Is 14282 high blood pressure in pregnancy

New Health Guide

High blood pressure or hypertension in pregnancy is diagnosed if the systolic pressure is ≥ 140 mm Hg and the diastolic blood pressure is ≥ 90 mm Hg on two separate blood pressure measurements taken 4 hours apart. High blood pressure pregnancy is a significant contributor to most of the complications and can be life threatening to both the mother and the baby. It can be controlled and managed by making lifestyle changes and with the help of medications.

Risk Factors for High Blood Pressure in Pregnancy

There are certain factors that can increase your risk of developing hypertension during pregnancy. These are:

  • If you have a family history of hypertension
  • If you are diabetic
  • If you are overweight or obese
  • If you already suffer from hypertension before pregnancy
  • If you are below 20 or over 40 years when you get pregnant
  • If you are having multiple babies
  • If this is your first pregnancy
  • If you smoke or drink alcohol
  • If you have resorted to techniques such as IVF (in vitro fertilization) to get pregnant

Types of Hypertension that Can Develop During Pregnancy

During your pregnancy you may be diagnosed with any of the following hypertensive disorders:

1. Chronic Hypertension

You are considered to have chronic hypertension:

  • In case you are already suffering from hypertension before you got pregnant
  • If you are diagnosed with hypertension within 20 weeks of your pregnancy
  • If your hypertension does not disappear by the time your reach your 12 week post-partum check up period

Chronic hypertension has been reported to complicate 5% of all pregnancies. The chances of developing chronic hypertension are higher if you delay child bearing. You are considered to have milder form of chronic hypertension if your systolic pressure is up to 179 mm Hg and your diastolic pressure is 109 mm Hg. However, if your systolic pressure is ≥ 180 mm Hg and diastolic pressure is ≥ 110 mm Hg you are suffering from a severe form of chronic hypertension.

2. Preeclampsia

Preeclampsia develops when the blood supply to the placenta is not normal because of lack of tolerance of the maternal immune system to the fetus.

Mild preeclampsia occurs in 6% of pregnancies and severe preeclampsia occurs in 1-2% of pregnancies.

You are diagnosed with preeclampsia if you have hypertension or high blood pressure pregnancy and presence of protein in urine after 20 weeks of pregnancy.

The other symptoms of preeclampsia include:

  • Severe headache
  • Problems with vision
  • Fluid retention leading to swelling of hands, feet, face and ankles
  • Vomiting
  • Dizziness
  • Abdominal pain
  • Reduced urination

Although rare, in pregnant women preeclampsia can cause serious complications such as stroke, seizures, water retention in the lungs, heart failure and bleeding in the liver. In preeclampsia, there is reduced blood reaching the fetus, resulting in premature births and associated complications such as learning disabilities, epilepsy and vision and hearing problems.

3. Preeclampsia with Chronic Hypertension

In this condition, preeclampsia develops in pregnant women who have already been diagnosed with chronic hypertension before their pregnancy. After pregnancy their hypertension aggravates, leading to presence of protein in urine and other complications of preeclampsia.

4. Gestational Hypertension

You are considered to have gestational hypertension or pregnancy induced hypertension if you are diagnosed with hypertension after 20 weeks of your pregnancy.

You are diagnosed:

  • If you have had normal blood pressure before your pregnancy but had developed high blood pressure after 20 weeks of pregnancy (systolic pressure ≥ 140 mm Hg and diastolic pressure ≥ 90 mm Hg)
  • If there is absence of protein in your urine
  • If you do not show any of the symptoms associated with preeclampsia

It has been reported that 50% of women who are diagnosed with gestational hypertension develop preeclampsia. If you are diagnosed with gestational hypertension you will be carefully monitored throughout your pregnancy for hypertension related complications.

What are the Complications with High Blood Pressure Pregnancy?

  • Decreased placental blood flow

Decreased blood flow to the placenta leads to decreased supply of nutrients and oxygen to the fetus. This results in slow growth (intrauterine growth restriction), decreased birth weight and premature birth.

Elevated blood pressure can cause damage to kidneys, liver, heart, lungs and brain which can be life threatening.

Hypertension can result in premature delivery of the baby to prevent the hypertension related complications from worsening and to prevent further damage.

