Hypertension during pregnancy is dangerous and in some cases may be fatal for the mother and the baby So it is advised to monitor blood pressure during pregnancy periodically With your doctor.
Hypertension during pregnancy gestational hypertension or pregnancy-induced hypertension is defined as high blood pressure (140/90)mm/hg that develops after 20 weeks of gestation period without proteinuria.
Symptoms of hypertension during pregnancy
Most cases are asymptomatic only with high blood pressure (140/90) but some instances have Symptoms such as:
- Edema especially in the hands and face
- Increased body weight
- Pain in the upper abdomen toward the right side
- Nausea and vomiting
- Headache that may be continuous
- Changes in vision and sensitivity to the light
Diagnosis
Chronic hypertension develops before 20 weeks if the gestation period is diagnosed only by high blood pressure without any other Symptoms.
Hypertension during pregnancy is diagnosed only by high blood pressure after 20 weeks of the gestation period (140/90 mm hg) without proteinuria.
Still, the mother suffered from other Symptoms such as continuous headache, edema particularly in the face and hands, sudden body weight gain, stomach pain, nausea, vomiting, and blurred vision as we mentioned previously.
If the hypertension during pregnancy is accompanied by proteinuria ( high protein in urine>300 mg in 24-hour urine sample) it is now known as pre-eclampsia It is a case of hypertension during pregnancy with other organs affection such as:
- Kidney infection
- Liver enzymes affection
- Hemolytic anemia and low blood platelet count (thrombocytopenia)
- High blood pressure (160 /110)
- Brain injury
- Eclampsia
It is a case of hypertension during pregnancy in the affected woman who has high blood pressure, proteinuria, and tonic-clonic seizures which are types of generalized seizures that produce bilateral convulsive tonic and clonic muscle contraction.
Risk factors of hypertension during pregnancy
Maternal factors:
- The age of the mother is less than 20 or more than 40 years old
- History of hypertension, kidney disease, or diabetes mellitus
- Women who were overweight (obesity) before pregnancy
- In the case of women with donated kidneys (kidney transplantation in people with the last stages of renal disease)
Baby related factors:
- In case of multiple gestation as twins, triple or more
Complications with hypertension during pregnancy
- Low blood flow to the placenta so fewer nutrients will be delivered to the baby so the baby will be negatively affected
- Placental abruption (the placenta separated from the uterine wall)
- Premature delivery( sometimes doctors decide on early delivery before the 37 weeks of gestation period to avoid fetal complications for the mother and the baby as in the case of toxemia)
- Baby with low birth weight
- Baby with immature lung
- Fatal death (stillborn baby)
- The baby needs a neonatal intensive care unit
- A cesarean section is needed
- Sometimes doctors are forced to early delivery to save the life of the mother and the baby
- Developing of heart diseases after delivery and kidney diseases in mother
- Increased incidence of hypertension after delivery
- Infants exposed to Maternal hypertension during pregnancy may have structural and functional cardiac affection compared with infants that are not exposed
How to treat hypertension during pregnancy
Treatment of hypertension during pregnancy is essential to prevent pre-eclampsia and eclampsia.
Most anti-hypertensive drugs are contraindicated during pregnancy as they badly affect the baby so the medication for hypertension during pregnancy is limited but medications are safe and the doctors prescribe them as labetalol, hydralazin,e and thiazide diuretics.
Doses of aspirin150 mg is a good treatment for hypertension during pregnancy according to the advice of your doctor.
The most important way for treatment is monitoring the blood pressure for early diagnosis of hypertension during pregnancy to get a healthy pregnancy and mature delivery.
Exercising and physical activities that suit the pregnancy can improve blood pressure and blood circulation and reduce systolic and diastolic pressure so physical activities are considered as treatment for hypertension during pregnancy.
How can you lower your risk and avoid hypertension during pregnancy?
- The first and most important step is to visit your doctor as early as possible when you know that you are pregnant to monitor your blood pressure for early diagnosis.
-Eat healthy food such as vegetables and fruits and take care of the fat and salt levels in your diet.
Fat and salt increase blood pressure, so you should lower your intake to have a healthy pregnancy and a healthy baby without complications. A generally balanced diet is required for a healthy pregnancy.
- Avoid smoking and alcohol intake as they affect blood pressure.
- Walking and some sports that are suitable during pregnancy are important to avoid obesity and to keep proper body weight to avoid blood pressure problems caused by obesity. So women are advised to get a suitable body weight and body shape before the decision to be pregnant.
What should the women suffering from high blood pressure do before, during, and after the pregnancy?
Before pregnancy
- If the woman plans to be pregnant, she should tell her doctor that she suffers from high blood pressure to prescribe her a suitable anti-hypertensive drug.
- She should keep suitable body weight and avoid obesity through regular physical activities and Exercises.
- She should eat healthy food and a balanced diet.
During pregnancy
- Follow the doctor's instructions and don't take any medicine without telling her doctor.
- Take care of her weight and health status.
- Follow up on her blood pressure daily even at home with a home blood pressure monitor and tell the doctor about any changes.
After pregnancy
- Continue on the hypertensive drug according to the doctor's instructions.
- Tell the doctor if she has any Symptoms of pre-eclampsia (Headache, vision changes, or tonic and clonic convulsion).
- Keep her proper body weight during the suckling period.
- Continuous monitoring of her blood pressure.
Stress and hypertension during pregnancy
Stress can impact blood pressure so pregnant women are advised to avoid highly stressful situations it is important to learn How to Manage their emotional reactions towards difficult situations for a healthy pregnancy and to avoid fetal complications resulting from hypertension during pregnancy
In the end, the pregnant mom must take care of her food and periodically measure her blood pressure to notice any changes early and control any danger caused by high blood pressure.
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