risk of having chronic hypertension later in life. Regular prenatal check-ups are crucial for monitoring and managing blood pressure during pregnancy.

3. Preeclampsia

Preeclampsia is a serious medical condition defined by high blood pressure and often proteinuria (protein in the urine) that usually develops after the 20th week of pregnancy. It can affect various organs and lead to severe complications for both the mother and baby if not treated promptly. Symptoms may include swelling, severe headaches, vision changes, and upper abdominal pain. Early detection and management are vital, often requiring closer medical supervision and sometimes early delivery.

4. Eclampsia

Eclampsia is a severe progression of preeclampsia marked by the onset of seizures in a pregnant woman with preeclampsia. It is considerably a medical emergency that can have life-threatening critical consequences for both the mother and the baby. Immediate attention from a medical professional is necessary to stabilize the condition and ensure the safety of both.

5. Chronic Hypertension with Superimposed Preeclampsia

This condition occurs when a woman with chronic hypertension develops preeclampsia. It is characterized by a sudden increase in blood pressure and protein in the urine or other complications associated with preeclampsia. This dual diagnosis significantly increases the risk of adverse outcomes, making careful monitoring and prompt treatment essential.

Symptoms and Causes

Understanding the symptoms and causes of hypertension in pregnancy is crucial for early detection and effective management. Here are the key symptoms and common causes of this condition, helping expectant mothers and their families stay informed and vigilant:

Symptoms of Hypertension in Pregnancy

Symptoms of hypertension include the following:

  • High Blood Pressure: The primary indicator, often measured at prenatal visits.
  • Severe Headaches: Persistent and intense headaches that do not go away.
  • Swelling: Especially in the hands, feet, and face, beyond normal pregnancy swelling.
  • Vision Changes: Blurred vision, seeing spots, or light sensitivity.
  • Upper Abdominal Pain: Particularly under the ribs on the right side.
  • Nausea or Vomiting: Especially if sudden and severe in the second half of pregnancy.
  • Shortness of Breath: Difficulty breathing that is unusual or severe.
  • Sudden Weight Gain: Rapid weight increase due to fluid retention.

Causes of Hypertension in Pregnancy

During pregnancy, hypertension may be triggered by the following:

  • Pre-existing Hypertension: Chronic high blood pressure before pregnancy increases risk.
  • Gestational Hypertension: High blood pressure after the 20th week of pregnancy.
  • Preeclampsia: A medical condition defined by high blood pressure and signs of organ damage.
  • Multiple Pregnancies: Carrying twins, triplets, or more increases the risk.
  • Age: Pregnant women over 35 years old are at a higher risk.
  • Obesity: Excess body weight can contribute to high blood pressure.
  • First Pregnancy: Increased risk during a first pregnancy compared to subsequent pregnancies.
  • Family History: Genetic predisposition if hypertension runs in the family.
  • Lifestyle Factors: Poor diet, sedentary lifestyle, lack of physical activity, and high stress levels.
  • Certain Medical Conditions: Diabetes, kidney disease, and autoimmune disorders.

Diagnosis and Treatment

Pregnancy is a critical stage for every woman who requires immediate diagnosis and appropriate treatment for hypertension to ensure the well-being of both the mother and the baby. Early detection and effective management are vital to prevent complications. Here’s how hypertension in pregnancy is diagnosed and the treatment options available:

Diagnosis

Your healthcare provider can diagnose hypertension via the following tests:

  • Blood Pressure Measurement: Monitoring blood pressure is the primary method of diagnosing hypertension. 140/90 mm Hg or higher readings on two separate occasions are indicative of hypertension. The normal blood pressure for pregnant women is generally considered to be approximately 120/80 mm Hg.
  • Urine Tests: To check the presence of protein in the urine, which can signal preeclampsia. High protein levels indicate kidney involvement.
  • Blood Tests: To assess the liver function, kidney function, and platelet count. Abnormal results may indicate complications associated with hypertension, such as preeclampsia.
  • Fetal Ultrasound: To monitor the baby’s growth and development. Hypertension can affect the baby’s growth, so regular ultrasounds help ensure the baby is growing properly.
  • Non-Stress Test and Biophysical Profile: These tests monitor the baby’s heart rate and overall well-being. They help assess the baby’s health and detect any signs of distress.