If you have had preeclampsia during pregnancy then the risk of suffering from heart diseases in the future is increased.

It is a condition where the placenta separates from the inner wall of the uterus causing excessive bleeding. Preeclampsia increases the risk of placental abruption which is a serious life threatening complication for both the mother and the baby.

How to Manage High Blood Pressure

1. Eat Healthy

  • Eat healthy and balanced meals to help maintain normal blood pressure levels during your pregnancy.
  • Consume lots of fresh fruits and vegetables and avoid fried foods, fast foods and processed foods.
  • Add at least 6-8 servings of whole grains to your diet. There are reports that whole grains in your diet will help reduce your elevated blood pressure levels.
  • Avoid tea, coffee and other caffeinated drinks as they can increase your blood pressure. Consume fat free or low fat dairy products as they have been shown to reduce elevated systolic blood pressure. However, avoid cheese as it may increase your sodium intake.

2. Exercise

You are more prone to suffer from hypertension if you are following an inactive life style. You should start exercising from the time you decide to get pregnant. You should continue exercising throughout your pregnancy after consulting your doctor.

3. Carefully Monitor Your Weight

If you are overweight or obese you have a higher risk of developing high blood pressure pregnancy. During your pregnancy make sure your weight gain is within the recommended limits. Also ensure that you do not gain weight too fast. Eat healthy foods and exercise regularly to maintain a healthy weight. Regularly monitor your weight.

4. Reduce Stress

Reduce your stress levels during your pregnancy. Reduce your work load to reduce work related stress. Try meditation, yoga and breathing exercises to relax.

5. Monitor Your Salt Intake

The daily recommended salt intake is 2400 mg. However, restricting your intake to 1500 mg can help decrease your blood pressure. Avoid foods such as processed foods, fast foods and certain sports drinks that are high in sodium.

6. Avoid Alcohol and Smoking

If you smoke or drink alcohol you have a higher risk of developing hypertension. Smoking and drinking alcohol can also harm your baby.

7. Increase Your Potassium Intake

Increase your potassium intake by consuming foods rich in potassium such as bananas, orange juice, avocados, cantaloupe and chicken. Consuming 2000 mg of potassium from dietary supplements will help control your hypertension.

8. Follow Medical Instructions

Your doctor may recommend medications or life style changes to control your hypertension. Follow the instructions of your doctor carefully. Do not skip appointments with your doctor or skip medications.

Now you know all about high blood pressure pregnancy.

High blood pressure in pregnancy (gestational hypertension)

In this article

What is gestational hypertension?

How will I know if I’ve got high blood pressure?

  • Mild hypertension is when your top figure is 140-9 and your bottom figure is 90-99. You won’t need treatment, but your midwife will want to check your blood pressure once a week from now on. She’ll also test your urine for protein at each visit.

  • Moderate hypertension is when your top figure is 150-9 and your bottom figure is 100-9. You’ll be given medication to bring it down and your midwife will test your blood pressure twice a week. She’ll also test your urine for protein at each visit, and you’ll have a blood test to check kidney function and your levels of minerals and salts.

  • Severe hypertension is when your top figure is 160 or greater and your bottom figure is 110 or greater. Your doctor will admit you to hospital until your blood pressure falls. You’ll be given medication to bring it down and while there, nurses will check your blood pressure at least four times a day. They’ll also give you a urine and blood test when you arrive, followed by daily urine tests and weekly blood tests. (NCCWCH 2010)
  • How common is high blood pressure in pregnancy?

    • You had diabetes before you were pregnant.

  • You had chronic high blood pressure before you were pregnant or problems caused by hypertension in a previous pregnancy.

  • You have chronic kidney disease or an autoimmune disease.

  • You were obese at the start of your pregnancy. (NCCWCH 2010) Your midwife will work out your body mass index (BMI) at your booking appointment. If it’s 35 or more, it increases your chance of developing high blood pressure.

  • This is your first pregnancy, particularly if you’re an older mum.

    Is high blood pressure in pregnancy serious?

    How is high blood pressure in pregnancy treated?

