Hypertension in pregnancy

Hypertension or high blood pressure is a condition that may cause serious problems during pregnancy and requires special care and attention. Blood pressure is the pressure of blood against the walls of the arteries. When blood pressure increases, organs start having problems. This can happen during pregnancy causing trouble for the mother and baby.  About 6-8% of women between 20-44 years of age will have this condition during pregnancy.

Different types of hypertension in pregnancy

Hypertension in pregnancy is treatable in general, but it can be hard to manage in some women. Depending on its onset and complications, hypertension is divided into:

• Chronic/pre-existing hypertension

Chronic hypertension is when you have high blood pressure before you get pregnant or before the 20^th week of pregnancy. The reason why women could have hypertension without knowing is simply that hypertension itself causes no symptoms, so it goes undiscovered for a while.

• Gestational hypertension

In this case, hypertension appears for the first time after 20 weeks of pregnancy. Women who have gestational hypertension show no signs of organ damage, but they need to be monitored closely. In most cases, blood pressure will normalize after delivering the baby.

• Pre-eclampsia

Pre-eclampsia happens when hypertension during pregnancy is accompanied by signs of damage to other organs, including the kidneys, liver, blood, or brain.

• Eclampsia

Eclampsia is a medical emergency. Here, brain injuries caused by pre-eclampsia cause seizures or coma during pregnancy or after giving birth.

• Chronic/pre-existing hypertension with superimposed preeclampsia-eclampsia

Chronic hypertension can also lead to pre-eclampsia or eclampsia after 20 weeks of gestation. Up to 30% of women with chronic hypertension develop pre-eclampsia.

What causes hypertension in pregnancy?

The exact reason for hypertension in pregnancy is unknown. However, certain risk factors may increase the chance of developing this condition. Those include:

• Overweight or obesity
• Low physical activity
• Smoking or drinking alcohol
• Being pregnant for the first time
• Having a family history of hypertension during pregnancy
• Carrying more than one baby
• Being over 35 years of age
• Previous pre-eclampsia
• Chronic high blood pressure
• Chronic kidney disease
• Using assistive reproductive technology (such as in vitro fertilization, or IVF)
• Having certain autoimmune diseases

What are the symptoms and signs of having high blood pressure during pregnancy?

Hypertension itself doesn’t make you feel ill, the best way to discover high blood pressure is through monitoring. During pregnancy, you'll visit your doctor regularly. You will have your weight and blood pressure checked at every visit. The doctor might order frequent laboratory tests to make sure everything is going well.

What are the signs and symptoms of pre-eclampsia?

A pregnant woman who has hypertension should tell the doctor immediately if she notices any of the following:

• Abnormal swelling in the hands and face.
• Persistent headaches.
• Changes in vision, such as blurred vision, seeing spots, or being sensitive to light.
• Upper abdominal pain.
• Nausea or vomiting later in pregnancy.
• Difficulty breathing.

Can hypertension in pregnancy harm the baby?

Most women with hypertension during pregnancy will deliver a healthy baby. But if left untreated, severe gestational hypertension may cause dangerous seizures (eclampsia) and even death in the mother and fetus.

High blood pressure during pregnancy might lead to:

• Preterm delivery: Birth that happens before 37 weeks of pregnancy.
• Low birth weight: The baby doesn’t get enough oxygen and nutrients to fully grow during the third trimester of pregnancy.
• Placental abruption: The placenta separates from the uterus requiring emergent medical care.
• Stillbirth.

Your doctor will closely monitor the baby's health, using ultrasounds and fetal tests. They might also recommend tracking the baby's daily movements.

Treatment of hypertension in pregnancy

Hypertension during pregnancy is managed using drugs that are safe for the mother and baby. Your doctor will prescribe certain medications. Take the medications exactly as prescribed and avoid changing the dose or stopping the drug on your own. Low-dose daily aspirin can lower the risk of pre-eclampsia in those who are at high risk and is often recommended.

What can I do to prevent hypertension during pregnancy?

There are a few tips that you can follow to lower the risk of developing hypertension during pregnancy, these are:

• Staying physically active.
• Sticking to a healthy diet.
• Lowering sodium intake.
• Limiting stress.
• Avoiding smoking and alcohol.
• Visiting the doctor regularly throughout the pregnancy.
• Taking your blood pressure medications as prescribed.

Please note that the information in this article is for educational purposes only. If you have any concerns regarding your pregnancy, you should talk to your doctor.

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