Hypertension (high blood pressure) is a common complication of pregnancy and can cause serious health problems for both the mother and baby. Disorders related to high blood pressure during pregnancy are a major cause of serious illness, long-term disability, and death in both the mother and baby. 14% of maternal deaths worldwide are related to pregnancy-related hypertension. Blood pressure (BP) is a measure of the force blood puts on the walls of the arteries (blood vessels that carry blood away from the heart). When blood pressure is too high, it can cause heart attacks, heart failure, stroke, pulmonary oedema, or kidney failure due to increased stress on the organs. In pregnant women, additional complications can arise, including pre-eclampsia, eclampsia, Haemolysis, Elevated Liver Enzymes and Low Platelets (HELLP syndrome), placental abruption, gestational diabetes, and post-partum haemorrhage, all of which may be life-threatening to the mother and baby. In addition, babies born to mothers with high blood pressure may have premature delivery or low birth weight due to decreased blood flow to the placenta, even in the absence of more severe, life-threatening complications.
There are two types of high blood pressure in pregnancy: chronic hypertension, and gestational hypertension. Chronic hypertension occurs when the mother has high blood pressure before pregnancy or when it develops during the first 20 weeks of pregnancy. This usually doesn’t go away after delivery. Gestational hypertension is unique to pregnant women and develops after 20 weeks. Generally, this type of high blood pressure will go away after delivery. Both types of pregnancy-related high blood pressure increase the risk of complications.
Often, there may not be any obvious signs or symptoms of high blood pressure in pregnancy. So, it is important to see your doctor regularly so that your blood pressure can be monitored.
Blood pressure measurements consist of 2 numbers: systolic (the top number), and diastolic (the bottom number). It is categorized based on how high the readings are.
Normal blood pressure is less than 120/80.
Elevated blood pressure is a systolic BP of 120-129, and a diastolic BP of less than 80.
Stage 1 hypertension is a systolic BP of 130-139, and diastolic BP of 80-89.
Stage 2 hypertension s BP greater than 140/90.
If your blood pressure is systolic BP greater than 180 and/or diastolic BP greater than 120, this is a hypertensive crisis, and you should seek medical attention right away.
Symptoms of high BP that could signal a heart problem or other complication include severe or worsening headache, dizziness, trouble breathing, chest or stomach pain, nausea, excessive tiredness, and swelling. You should consult your healthcare provider if you experience any of these symptoms.
While pregnancy itself is a major risk factor for developing high blood pressure, other factors can increase the risk as well. These include:
-Being overweight
-Inactivity/sedentary lifestyle
-First pregnancy (the risk is lower after the first pregnancy)
-Carrying multiples (twins, triplets, etc.)
-Age greater than 35
-Using assistive technology such as in-vitro fertilization (IVF) to get pregnant
-Smoking and alcohol use
-Emotional stress
Having high blood pressure before becoming pregnant can increase the risk of high blood pressure-related complications.
Your doctor will check your blood pressure at every prenatal appointment, as well as check your urine for protein (which can be a sign of eclampsia, a life-threatening complication), and ask about any potentially alarming symptoms. You may be asked to monitor your blood pressure at home with an automatic blood pressure cuff as well.
High blood pressure in pregnancy can be treated with medications. Not all blood pressure medications are safe in pregnancy, though, so it is important to only use medications prescribed for you during your pregnancy. Women with high blood pressure before pregnancy may need to switch medications to one that is safe to use during pregnancy.
Maintaining a healthy weight and lifestyle can help to prevent pregnancy-related high blood pressure, but even women with active and healthy lifestyles who are not overweight can develop high BP. To prevent complications, be sure to keep all your prenatal doctor appointments, monitor your BP at home as directed by your doctor, eat a healthy diet, avoid smoking, illicit drugs, and alcohol, and use stress-reducing techniques such as rest and meditation. Seek medical attention right away if you experience any of the symptoms listed above that could indicate a heart problem or other BP-related complication.