High Blood Pressure And Pregnancy: Know The Facts

Blood pressure refers to the pressure exerted by blood on artery walls. High blood pressure, known as hypertension, signifies excessive force on arteries. Neglecting hypertension, especially during pregnancy, can result in severe consequences.

Approximately 8% to 16% of pregnant women encounter high blood pressure during pregnancy. This hypertension can persist for up to 6 weeks following childbirth. This condition has the potential to adversely affect the well-being of both the mother and her baby throughout the pregnancy journey and afterward. The mother becomes susceptible to a range of complications, including but not limited to heart issues, seizures, and even coma. Meanwhile, the baby faces increased chances of being born prematurely or even facing mortality.

On a positive note, hypertension during pregnancy can be effectively managed through blood pressure medications and other suitable treatments. Yet, in cases of more severe associated disorders like preeclampsia or eclampsia, women might necessitate hospitalization or careful monitoring conducted by their Obstetrics and Gynecology doctors.

What is high blood pressure during pregnancy?

High blood pressure during pregnancy is defined as hypertension when a pregnant women’s blood pressure registers at 140/90 or higher on two separate occasions. If the reading is between 140/90 and 160/110, it’s classified as mild high blood pressure; readings exceeding 160/110 are categorized as severe high blood pressure.

Blood pressure is measured through an inflatable cuff wrapped around the upper arm. This measurement produces two values: the upper number (systolic blood pressure) signifies blood vessel pressure during heartbeats, while the lower number (diastolic blood pressure) indicates pressure when the heart is in its resting phase. Blood pressure naturally fluctuates due to factors like physical activity, diet, caffeine, smoking, and stress. Normal blood pressure is generally considered to be 120/80 or lower.

Different types of high blood pressure during pregnancy

High blood pressure during pregnancy can manifest in different ways. It might emerge prior to pregnancy or develop during gestation. There are distinct types:

• Chronic Hypertension: This type involves high blood pressure that arises before pregnancy or within the initial 20 weeks of pregnancy. Identifying the precise onset can be challenging as high blood pressure often lacks noticeable symptoms.
• Chronic Hypertension with Superimposed Preeclampsia: This condition arises when pre-existing chronic hypertension worsens during pregnancy, potentially leading to intensified high blood pressure levels. People affected by this condition might exhibit protein in their urine or experience other complications.
• Gestational Hypertension: Gestational hypertension emerges after the 20th week of pregnancy. It is characterized by high blood pressure without accompanying excess protein in the urine or signs of organ damage. Although in certain instances, gestational hypertension can progress into preeclampsia.
• Preeclampsia emerges when high blood pressure develops after 20 weeks into pregnancy. This condition is linked to observable indications of harm affecting various organ systems such as the kidneys, liver, blood, or brain.

If left untreated, preeclampsia can give rise to severe and even life-threatening complications for both the mother and the baby. These complications might encompass eclampsia, a condition characterized by the onset of seizures.

In the past, preeclampsia was solely diagnosed if both high blood pressure and excess protein in the urine were present. However, Obstetrics and Gynecology experts now recognize that preeclampsia can manifest even without the presence of protein in the urine.

What are the signs of high blood pressure during pregnancy?

High blood pressure is occasionally referred to as “the silent killer” due to its often unnoticed nature. Apart from healthcare professionals identifying high blood pressure, there are additional signs to be aware of:

• Swelling (edema)
• Headaches.
• Unexpected weight gain.
• Nausea or vomiting.
• Abdominal (belly) discomfort.

What risks can arise from high blood pressure during pregnancy?

High blood pressure during pregnancy can be problematic due to the following reasons:

• Inadequate blood flow to the placenta can result in reduced oxygen and nutrients reaching the fetus. It can lead to problems like slow fetal growth, low birth weight, and premature birth. Prematurely born babies are at a higher risk of respiratory problems, increased risk of infections, and other potential complications.
• Placental abruption occurs when the placenta detaches from the uterine wall before childbirth. Both preeclampsia and high blood pressure heighten the likelihood of experiencing placental abruption. If this separation is severe, it can lead to significant bleeding, posing life-threatening risks for both the mother and the baby.
• There is a possibility of intrauterine growth restriction leading to reduced or slowed fetal growth if you have high blood pressure.
• If high blood pressure is inadequately managed, it can cause harm to various vital organs such as the brain, eyes, heart, lungs, kidneys, and liver. In severe instances, this condition can escalate to a life-threatening level.
• Premature childbirth may become necessary at times to avert life-threatening issues arising from high blood pressure throughout pregnancy.
• Experiencing preeclampsia could increase the chances of developing subsequent cardiovascular issues involving the heart and blood vessels. The risk of future cardiovascular problems escalates in cases of recurrent preeclampsia occurrences or if premature birth results from high blood pressure during pregnancy.

How is high blood pressure during pregnancy diagnosed?

A pregnant woman receives a diagnosis of hypertension when her blood pressure readings surpass 140 systolic or 90 diastolic on two separate instances, usually during her appointments with her Obstetrics and Gynecology provider. If the reading reaches 160/110 or exceeds this level, it signifies a diagnosis of severe high blood pressure.

Your medical background holds significance. If you had a history of high blood pressure before conception, or if you or a family member experienced diagnoses like high blood pressure, preeclampsia/eclampsia, or HELLP syndrome in a prior pregnancy, you need to inform your doctor.

When you’re diagnosed with high blood pressure during pregnancy, you will be provided with tests to check the presence of preeclampsia/eclampsia or HELLP syndrome.

Tests may include:

• Blood tests reveal irregular liver or kidney function, indicative of preeclampsia or HELLP syndrome. These tests can also unveil hemolysis, where red blood cells rupture and release hemoglobin into the bloodstream, a characteristic of HELLP syndrome. Regular monitoring might be necessary for these tests.
• A urine test will detect protein presence in the urine. High protein levels can signal preeclampsia, though it’s important to note that not all expectant individuals with preeclampsia will have protein in their urine.