    • It’s your first pregnancy

  • It’s been 10 years since your last pregnancy

  • You’re carrying twins or more

  • Your BMI is 35 or more

  • You already have vascular disease or kidney disease (NCCWCH 2010)
  • You’ll have more frequent blood pressure checks, plus urine and blood tests. Some women with mild to moderate high blood pressure may have extra scans.

    High Blood Pressure in Pregnancy

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    See, Play and Learn

    If you are pregnant, high blood pressure can cause problems for you and your unborn baby. You may have had high blood pressure before you got pregnant. Or you may get it once you are pregnant – a condition called gestational hypertension. Either one can cause low birth weight or premature delivery of the baby.

    Controlling your blood pressure during pregnancy and getting regular prenatal care are important for the health of you and your baby. Treatments for high blood pressure in pregnancy may include close monitoring of the baby, lifestyle changes, and certain medicines.

    Some pregnant women with high blood pressure develop preeclampsia. It’s a sudden increase in blood pressure after the 20th week of pregnancy. It can be life-threatening for both you and the unborn baby. There is no proven way to prevent it. Most women who have signs of preeclampsia are closely monitored to lessen or avoid complications. The only way to “cure” preeclampsia is to deliver the baby.

    NIH: National Heart, Lung, and Blood Institute

    High Blood Pressure in Pregnancy

    Patient is a certified member of

    The Information Standard

    Dr Jacqueline Payne, 30 Oct 2017

    In this series

    In this article

    • Arrow-downWhat is high blood pressure?
    • Arrow-downWhat are the different types of high blood pressure in pregnancy?
    • Arrow-downHow common is high blood pressure during pregnancy?
    • Arrow-downWhat are the possible problems with high blood pressure during pregnancy?
    • Arrow-downHow do I know if I have high blood pressure whilst I am pregnant?
    • Arrow-downWhat is the treatment for high blood pressure in pregnancy?

    High Blood Pressure in Pregnancy

    In this article

    What is high blood pressure?

    If you have high blood pressure (hypertension), the pressure of the blood in your blood vessels (arteries) is too high. Blood pressure is recorded as two figures. For example, 140/85 mm Hg. This is said as “140 over 85”. Blood pressure is measured in millimetres of mercury (mm Hg). The first (or top) number is your systolic blood pressure. This is the pressure in your arteries when your heart contracts. The second (or bottom) number is your diastolic blood pressure. This is the pressure in your arteries when your heart rests between each heartbeat.

    Normal blood pressure is below 140/90 mm Hg. During pregnancy:

    • Mildly high blood pressure is blood pressure between 140/90 and 149/99 mm Hg (ie the systolic or upper number is between 140 and 149, and/or the lower or diastolic number is between 90 and 99).
    • Moderately high blood pressure is blood pressure between 150/100 and 159/109 mm Hg. (The systolic is between 150 and 159 and/or the diastolic is between 100 and 109.)
    • Severely high blood pressure is blood pressure of 160/110 mm Hg or higher. (The systolic is 160 or more, and/or the diastolic is 110 or more.)

    Our blood pressure goes up when we are anxious or stressed, such as when we have to rush. Some people find it stressful seeing a doctor or midwife. It is important to give yourself enough time for your antenatal appointments so that you can relax and your blood pressure is not higher than it normally would be. Your employer is obliged to give you adequate time off work to attend antenatal appointments. If your blood pressure is high when you attend the clinic but normal when, for example, your midwife takes your blood pressure at home, this is called “white coat” hypertension. See separate leaflet called Home and Ambulatory Blood Pressure Recording.

    What are the different types of high blood pressure in pregnancy?

    Pre-existing high blood pressure

    Some women already have high blood pressure (hypertension) Before they become pregnant and they may be on treatment for this. Some women are found to have high blood pressure Before they are 20 weeks pregnant. (If high blood pressure is first discovered before you are 20 weeks pregnant, this usually means that you had previously undetected high blood pressure before you were pregnant.)

    So, high blood pressure before 20 weeks of pregnancy is not caused by pregnancy but is pre-existing, or chronic, high blood pressure. There are various causes. See separate leaflet called High Blood Pressure (Hypertension).

    If you have pre-existing high blood pressure, you have an increased risk of developing pre-eclampsia during your pregnancy (see below).