Treatment

There are numerous treatment options to address hypertension during pregnancy. Here are some of these:

  • Lifestyle Changes: Adopting a low-salt diet, regular physical activity, and adequate rest can help manage blood pressure levels. These lifestyle adjustments are often the first step in treatment.
  • Medications: Antihypertensive medications may be prescribed to lower blood pressure. It’s essential to use medications that are safe for pregnancy, as some antihypertensives can harm the developing baby.
  • Frequent Monitoring: Regular check-ups and blood pressure monitoring are crucial. It includes both self-monitoring at home and routine prenatal visits.
  • Bed Rest: Doctors may also recommend bed rest to help lower blood pressure. It can range from reducing daily activities to complete bed rest in severe cases.
  • Hospitalization: Severe hypertension or preeclampsia might require hospitalization for close monitoring and more intensive treatment. It ensures immediate medical intervention if complications arise.
  • Early Delivery: In cases where hypertension poses a significant risk to the mother or baby, early delivery might be necessary. This decision balances the risks of continued pregnancy against the benefits of delivering the baby early.

Managing Blood Pressure: Tips and Dietary Recommendations

Here are some tips on how you can manage low blood pressure during your pregnancy as well as hypertension:

How to Lower Blood Pressure During Pregnancy

  • Regular Exercise: Gentle activities like walking or prenatal yoga can help manage low blood pressure while pregnant.
  • Healthy Diet: Focus on a healthy, nutrient-rich diet that includes fruits, vegetables, lean proteins, and whole grains.

How to Manage Hypertension During Pregnancy

  • Monitor Blood Pressure Regularly: Tracking your blood pressure at home can help you stay aware of any changes and seek medical advice promptly.
  • Stay Hydrated: Drinking plenty of water everyday to maintain good hydration, which can support healthy blood pressure levels.
  • Reduce Stress: Practicing techniques such as deep breathing, meditation, or prenatal massage to lower stress and manage blood pressure.
  • Avoid Excessive Caffeine: Limit your intake of caffeinated beverages, as high caffeine consumption can raise blood pressure.
  • Follow Medical Advice: Take prescribed medications as instructed by your doctor to manage your hypertension safely.

Post-Pregnancy Considerations for Hypertension

Successful pregnancy with hypertension is still possible. However, after pregnancy, managing blood pressure remains crucial for the mother’s long-term health. It’s important to continue monitoring blood pressure regularly, as persistent hypertension may require ongoing medical management. Scheduling postpartum visits with your healthcare provider is essential to discuss any hypertension-related concerns and adjust treatment plans if necessary. Additionally, maintaining an active, healthy lifestyle, a balanced diet, regular exercise, and stress reduction techniques continue to be important for supporting overall cardiovascular health.

Breastfeeding mothers should consult their healthcare provider about safe antihypertensive medications. Staying vigilant for any signs of hypertension, such as headaches or vision changes, and seeking medical advice promptly if they occur is also crucial. Addressing lifestyle factors that may contribute to high blood pressure, such as weight management and reducing sodium intake, can help prevent future cardiovascular issues. Through these steps, you can effectively manage hypertension after pregnancy and support your overall well-being.

Takeaways

Understanding hypertension in pregnancy is vital for expectant mothers. By recognizing symptoms, adhering to management strategies, and maintaining regular prenatal check-ups, you can navigate a healthy pregnancy journey. Always consult with healthcare providers to tailor the best plan for your individual needs.

When Should Swelling During Pregnancy Be a Concern?

Swelling is common during pregnancy, particularly in the feet and ankles. Still, it should be a concern if it occurs suddenly, is severe, affects the face or hands, or is accompanied by high blood pressure, as these symptoms could indicate preeclampsia.

Why Do Doctors Prescribe Aspirin During Pregnancy?

Doctors prescribe low-dose aspirin during pregnancy to reduce the risk of preeclampsia, especially in women with risk factors such as chronic hypertension, previous preeclampsia, or multiple pregnancies. Aspirin helps improve blood flow to the placenta and reduce inflammation, thereby lowering the chances of developing preeclampsia and other related complications.

How to Lower Blood Pressure During Pregnancy?

To manage high blood pressure during pregnancy, stay active through exercises like walking or prenatal yoga, and have a healthy diet with fruits, vegetables, lean proteins, and whole grains while reducing salt intake. 

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