HYPERTENSION DURING PREGNANCY

HYPERTENSION DURING PREGNANCY

Hypertension, commonly called high blood pressure, is when the force of blood pumping through your arteries is too strong. Arteries are blood vessels that carry blood from the heart throughout the body. Hypertension during pregnancy can cause problems for you and your baby. Your baby may be born early (prematurely) or may not weigh as much as he or she should at birth. Very bad cases of hypertension during pregnancy can be life-threatening.

Different types of hypertension can occur during pregnancy. These include:

  • Chronic hypertension. This happens when:
    • You have hypertension before pregnancy and it continues during pregnancy.
    • You develop hypertension before you are 20 weeks pregnant, and it continues during pregnancy.
  • Gestational hypertension. This is hypertension that develops after the 20th week of pregnancy.
  • Preeclampsia, also called toxemia of pregnancy. This is a very serious type of hypertension that develops only during pregnancy. It affects the whole body, and it can be very dangerous for you and your baby.

Gestational hypertension and preeclampsia usually go away within 6 weeks after your baby is born. Women who have hypertension during pregnancy have a greater chance of developing hypertension later in life or during future pregnancies.

There are certain factors that make it more likely for you to develop hypertension during pregnancy. These include:

  • Having hypertension during a previous pregnancy or prior to pregnancy.
  • Being overweight.
  • Being older than age 40.
  • Being pregnant for the first time or being pregnant with more than one baby.
  • Becoming pregnant using fertilization methods such as IVF (in vitro fertilization).
  • Having diabetes, kidney problems, or systemic lupus erythematosus.
  • Having a family history of hypertension.

Chronic hypertension and gestational hypertension rarely cause symptoms. Preeclampsia causes symptoms, which may include:

  • Increased protein in your urine. Your health care provider will check for this at every visit before you give birth (prenatal visit).
  • Severe headaches.
  • Sudden weight gain.
  • Swelling of the hands, face, legs, and feet.
  • Nausea and vomiting.
  • Vision problems, such as blurred or double vision.
  • Numbness in the face, arms, legs, and feet.
  • Dizziness.
  • Slurred speech.
  • Sensitivity to bright lights.
  • Abdominal pain.
  • Convulsions.

You may be diagnosed with hypertension during a routine prenatal exam. At each prenatal visit, you may:

  • Have a urine test to check for high amounts of protein in your urine.
  • Have your blood pressure checked. A blood pressure reading is recorded as two numbers, such as “120 over 80” (or 120/80). The first (“top”) number is called the systolic pressure. It is a measure of the pressure in your arteries when your heart beats. The second (“bottom”) number is called the diastolic pressure. It is a measure of the pressure in your arteries as your heart relaxes between beats. Blood pressure is measured in a unit called mm Hg. A normal blood pressure reading is:
    • Systolic: below 120.
    • Diastolic: below 80.

The type of hypertension that you are diagnosed with depends on your test results and when your symptoms developed.

  • Chronic hypertension is usually diagnosed before 20 weeks of pregnancy.
  • Gestational hypertension is usually diagnosed after 20 weeks of pregnancy.
  • Hypertension with high amounts of protein in the urine is diagnosed as preeclampsia.
  • Blood pressure measurements that stay above 160 systolic, or above 110 diastolic, are signs of severe preeclampsia.

Treatment for hypertension during pregnancy varies depending on the type of hypertension you have and how serious it is.

  • If you take medicines called ACE inhibitors to treat chronic hypertension, you may need to switch medicines. ACE inhibitors shouldnot be taken during pregnancy.
  • If you have gestational hypertension, you may need to take blood pressure medicine.
  • If you are at risk for preeclampsia, your health care provider may recommend that you take a low-dose aspirin every day to prevent high blood pressure during your pregnancy.
  • If you have severe preeclampsia, you may need to be hospitalized so you and your baby can be monitored closely. You may also need to take medicine (magnesium sulfate) to prevent seizures and to lower blood pressure. This medicine may be given as an injection or through an IV tube.
  • In some cases, if your condition gets worse, you may need to deliver your baby early.

Eating and drinking

  • Drink enough fluid to keep your urine clear or pale yellow.
  • Eat a healthy diet that is low in salt (sodium).Do not add salt to your food. Check food labels to see how much sodium a food or beverage contains.

Lifestyle

  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Do not use alcohol.
  • Avoid caffeine.
  • Avoid stress as much as possible. Rest and get plenty of sleep.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • While lying down, lie on your left side. This keeps pressure off your baby.
  • While sitting or lying down, raise (elevate) your feet. Try putting some pillows under your lower legs.
  • Exercise regularly. Ask your health care provider what kinds of exercise are best for you.
  • Keep all prenatal and follow-up visits as told by your health care provider. This is important.
  • You have symptoms that your health care provider told you may require more treatment or monitoring, such as:
    • Fever.
    • Vomiting.
    • Headache.
  • You have severe abdominal pain or vomiting that does not get better with treatment.
  • You suddenly develop swelling in your hands, ankles, or face.
  • You gain 4 lbs (1.8 kg) or more in 1 week.
  • You develop vaginal bleeding, or you have blood in your urine.
  • You do not feel your baby moving as much as usual.
  • You have blurred or double vision.
  • You have muscle twitching or sudden tightening (spasms).
  • You have shortness of breath.
  • Your lips or fingernails turn blue.

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