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Pregnancy and
high blood pressure
Having high blood pressure (hypertension) during pregnancy
— whether you develop the condition before or after conception — requires special care.
Here's what you need to know about high blood pressure and pregnancy.
Are there different types of high blood pressure during pregnancy?
Sometimes high blood pressure is present before pregnancy. In other cases, high blood
pressure develops during pregnancy. For example:
• Gestational hypertension. Women with gestational hypertension have high blood
pressure that develops after 20 weeks of pregnancy. There is no excess protein in the
urine or other signs of organ damage. Some women with gestational hypertension
eventually develop preeclampsia.
• Chronic hypertension. Chronic hypertension is high blood pressure that was present
before pregnancy or that occurs before 20 weeks of pregnancy. But because high blood
pressure usually doesn't have symptoms, it might be hard to determine when it began.
• Chronic hypertension with superimposed preeclampsia. This condition occurs in
women with chronic high blood pressure before pregnancy who then develop worsening
high blood pressure and protein in the urine or other health complications during
pregnancy.
• Preeclampsia. Sometimes chronic hypertension or gestational hypertension leads to
preeclampsia, a pregnancy complication characterised by high blood pressure and signs
of damage to another organ system — usually after 20 weeks of pregnancy. Left
untreated, preeclampsia can lead to serious — even fatal — complications for mother
and baby. Previously, preeclampsia was only diagnosed if a pregnant woman had high
blood pressure and protein in her urine. However, experts now know that it's possible to
have preeclampsia, yet never have protein in the urine.
Why is high blood pressure a problem during pregnancy?
High blood pressure during pregnancy poses various risks, including:
• Decreased blood flow to the placenta. If the placenta doesn't get enough blood, your
baby might receive less oxygen and fewer nutrients. This can lead to slow growth, low
birth weight or preterm birth. Prematurity can lead to breathing problems for the baby.
• Placental abruption. Preeclampsia increases your risk of placental abruption, in which
the placenta separates from the inner wall of your uterus before delivery. Severe abruption
can cause heavy bleeding and damage to the placenta, which can be life-threatening
for both you and your baby.
• Premature delivery. Sometimes an early delivery is needed to prevent potentially lifethreatening complications.
• Future cardiovascular disease. Having preeclampsia increases your risk of future heart
and blood vessel (cardiovascular) disease. The risk is even greater if you've had
preeclampsia more than once or you've had a premature birth. To minimize this risk, after
delivery try to maintain your ideal weight, eat a variety of fruits and vegetables, exercise
regularly, and don't smoke.
What do I need to know about
preeclampsia?
Preeclampsia
sometimes
develops
without any symptoms. High blood
pressure might develop slowly, but more
commonly it has a sudden onset.
Monitoring your blood pressure is an
important part of prenatal care because
the first sign of preeclampsia is commonly
a rise in blood pressure. Blood pressure
that is 140/90 millimeters of mercury (mm
Hg) or greater — documented on two
occasions, at least four hours apart — is
abnormal.
Other signs and symptoms of
preeclampsia might include:
• Excess protein in your urine
(proteinuria) or additional signs of
kidney problems.
• Severe headaches.
• Changes in vision, including temporary
loss of vision, blurred vision or light
sensitivity.
• Upper abdominal pain, usually under
your ribs on the right side.
• Nausea or vomiting.
• Decreased urine output.
• Decreased levels of platelets in your
blood (thrombocytopenia).
• Impaired liver function.
• Shortness of breath, caused by fluid in
your lungs.
• Sudden weight gain and swelling
(edema) — particularly in your face
and hands — often accompanies
preeclampsia. But these things also
occur in many normal pregnancies, so
they're not considered reliable signs of
preeclampsia.
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Is it safe to take blood pressure
medication during pregnancy?
Any medication you take during
pregnancy can affect your baby.
Although some medications used to
lower blood pressure are considered
safe during pregnancy, others are
generally avoided during pregnancy.
Treatment is important, however. If
you need medication to control your
blood pressure during pregnancy, your
healthcare provider will prescribe the
safest medication at the most
appropriate dose. Take the medication
exactly as prescribed. Don't stop
taking the medication or adjust the
dose on your own.
What can I do to reduce the risk of complications?
Taking good care of yourself is the best way to take care of your baby. For example:
• Keep your pre-natal appointments. Visit your healthcare provider regularly throughout
your pregnancy.
• Take your blood pressure medication as prescribed. Your healthcare provider will
prescribe the safest medication at the most appropriate dose.
• Stay active. Follow your healthcare provider's recommendations for physical activity.
• Eat a healthy diet. Choose foods low in sodium.
• Know what's off-limits. Avoid smoking, alcohol and illicit drugs. Talk to your healthcare
provider before taking any over-the-counter medications.
What about labour and
delivery?
Your healthcare provider might suggest
inducing labour a few days before your
due date to avoid complications. If you
develop
preeclampsia
or
other
complications, induction might be
needed even earlier. If you have severe
preeclampsia, you might be given
medication during labour to help
prevent seizures. In some cases, a
Caesarian-section might be needed.
Will I be able to breast-feed my
baby?
Breast-feeding is encouraged for most
women who have high blood pressure,
even those who take medication.
Discuss any medication adjustments
you'll need to make with your healthcare
provider ahead of time. Sometimes an
alternate blood pressure medication is
recommended. Your healthcare provider
might also recommend that you avoid
breast-feeding right after you take your
medication.
As a Platinum Health member you have the benefit of consulting
with a healthcare provider who will assist you with making the right
choices during your pregnancy. For more information, kindly contact
the Platinum Health Client Liaison department on 014 591 6600.