    Note: if you are taking medicines to treat high blood pressure then, ideally, you should have this reviewed Before you become pregnant. Some medicines that are used to treat high blood pressure should not be taken during pregnancy – for example, medicines called:

    • Angiotensin-converting enzyme (ACE) inhibitors.
    • Angiotensin-II receptor antagonists (AIIRAs) – sometimes called angiotensin receptor blockers (ARBs).
    • ‘Water’ tablets (diuretics).

    This is because these medicines may harm a developing baby. If you are taking one of these medicines then it is very likely that your medicine will be changed to another medicine that is not known to harm a developing baby.

    Gestational high blood pressure

    Some women can develop New high blood pressure during their pregnancy. This is called gestational high blood pressure (or hypertension) or pregnancy-induced high blood pressure (or hypertension).

    Gestational high blood pressure is high blood pressure that develops for the first time after the 20th week of pregnancy. Doctors can confirm this type of high blood pressure if you do not go on to develop pre-eclampsia during your pregnancy (see below) And if your blood pressure has returned to normal within six weeks of giving birth. If you have gestational high blood pressure, you do not have protein in your urine when it is tested by your midwife or doctor during your pregnancy.

    Note: some women may be found to have new high blood pressure after 20 weeks of pregnancy. At first, they may not have any protein in their urine on testing. However, they may later develop protein in their urine and so be diagnosed with pre-eclampsia (see below). You are only said to have gestational hypertension if you Do not go on to develop pre-eclampsia during your pregnancy.

    Pre-eclampsia and eclampsia

    Pre-eclampsia is a condition that can affect some women who develop new high blood pressure after the 20th week of their pregnancy. Pre-eclampsia can also sometimes develop in women who have high blood pressure before they are pregnant (pre-existing high blood pressure) or in women who have protein in their urine before they are pregnant (for example, due to kidney problems).

    Pre-eclampsia not only causes high blood pressure; it also affects other parts of your body such as your kidneys, liver, brain and blood clotting system. Pre-eclampsia causes protein to leak from your kidneys into your urine. If you have pre-eclampsia, you will have high blood pressure and protein will be found in your urine when it is tested. Pre-eclampsia gets better within six weeks of you giving birth.

    Eclampsia can be a complication of pre-eclampsia. In eclampsia, a woman with pre-eclampsia has one or more fits (seizures or convulsions). This is a serious condition. The aim is to detect and treat pre-eclampsia successfully to try to prevent eclampsia from developing.

    How common is high blood pressure during pregnancy?

    High blood pressure (hypertension) during pregnancy is quite a common problem.

    • About 1 in 10 pregnant women have problems with high blood pressure.
    • Up to 3 in 100 pregnant women have pre-existing high blood pressure.
    • About 4 to 8 in 100 pregnant women have gestational high blood pressure and do not go on to develop pre-eclampsia.
    • Between 2 and 8 in 100 pregnant women develop pre-eclampsia.
    • For every 100 women who have already developed pre-eclampsia in one pregnancy, 16 will develop it again in a future pregnancy. Up to half of these women will develop gestational hypertension in a future pregnancy.

    Problems with new high blood pressure are more common during your first pregnancy.

    What are the possible problems with high blood pressure during pregnancy?

    As a rule, the higher your blood pressure, the greater the risk for you and your baby.

    Mild-to-moderate high blood pressure

    If your blood pressure remains mildly to moderately raised and you do not develop pre-eclampsia then the risk is low. Most women with high blood pressure (hypertension) during pregnancy just have mildly or moderately raised blood pressure. However, it is important that your blood pressure and urine should be checked regularly throughout your pregnancy and that you look out for any signs of possible pre-eclampsia (see below).

    Severe high blood pressure or pre-eclampsia

    Severe high blood pressure, especially with pre-eclampsia, is serious.

    • The risks to you as the mother include:
      • An increased chance of having a stroke.
      • Damage to your kidneys and liver.
      • An increased risk of blood clotting problems.
      • An increased risk of severe bleeding from your placenta.
      • Having fits (seizures) if you go on to develop eclampsia.
    • The risks to your baby include:
      • An increased chance of poor growth.
      • An increased chance of premature birth.
      • An increased chance of stillbirth.

