Postpartum hypertension is high blood pressure after pregnancy that remains higher than normal for more than two days after delivery. You may not realize that you have postpartum hypertension if your blood pressure is not being checked regularly. In some cases, postpartum hypertension will go away on its own, usually within a week of delivery. However, for some women, medical treatment is required to prevent serious complications, such as seizures or stroke.

The following things can affect your blood pressure:

  • The type of delivery you had.
  • Having received IV fluids or other medicines during or after delivery.

Postpartum hypertension may be caused by any of the following or by a combination of any of the following:

  • Hypertension that existed before pregnancy (chronic hypertension).
  • Gestational hypertension.
  • Preeclampsia or eclampsia.
  • Receiving a lot of fluid through an IV during or after delivery.
  • Medicines.
  • HELLP syndrome.
  • Hyperthyroidism.
  • Stroke.
  • Other rare neurological or blood disorders.

In some cases, the cause may not be known.

Postpartum hypertension can be related to one or more risk factors, such as:

  • Chronic hypertension. In some cases, this may not have been diagnosed before pregnancy.
  • Obesity.
  • Type 2 diabetes.
  • Kidney disease.
  • Family history of preeclampsia.
  • Other medical conditions that cause hormonal imbalances.

As with all types of hypertension, postpartum hypertension may not have any symptoms. Depending on how high your blood pressure is, you may experience:

  • These may be mild, moderate, or severe. They may also be steady, constant, or sudden in onset (thunderclap headache).
  • Visual changes.
  • Dizziness.
  • Shortness of breath.
  • Swelling of your hands, feet, lower legs, or face. In some cases, you may have swelling in more than one of these locations.
  • Heart palpitations or a racing heartbeat.
  • Difficulty breathing while lying down.
  • Decreased urination.

Other rare signs and symptoms may include:

  • Sweating more than usual. This lasts longer than a few days after delivery.
  • Chest pain.
  • Sudden dizziness when you get up from sitting or lying down.
  • Seizures.
  • Nausea or vomiting.
  • Abdominal pain.

The diagnosis of postpartum hypertension is made through a combination of physical examination findings and testing of your blood and urine. You may also have additional tests, such as a CT scan or an MRI, to check for other complications of postpartum hypertension.

When blood pressure is high enough to require treatment, your options may include:

  • Medicines to reduce blood pressure (antihypertensives). Tell your health care provider if you are breastfeeding or if you plan to breastfeed. There are many antihypertensive medicines that are safe to take while breastfeeding.
  • Stopping medicines that may be causing hypertension.
  • Treating medical conditions that are causing hypertension.
  • Treating the complications of hypertension, such as seizures, stroke, or kidney problems.

Your health care provider will also continue to monitor your blood pressure closely and repeatedly until it is within a safe range for you.

  • Take medicines only as directed by your health care provider.
  • Get regular exercise after your health care provider tells you that it is safe.
  • Follow your health care provider’s recommendations on fluid and salt restrictions.
  • Do not use any tobacco products, including cigarettes, chewing tobacco, or electronic cigarettes. If you need help quitting, ask your health care provider.
  • Keep all follow-up visits as directed by your health care provider. This is important.
  • Your symptoms get worse.
  • You have new symptoms, such as:
    • Headache.
    • Dizziness.
    • Visual changes.
  • You develop a severe or sudden headache.
  • You have seizures.
  • You develop numbness or weakness on one side of your body.
  • You have difficulty thinking, speaking, or swallowing.
  • You develop severe abdominal pain.
  • You develop difficulty breathing, chest pain, a racing heartbeat, or heart palpitations.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services. Do not drive yourself to the hospital.

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