High Blood Pressure During Pregnancy

What is high blood pressure during pregnancy?

A small percentage of pregnant women in the U.S. have high blood pressure at some point during their pregnancy. Some cases are mild; other cases are severe. Treatment varies depending on the type you have and how far along you are in your pregnancy.

There are three main types of high blood pressure during pregnancy:

• Chronic hypertension. This is high blood pressure you had before you became pregnant. It can also refer to high blood pressure you get before the 20th week of pregnancy. Sometimes you may have high blood pressure for a long time before becoming pregnant but don’t know it until your first prenatal visit with your doctor. Chronic hypertension can lead to serious problems, including preeclampsia. This type of high blood pressure continues after you have your baby.
• Gestational hypertension. This is high blood pressure you get after your 20th week of pregnancy. Most of the time, this hypertension doesn’t hurt you or your baby. You may not even have other symptoms. However, sometimes this type of hypertension is severe. It can cause your baby to be born smaller than normal (have a low birth weight). Your baby may even be born early because of it. It can lead to preeclampsia. And while it usually goes away within three months of giving birth, it can raise your risk of getting high blood pressure in the future.
• Preeclampsia.This is a sudden rise in your blood pressure after your 20th week of pregnancy, typically in your third trimester. It may cause damage to your liver, kidneys, or brain. You may have seizures. You may have significant swelling in your legs and sometimes your arms and face. This condition is serious. It can hurt both you and your baby, and even be life threatening. Some women get preeclampsia after they deliver their baby. This is called postpartum preeclampsia.

In some cases, high blood pressure during pregnancy can cause harm to you and your baby. You may develop gestational diabetes. You may also experience problems with your heart or kidneys. You’re also at greater risk for a stroke.

High blood pressure may prevent the placenta from getting enough blood. If the placenta doesn’t get enough blood, your baby doesn’t get enough oxygen and food. This can cause low birth weight and premature birth.

High blood pressure can also lead to placental abruption. This is when the placenta becomes unattached to the uterus. This can be a life-threatening situation to both you and your baby.

Symptoms of high blood pressure during pregnancy

Keep in mind that some of these symptoms are common among pregnant women and don’t necessarily mean you have a problem. Talk with your doctor if you have any of the following:

• Constant headache
• Changes to your vision
• Abdominal pain
• Nausea and vomiting
• Shortness of breath
• Swelling of your hands and face
• Low, or no, urine

What causes high blood pressure during pregnancy?

Some women have a greater risk of getting high blood pressure while they’re pregnant. These include women who:

• Are having their first baby
• Have a mom or sister who had high blood pressure while pregnant
• Are carrying multiple babies (twins, triplets)
• Are older than 40 years old
• Are African American
• Were overweight when they became pregnant
• Had high blood pressure before they became pregnant

How is high blood pressure during pregnancy diagnosed?

No one test diagnoses high blood pressure while pregnant. Instead, your doctor will take your blood pressure at each of your prenatal appointments. They will keep track of your blood pressure readings during your pregnancy and be able to spot any changes that could indicate an overall problem. They will also use urine and blood tests to watch for possible issues.

Can high blood pressure during pregnancy be prevented or avoided?

It can’t be prevented. However, you can lower your chances of getting it by making necessary adjustments before getting pregnant. These include getting or maintaining a healthy weight, eating a healthy diet, and exercising regularly.

If you have chronic hypertension before you get pregnant, talk with your doctor. They will look at how well your hypertension is being managed and let you know if you need to make any changes before getting pregnant.

High blood pressure during pregnancy treatment

If you have chronic hypertension, you may have been taking medicine for it before you became pregnant. Tell your doctor which medicine you’re taking. He or she may say it’s okay to continue that medicine. But if the medicine isn’t safe for your baby, you may need to switch to another medicine during your pregnancy. Like with all pregnancies, your doctor will check your blood pressure and urine during your regular appointments.

If you have gestational hypertension, your doctor will monitor your blood pressure and urine more closely. They will do this to watch for signs of preeclampsia. Your doctor may also monitor your baby. One way to do that is with an ultrasound. This is a painless test that lets your doctor see your baby inside your body.

If you have preeclampsia, treatment depends on where you are in relation to your due date. That’s because preeclampsia often goes away after you have your baby. If you’re 37 weeks or more pregnant, your doctor may suggest having the baby as soon as possible. However, if you’re less than 37 weeks pregnant, your doctor may choose to monitor you even more closely than before.

Along with the regular urine and blood tests, you may need to take medicine to help your blood pressure. You may also need to take medicine that help prevent seizures, which can happen with preeclampsia. You may be told to stay in bed until your baby is born. You may be given a steroid shot of a medicine that will help your baby’s lungs develop quicker in case your baby needs to be born early. Your baby will continue to be watched with ultrasound. Your doctor may also watch your baby’s health through a heart monitor. If your preeclampsia is extremely severe, your doctor may say you need to deliver your baby right away, regardless of how close you are to your due date.

Living with high blood pressure during pregnancy

Go to each of your prenatal visits with your doctor. This will allow them to monitor your blood pressure. Your doctor may ask you to record your blood pressure at home. They can give advice on how to do that. Your doctor will check your urine at each visit. High levels of protein in urine can be a symptom of preeclampsia.

Discuss all your medicines with your doctor. Also, don’t start or stop taking any medicines, including over-the-counter medicines, without talking to your doctor. Some of these may affect your blood pressure.

Questions for your doctor

• I’m pregnant and have high blood pressure. How great is my risk of developing gestational hypertension or preeclampsia?
• Is there anything I can do to reduce my risk?
• Will medicines help me?
• How often will I need to see you for appointments?
• What are my treatment options?
• Will I need bed rest?
• Will I need a C-section? Or can I have a vaginal birth?

Resources

Centers for Disease Control and Prevention: High Blood Pressure During Pregnancy

March of Dimes: High Blood Pressure During Pregnancy