Hypertension in pregnancy
Pregnancy-related hypertension is high blood pressure that begins after 20 weeks of pregnancy and ends shortly after your baby is born. It happens in about 6% to 8% of pregnancies. Your provider may also refer to high blood pressure during pregnancy as gestational hypertension or pregnancy-induced hypertension.
High blood pressure may not cause any noticeable symptoms, so it’s important that you attend all your prenatal appointments so your pregnancy care provider can take your blood High blood pressure during pregnancy impacts your body differently than it would if you weren’t pregnant. Your heart works harder during pregnancy because it has to pump much more blood. This puts extra stress on your body.
High blood pressure can also affect how the placenta develops and functions. This means the fetus may not get the nutrients it needs to grow at a normal rate. Both you and your child are at higher risk of complications before labor, during labor and after delivery if you have high blood pressure.
pressure. High blood pressure during pregnancy can lead to complications
Types
Chronic hypertension: High blood pressure before pregnancy or early pregnancy (before 20 weeks). This type of hypertension continues after your baby is born. People with chronic hypertension can also develop preeclampsia. This is known as chronic hypertension with superimposed preeclampsia.
Gestational hypertension: High blood pressure in the latter part of pregnancy. Some people with gestational hypertension will go on to develop preeclampsia. Your provider will need to see you more frequently if you develop gestational hypertension.
Preeclampsia: A condition only found in the second half of pregnancy (typically after 27 weeks of pregnancy). Your provider diagnoses this condition if you have elevated blood pressure readings and protein in your pee. It can affect your liver, kidneys, lungs or brain as well as the placenta. When it affects your brain, you’re at risk for seizures (eclampsia).
Risk factors
You may be more likely to develop high blood pressure during pregnancy if you:
Are under age 20 or over age 40.
Have had gestational hypertension or preeclampsia during past pregnancies.
Have a family history of gestational hypertension.
Have diabetes or gestational diabetes.
Have an immune system disorder, such as lupus.
Have kidney disease.
Are expecting multiple babies (twins, triplets or more).
Are Black.
Symptoms
High blood pressure is sometimes called “the silent killer” because most people don’t notice their blood pressure is high. Other than a provider telling you that your blood pressure is high, some other signs are:
- Swelling (edema).
- Headaches.
- Sudden weight gain.
- Changes in vision.
- Nausea or vomiting.
- Peeing only a little bit at a time.
- Pain in your abdomen (belly).
Complications
Not everyone will develop complications from hypertension during pregnancy. However, high blood pressure puts you in danger of the following complications:
- Seizures.
- Stroke.
- Temporary kidney failure.
- Liver problems.
- Blood clotting problems.
You’re also at higher risk of needing a C-section delivery if you have hypertension.
Effect on baby
High blood pressure (hypertension) during pregnancy can prevent the placenta (the food and oxygen supply for a fetus) from receiving enough blood. This decrease in blood and nutrients can cause:
- Low birth weight or intrauterine growth restriction (IUGR). Low birth weight is when a baby is born weighing less than 5 pounds, 8 ounces.
- Premature birth (being born before 37 weeks of pregnancy).
- Stillbirth.
- Labor induction before your baby is full-term (39 weeks of pregnancy).
Most people who have high blood pressure will deliver healthy babies when the condition is caught early in pregnancy. The more severe the condition is, the more at risk you are for serious complications.
Diagnosis
Your pregnancy care provider takes your blood pressure at each prenatal appointment. Your blood pressure fluctuates throughout the day and many factors can make it rise.
If your provider sees any changes in your usual blood pressure readings or gets higher-than-normal reading, they may suspect you have hypertension. Checking your blood pressure later in the appointment for a more normal reading is the first course of action. If your blood pressure doesn’t stabilize, your provider may perform additional tests.
Other than additional blood pressure readings, your provider may also:
- Check your pee for protein.
- Check for swelling.
- Perform blood tests to check liver and kidney function and blood clotting factors.
Management
Healthcare providers treat high blood pressure during pregnancy in a variety of ways. Treatment depends on the severity of the condition, your overall health and how far along you are in pregnancy.
Your pregnancy care provider will want to monitor your blood pressure closely and check for symptoms of hypertension. This may mean more frequent prenatal visits to check your blood pressure and test your pee for signs of preeclampsia. Your healthcare provider may also recommend the following as part of your treatment:
- Monitoring your blood pressure at home.
- Medication to decrease your blood pressure.
- Hospitalization.
The goal of treatment is to reduce your blood pressure or prevent it from getting worse and causing complications.
Other tests
They’ll also want to monitor the fetus and perform frequent tests to check on its health. Some of these tests include:
- Ultrasound.
- Nonstress test.
- Biophysical profile.
- Doppler ultrasound (a type of ultrasound that measures blood flow).
- Counting your fetal movement (or kick counting).
If your provider feels the fetus will be born early, they may give you steroids that help mature its lungs. These steroids decrease the chance that your baby has breathing problems at birth.
Steps to have a safe delivery
Steps that you can take to help the chances of having a safe and healthy delivery include:
- Taking any blood pressure medication as prescribed.
- Checking your blood pressure at home.
- Going to all of your prenatal visits.
- Having an early delivery if needed.
- Maintaining a healthy diet and consuming less salt.
- Following your healthcare provider’s instructions regarding activity and exercise.
Induction of labor
If your pregnancy care provider feels it’s safer to deliver early, they may recommend inducing labor. This could happen before your child is 37 weeks gestation (preterm).
Bed rest
Bed rest is one of the treatments your pregnancy care provider may recommend for treating hypertension during pregnancy.
Prevention
Since the cause of high blood pressure (hypertension) during pregnancy is unknown, it’s hard to prevent it. The best thing you can do to prevent high blood pressure during pregnancy (and when you aren’t pregnant) is:
- Maintain a healthy weight.
- Eat a healthy diet.
- Walk, ride a bike, practice yoga or do some other form of exercise several times per week.
- Avoid smoking and alcohol-containing beverages.
- Get plenty of rest.
Outlook
High blood pressure (hypertension) during pregnancy typically goes away after your baby’s delivered. However, it increases your risk of high blood pressure and heart disease in the future. If you had a severe form of preeclampsia or gestational hypertension, you may need medication for a few weeks after delivery. It’s important to see your provider within 10 days postpartum (after your baby is born) if you had a severe form of high blood pressure at delivery.
When should I worry
Call your pregnancy care provider if you experience any of the following symptoms:
- Sudden headaches that don’t go away.
- Blurred vision or seeing double.
- Swelling.
- Peeing less than usual.
If you’ve been diagnosed with hypertension, talk to your pregnancy care provider about how you can best manage the condition. They can help make sure high blood pressure doesn’t cause serious complications for you or the fetus.
Carry home message
Gestational hypertension, or high blood pressure during pregnancy, can cause serious complications for both you and the fetus. The good news is that this type of high blood pressure usually goes away after your baby is born. Treatment for high blood pressure involves more blood pressure readings, medication and lifestyle changes. When high blood pressure is well-managed, it doesn’t cause serious problems. However, if left unmanaged, it can lead to premature birth, placental abruption or other serious complications. Speak to your pregnancy care provider if you have any concerns about your blood pressure readings or managing your blood pressure.
