High Blood Pressure During Pregnancy

Blood Pressure

Normal blood pressure levels are essential for maintaining good health. Blood pressure is generated by the rhythmic contractions of the heart. With each heartbeat, the heart pumps blood into the arteries, which then carry it to the body’s organs. Subsequently, the veins return the blood to the heart for recirculation throughout the body. Blood pressure is recorded as two numbers:

Systolic Pressure

Systolic Pressure is the top number and measures the pressure when your heart beats (contracts). A normal systolic pressure is less than 120.

Diastolic Pressure 

Diastolic Pressure is the bottom number and measures the pressure when the heart is relaxed between heartbeats. Normal diastolic pressure is less than 80.

Blood pressure changes often throughout the day. It will increase if you exercise or are excited and decrease when resting. These short-term changes are normal. If blood pressure stays high for longer periods, it may signal a problem.A reading of 120/80 or less is normal in most pregnant women.

Effects on Pregnancy

During pregnancy, the fetus obtains essential nutrients and oxygen required for normal growth from the mother. This occurs through the placenta, where an adequate amount of blood flows and passes through the umbilical cord to provide nutrients and oxygen to the baby. However, high blood pressure during pregnancy can pose significant risks by potentially diminishing blood flow to the placenta. This restriction in blood flow can compromise the supply of oxygen and nutrients vital for the fetus’s growth.

Types of High Blood Pressure

Chronic Hypertension

Chronic Hypertension is when high blood pressure has been present for some time before the pregnancy. This condition continues during the pregnancy and after the birth of the baby. It is vital that it be controlled, because it can lead to health problems like heart attacks and stroke. During pregnancy, it may affect the growth of the fetus. Talk with your health care provider about the best treatment options for this condition during pregnancy.

Gestational Hypertension

Gestational Hypertension is when the blood pressure is high during the second half of pregnancy. This type of high blood pressure will go away after the baby is born. Your health care provider may want to see you more frequently to monitor your blood pressure. Gestational hypertension may also lead to preeclampsia.

Preeclampsia

Preeclampsia is a serious medical condition affecting all organs of the body. The most common sign of preeclampsia is gestational hypertension. Signs of preeclampsia include:

• Headaches
• Visual problems
• Rapid weight gain
• Swelling (edema) of the hands and face
• Increased amounts of protein in the urine

Some women are at higher risk of developing preeclampsia. Risk is increased in women who:

• Are pregnant for the first time
• Have had preeclampsia in a previous pregnancy
• Have a history of chronic hypertension
• Are 35 years or older
• Are carrying more than one fetus
• Have diabetes or kidney disease
• Are obese
• Are African American
• Have certain immune disorders such as lupus or blood diseases

Women with preeclampsia may need to stay in the hospital for monitoring. Preeclampsia is a very serious illness for both the woman and baby. Preeclampsia can lead to a woman’s organs being damaged, including the kidneys, liver, brain, heart and eyes. Severe cases may require early delivery of the baby, even if the baby is not fully grown. Babies born prematurely may have complications.

Prenatal Care

If you have high blood pressure before pregnancy there are steps you can take to reduce the chance of severe effects to you and the baby. The best thing you can do is to see your health care provider before pregnancy and get regular prenatal care.

Prior to Pregnancy

• Work with your doctor to lower your blood pressure.
• Lose weight through diet and exercise.
• Take blood pressure medications as prescribed.
• Ask your health care provider if the medication is safe to use during pregnancy.

During Pregnancy

• See your health care provider for regular prenatal care. They will monitor your blood pressure and weight for changes.
• Tell your health care provider early if you have kidney disease or other risk factors.
• If you develop any warning signs for preeclampsia tell your health care provider right away.
• If directed by your health care provider monitor blood pressure and weight.

Treatment

When blood pressure increases slightly, and you are not near the end of pregnancy, bed rest may be prescribed at home or in the hospital to help reduce the pressure. If the blood pressure does not increase to dangerous levels, pregnancy may be allowed to continue until labor begins naturally.

If preeclampsia develops, the only real cure is to have the baby. The decision to deliver will depend on the risks to you and whether the risk to the baby is greater in the uterus or in a special nursery. The labor may occur naturally or may be induced. Sometimes a cesarean birth may be needed. Before deciding on early delivery, your health care provider may monitor your condition to see if it improves.