How is high blood pressure treated in pregnant women?
The treatment will depend on the type of high blood pressure:
- Chronic hypertension: If you are already taking medicine for high blood pressure, your doctor may want you to keep taking that medicine. If that medicine is not safe for the baby, your doctor might want you to change to another medicine or to stop taking medicine while you are pregnant. Your doctor will pay special attention to how your baby is growing. You might have ultrasound exams more often. You might have some other tests near the end of your pregnancy to make sure that your baby is healthy. Your doctor will monitor you closely for signs of PIH.
- Gestational hypertension: This condition doesn't need any treatment. But it can be hard to tell this condition from early or mild PIH, so your doctor will monitor you very closely to make sure your high blood pressure does not turn into PIH. Your doctor might tell you to take aspirin or extra calcium to prevent PIH. Your doctor might also tell you to lie on your left side while you are resting. This will improve blood flow and take weight off your large blood vessels.
- PIH: How your doctor treats this condition depends on how close you are to your due date and how you and your baby are doing. The only treatment that stops PIH is to deliver the baby. If your baby is born very early, it may have serious health problems. But your doctor may want your baby to be delivered early if you or the baby are very sick. If your doctor thinks it is safe for the pregnancy to continue to full term, he or she will monitor you and your baby very closely until delivery. You will see your doctor often and get blood tests. Your baby will also get some tests to make sure he or she is healthy. You might need to stay home from work and rest in bed. In some cases, hospitalization may be necessary.
A note about salt
One way to control high blood pressure when you're not pregnant is to cut the amount of salt you eat. This is not a good idea if you have high blood pressure during pregnancy. Your body needs salt to keep up the flow of fluid in your body, so you need a normal intake of salt. Your doctor will tell you how much salt to eat each day and how much water you should drink each day.
If my doctor decides to deliver the baby early, will I have to have a Cesarean section?
This is up to your doctor and you. A Cesarean section (an operation to deliver the baby) is more likely if your health or your baby's health is in danger. If things aren't this serious, your doctor may use medicine (such as oxytocin) to start your labor, and you can deliver your baby through a vaginal delivery.
What happens to high blood pressure after delivery?
- Chronic hypertension: Your blood pressure will probably stay high after you have your baby. You will have to keep taking medicine for high blood pressure, watch your diet and exercise.
- Gestational hypertension: Your blood pressure will go back to normal within a few weeks after you have your baby, but you are more likely to develop chronic high blood pressure later in life.
- PIH: Your blood pressure will go back to normal within a few weeks after you have your baby.
NHBPEP Report on High Blood Pressure in Pregnancy: A Summary for Family Physicians by MA Zamorski, M.D., M.H.S.A. and LA Green, M.D., M.P.H. (American Family Physician July 15, 2001, http://www.aafp.org/afp/20010715/263.html)
Written by familydoctor.org editorial staff