    How do I know if I have high blood pressure whilst I am pregnant?

    Many women with high blood pressure (hypertension) during their pregnancy do not have any symptoms. This is why your blood pressure is checked regularly by your doctor or midwife during your pregnancy. Your urine is also tested regularly for protein, to look for possible pre-eclampsia.

    However, there are some symptoms that you should look out for that could be signs of pre-eclampsia. If you develop any of these, you should see your doctor or midwife Urgently so that they can check your blood pressure and test your urine for protein. They include:

    • Severe headaches that do not go away.
    • Problems with your vision, such as blurred vision, flashing lights or spots in front of your eyes.
    • Tummy (abdominal) pain. The pain that occurs with pre-eclampsia tends to be mainly in the upper part of the abdomen, just below your ribs, especially on your right side.
    • Vomiting later in your pregnancy (not the morning sickness of early pregnancy).
    • Sudden swelling or puffiness of your hands, face or feet.
    • Feeling out of breath.
    • Not being able to feel your baby move as much.
    • Just not feeling right.

    Note: swelling or puffiness of your feet, face, or hands (oedema) is common in normal pregnancy. Most women with this symptom do not have pre-eclampsia but it can become worse in pre-eclampsia. Therefore, report any sudden worsening of swelling of the hands, face or feet promptly to your doctor or midwife.

    What is the treatment for high blood pressure in pregnancy?

    If your doctor or midwife finds that your blood pressure is high during your pregnancy, they will usually check to see if you have any protein in your urine and ask you if you have any symptoms of pre-eclampsia. If your blood pressure remains high, or if you have any signs of pre-eclampsia, you will usually be seen by a specialist (an obstetrician). In order to advise on treatment, there are various questions that need to be considered by the specialist, such as:

    • How severe is your high blood pressure (hypertension)?
    • Is there pre-eclampsia and, if so, how severe is it?
    • How far on is your pregnancy?
    • What are the risks to you, the mother, and your baby? This will depend on the severity of your high blood pressure and whether or not pre-eclampsia is present.

    If high blood pressure remains mild and pre-eclampsia does not develop

    There is usually little risk. Regular checks of your blood pressure and your urine for protein, as well as checks to see how your pregnancy is progressing, may be all that is needed until the natural time of birth. Checks may include blood tests and an ultrasound scan to look at how your baby is growing and to check the blood flow from the afterbirth (placenta) to the baby. You may be followed up by an obstetrician. You may need medicines to control your blood pressure during your pregnancy.

    If high blood pressure becomes severe, or if pre-eclampsia develops

    There are risks to both you, as the mother, and to your baby if high blood pressure becomes more severe, especially if you develop pre-eclampsia. You will usually be seen urgently by a specialist and you may be admitted to hospital. Blood tests may be suggested to check to see how much your blood pressure or pre-eclampsia is affecting you. The well-being of your baby may also be checked using ultrasound scanning. A recording of your baby’s heart rate may be carried out.

    For severe high blood pressure, especially if pre-eclampsia develops, there is often a dilemma. If the high blood pressure is caused by the pregnancy, the only cure is to deliver your baby. This may be fine if your pregnancy is near to the end. The birth can be induced, or your baby can be born by caesarean section if necessary. However, a difficult decision may have to be made if high blood pressure or pre-eclampsia becomes severe earlier in your pregnancy.

    Medicine to lower the blood pressure may be prescribed for a while. The most commonly used medicine is labetalol. This may allow your pregnancy to progress further before delivering your baby. The best time to induce the birth (or deliver by caesarean section) varies depending on the factors mentioned above.

    If you have severe pre-eclampsia, the medicine magnesium sulfate may be given via a drip around the time that your baby is delivered. This may reduce your chance of developing eclampsia and prevent you having fits (seizures).

    There is some evidence to suggest that regular low-dose aspirin and calcium supplements may help to prevent pre-eclampsia in some women who may be at increased risk of developing it. Your specialist may recommend you take one or both of these. They will be able to discuss this with you in more detail.

    Pre-eclampsia, Eclampsia and HELLP Syndrome

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