High Blood Pressure During Pregnancy
High blood pressure is a serious concern during pregnancy, especially for women who have chronic hypertension. Chronic hypertension refers to high blood pressure which is already present before pregnancy. It also includes high blood pressure which develops before 20 weeks of pregnancy, or lasts for longer than 12 weeks after giving birth.
The onset of high blood pressure during pregnancy may be a sign of preeclampsia. Although high blood pressure and preeclampsia can be related, they are different. If you were diagnosed with hypertension before becoming pregnant, you may be wondering how this will affect your pregnancy, or even if you should become pregnant at all.
Can I have a healthy pregnancy with High Blood Pressure?
It is ideal to see your doctor before you become pregnant. This gives your healthcare provider an opportunity to see if your high blood-pressure is under control and review your medications. Certain medications are not safe during pregnancy and can harm your baby.
During pregnancy, chronic hypertension can worsen, especially if you develop preeclampsia in addition to chronic hypertension. If this happens, you may develop complications such as congestive heart failure, vision changes, stroke, seizures, and kidney or liver problems.
Am I predisposed to develop preeclampsia?
Preeclampsia is high blood pressure that occurs exclusively in pregnancy. Therefore, even if your chronic high blood pressure is under control before you are pregnant, you may later develop preeclampsia, as well. If you have chronic hypertension, you are more likely to develop preeclampsia, but it does not necessarily mean you will. Also, should you develop preeclampsia, your doctor may recommend inducing labor before your due date to prevent further pregnancy complications. If the preeclampsia is severe, your doctor may recommend a cesarean birth.
Will my pregnancy be classified as high-risk?
One indicator of a high-risk pregnancy includes certain chronic medical problems, such as high blood pressure. Therefore, since you already have hypertension and have become pregnant, your pregnancy is automatically classified as high risk.
High-risk pregnancies typically need expert advice and the care of a healthcare specialist. You will most likely see a perinatologist—- an obstetrician who specializes in the care of high-risk pregnancies. Perinatologists give expert care to women who have pre-existing medical conditions, as well as women who develop complications during pregnancy.
In addition, you may be referred to a perinatal care center, before delivery, to lessen the likelihood your baby may become ill. Usually, these centers work together with obstetricians and a newborn intensive care unit to provide the best care for you and your baby.
How may high blood pressure during pregnancy affect my baby?
It is possible to have chronic hypertension and go on to have a healthy baby. However, chronic hypertension has the possibility of a number of adverse effects on your developing baby.
These possible concerns include:
- Impairment of the baby’s growth
- Higher risk of breathing problems before or during labor
- Higher risk of placental abruption (placenta separating from the uterus before labor)
- Possible side effects from the medications you are taking.
How can I manage my high blood pressure during pregnancy?
Although there is no cure for chronic hypertension, there are ways to successfully manage your condition when pregnant. Taking care of yourself is the best way to take care of your developing baby.
- Eat a healthy diet, and especially limit your sodium intake
- Take your blood pressure medications the way you are supposed to
- Keep all your prenatal appointments
- Stay physically active, although your healthcare provider may prescribe bed rest if you develop preeclampsia
- Do not smoke, drink alcohol, or take illicit drugs
- Monitor your weight gain—do not gain too much
Last updated: April 7, 2017 at 21:08 pm
Compiled using information from the following sources:
1. Harms, R. W., Johnson, R. V., & Murray, M. M. (2004). Mayo Clinic Guide to a Healthy Pregnancy. New York: HarperCollins Publishers.
2. Mayo Clinic Staff. (2014, July 3). Preeclampsia.
3. The American College of Obstetricians and Gynecologists. (2010). Your Pregnancy and Childbirth: Month to Month, Fifth Edition. Washington, DC: American College of Obstetricians and Gynecologists.
Preeclampsia – Topic Overview
Articles On Preeclampsia
What is preeclampsia?
Preeclampsia is new high blood pressure after 20 weeks of pregnancy. It usually goes away after you give birth.
Not all high blood pressure is preeclampsia. In some women, blood pressure goes up very high in the second or third trimester. This is sometimes called gestational hypertension, and it can lead to preeclampsia.
Preeclampsia can be dangerous for the mother and baby. It can keep the baby from getting enough blood and oxygen. It also can harm the mother’s liver, kidneys, and brain. Women with very bad preeclampsia can have dangerous seizures. This is called eclampsia.
What causes preeclampsia?
Experts don’t know the exact cause.
Preeclampsia seems to start because the placenta doesn’t grow the usual network of blood vessels deep in the wall of the uterus. This leads to poor blood flow in the placenta.
If your mother had preeclampsia while she was pregnant with you, you have a higher chance of getting it during pregnancy. You also have a higher chance of getting it if the mother of your baby’s father had preeclampsia.
Already having high blood pressure when you get pregnant raises your chance of getting preeclampsia.
What are the symptoms?
Mild preeclampsia usually doesn’t cause symptoms.
But preeclampsia can cause rapid weight gain and sudden swelling of the hands and face.
Severe preeclampsia causes symptoms such as a very bad headache and trouble seeing and breathing. It also can cause belly pain and decreased urination.
How is preeclampsia diagnosed?
Preeclampsia is usually found during a prenatal visit.
This is one reason why it’s so important to go to all of your prenatal visits. You need to have your blood pressure checked often. During these visits, your blood pressure is measured. A sudden increase in blood pressure often is the first sign of a problem.
You also will have a urine test to look for protein, another sign of preeclampsia.
If you have high blood pressure, tell your doctor right away if you have a headache or belly pain. These signs of preeclampsia can occur before protein shows up in your urine.
How is it treated?
The only cure for preeclampsia is having the baby.
You may get medicines to lower your blood pressure and to prevent seizures.
You also may get medicine to help your baby’s lungs get ready for birth.
Your doctor will try to deliver your baby when the baby has grown enough to be ready for birth. But sometimes a baby has to be delivered early to protect the health of the mother or the baby. If this happens, your baby will get special care for premature babies.
High blood pressure in pregnancy (gestational hypertension)
In this article
What is gestational hypertension?
How will I know if I’ve got high blood pressure?
- Mild hypertension is when your top figure is 140-9 and your bottom figure is 90-99. You won’t need treatment, but your midwife will want to check your blood pressure once a week from now on. She’ll also test your urine for protein at each visit.
How common is high blood pressure in pregnancy?
- You had diabetes before you were pregnant.
Is high blood pressure in pregnancy serious?
How is high blood pressure in pregnancy treated?
- it’s your first pregnancy
You’ll have more frequent blood pressure checks, plus urine and blood tests. Some women with mild to moderate high blood pressure may have extra scans.
High Blood Pressure During Pregnancy
High blood pressure, or hypertension, is defined as blood pressure higher than 140/90 mm Hg. The condition is a serious concern for some pregnant women.
High blood pressure during pregnancy isn’t always dangerous. But it can sometimes cause severe health complications for both mother and developing baby. According to the Centers for Disease Control and Prevention, an increasing number of pregnant women in the United States have this condition.
According to the National Heart, Lung, and Blood Institute (NHLBI), there are several possible causes of high blood pressure during pregnancy.
- being overweight or obese
- failing to stay active
- drinking alcohol
- first-time pregnancy
- a family history of pregnancy-related hypertension
- carrying more than one child
- age (over 40)
- assistive technology (such as IVF)
Unhealthy lifestyle choices may lead to high blood pressure during pregnancy. Being overweight or obese, or not staying active, are major risk factors for high blood pressure.
Women experiencing their first pregnancy are more likely to have high blood pressure. Fortunately, there’s a lower chance of this condition in subsequent pregnancies with the same partner.
Women carrying multiples are more likely to develop hypertension, as their body is under additional stress.
Maternal age is also a factor, with pregnant women over the age of 40 being more at risk.
According to the American Society for Reproductive Medicine, using assistive technologies (such as IVF) during the conception process can increase chances of high blood pressure in a pregnant woman.
Women who had high blood pressure before pregnancy are at higher risk for related complications during pregnancy than those with normal blood pressure.
- Chronic hypertension: Sometimes a woman has pre-existing high blood pressure, or hypertension before she gets pregnant. This may be referred to as chronic hypertension, and is usually treated with blood pressure medication. Doctors also consider hypertension that occurs in the first 20 weeks of pregnancy to be chronic hypertension.
- Gestational hypertension: Gestational hypertension develops after the 20th week of pregnancy. It usually resolves after delivery and the most common complication is induced labor. When diagnosed before 30 weeks, there’s a higher chance it will progress to preeclampsia (see below).
- Chronic hypertension with superimposed preeclampsia: Another variation of chronic hypertension is when a woman has hypertension before she becomes pregnant, then also experiences protein in her urine or additional complications as her pregnancy progresses.
A blood pressure reading is a fraction: your systolic blood pressure over your diastolic blood pressure.
- The top number is your systolic pressure, which is a measurement of the pressure on your heart’s arteries when the heart is beating or squeezing blood forward through your body.
- The diastolic or lower number is a measurement of the force of blood pressure in your heart when the heart is at rest.
What is considered normal blood pressure during pregnancy?
To determine what your “normal” blood pressure is during pregnancy, your doctor will likely take a baseline blood pressure measurement at your first visit. Then they will measure your blood pressure at every visit that follows.
Normal blood pressure is usually somewhere close to 120/80 mm Hg.
What is considered high blood pressure during pregnancy?
A blood pressure that is greater than 140/90 mm Hg, or that is 15 degrees higher on the top number from where you started out before pregnancy, may be cause for concern.
Early in pregnancy, usually from 5 weeks’ pregnant to the middle of the second trimester, a pregnant woman’s blood pressure may actually decrease. This is because pregnancy hormones can stimulate blood vessels to widen. As a result, the resistance to blood flow isn’t as high.
What is considered low blood pressure during pregnancy?
While there isn’t a definitive number that is too low, there are symptoms that are associated with low blood pressure:
As a woman progresses in her pregnancy, her blood pressure may change or return to prepregnancy levels. Reasons for this may include the following.
The amount of blood in a woman’s body increases. According to the journal Circulation, a woman’s blood volume increases by as much as 45 percent during pregnancy. This is an extra amount of blood that the heart must pump throughout the body.
The left ventricle (left side of the heart that does a significant amount of pumping) becomes thicker and larger. This temporary effect allows the heart to work harder to support the increased blood volume.
The kidneys release increased amounts of vasopressin, a hormone that leads to increased water retention.
In most cases, high blood pressure during pregnancy will subside almost immediately after the baby is delivered. In cases where blood pressure remains elevated, your doctor may prescribe medication to get it back to normal.
Tips for tracking blood pressure during pregnancy
There are many ways that you can track your blood pressure during pregnancy. Try out the following ideas:
If high blood pressure continues after 20 weeks of pregnancy, there can be complications. Preeclampsia can develop.
What is preeclampsia?
This condition can cause serious damage to your organs, including your brain and kidneys. Preeclampsia is also known as toxemia or pregnancy-induced hypertension. Preeclampsia with seizures becomes eclampsia. This can be fatal.
Thorough prenatal care, including regular doctor’s visits, should be able to address preeclampsia symptoms. Symptoms include:
- protein in a urine sample
- abnormal swelling in hands and feet
- persistent headaches
HELLP is an acronym that stands for hemolysis, elevated liver enzymes, and low platelet count. This condition is severe and life-threatening, and can be a complication of preeclampsia. Symptoms associated with HELLP include nausea, vomiting, headache, and upper abdominal pain. Because HELLP syndrome can severely damage organ systems vital to life, emergency medical care is aimed at reducing blood pressure for the health of the mother and the baby. In some cases, a premature delivery is required.
High blood pressure during pregnancy can also have an effect on the baby’s growth rate. This can result in low birth weight. According to the American Congress of Obstetricians and Gynecologists, other complications include:
- placental abruption, a medical emergency during which the placenta detaches from the uterus prematurely
- preterm delivery, defined as delivery prior to 38 weeks of pregnancy
- caesarean delivery
Common risk factors for high blood pressure, such as obesity and a history of high blood pressure, can be minimized through diet and exercise. Of course, during pregnancy, it is inevitable that you will gain some weight. It’s recommended that pregnant women consult with their doctor to identify a weight gain target that is healthy for them.
Dietary guidelines for pregnant women vary from person to person. Speak with a nutritionist who will keep your specific height and weight in mind when creating a nutrition plan for you.
The NHLBI emphasizes that it’s important to take steps to lessen your risk of high blood pressure. You should steer clear of smoking and drinking alcohol, both of which have been known to raise blood pressure.
Pregnancy causes hormone shifts, as well as psychological and physical changes. This can bring on stress, which can make high blood pressure harder to manage. Try stress reduction techniques such as yoga and meditation.
Some traditional blood pressure medications can cause problems in pregnant women.
According to Mayo Clinic, these medications for lowering blood pressure should be avoided when you are pregnant:
These drugs in particular will be passed through the bloodstream to the developing baby. They can negatively impact the baby’s health. These medications may also cause blood to thin, which can compromise the mother’s ability to carry the baby to term.
Methyldopa and labetalol are both drugs that have been deemed safe for use to manage blood pressure during pregnancy.
Talk to your doctor about how to control your blood pressure if you develop hypertension during pregnancy.
High blood pressure during pregnancy doesn’t usually lead to serious problems. However, if it goes untreated, hypertension can become life-threatening for both mother and baby. Unfortunately, hypertensive disorders resulting from high blood pressure are the second-leading cause of U.S. maternal death during pregnancy.
Always talk to your doctor about your concerns. Plan to stay on top of your prenatal care to have the healthiest pregnancy outcome possible.
Take the time to understand the risk factors and possible causes of high blood pressure before you get pregnant — and take preventive measures to keep your blood pressure down during pregnancy.