Even in the absence of pregnancy, high blood pressure or hypertension is an extremely common medical problem in the United States. The Centers for Disease Control (CDC) estimates that almost half of all adults in the United States (49.6%) have high blood pressure.
Developing high blood pressure while pregnant can fall under one of the following categories.
- Pre-existing high blood pressure – refers to women who were diagnosed with high blood pressure prior to becoming pregnant.
- Gestational hypertension – refers to women who develop high blood pressure for the very first time while pregnant. This typically starts after 20 weeks of pregnancy or beyond.
- Preeclampsia – refers to women who develop high blood pressure after 20 weeks of pregnancy combined with other symptoms that include protein in the urine, low platelets, abnormal liver enzyme tests or kidney problems.
How high blood pressure can affect the baby
High blood pressure while pregnant is a condition that can be managed but should always be taken very seriously. A high blood pressure can negatively affect the growth of a baby and lead to other pre-pregnancy complications such as
- Decreased blood flow to the placenta – If the placenta doesn’t get enough blood, the baby might receive less oxygen and fewer nutrients.
- Intrauterine growth restriction – high blood pressure might result in slowed or decreased growth of the baby
With good monitoring and proactive management of your blood pressure, many of these complications can be avoided.
Diagnosing high blood pressure while pregnant
Your doctor will carry out routine blood pressure readings during all of your prenatal appointments. They will also ask for a urine sample checking for protein in your urine. By consistently checking your blood pressure they can determine whether you develop high blood pressure while pregnant.
Managing high blood pressure while pregnant
Gestational hypertension is defined as blood pressure that exceeds 140/90 mm Hg (documented on two or more separate occasions) after 20 weeks of pregnancy. At this point, your doctor will do the following to help manage your blood pressure:
- Blood pressure monitoring -they will continue to closely monitor your blood pressure throughout the course of your pregnancy. Blood pressure readings will be taken at all prenatal appointments. You may also be advised to start home blood pressure monitoring.
- Medications – Some medications can help lower your blood pressure. These may be prescribed by your doctor. Any medication that is prescribed will be safe for your baby and only prescribed for the shortest period necessary at the most appropriate dose.
- Prenatal visits – During prenatal visits you can expect a weight, blood pressure check and urine test (this looks for protein in the urine).
- Ultrasounds – In some cases, more frequent ultrasounds my be done to track your baby’s growth and development
- Referral to a maternal fetal medicine specialist for consultation may also be done to more closely monitor the baby’s growth and development as well as assess the need for delivering your baby earlier than your due date.
In all cases, managing high blood pressure while pregnant is a team effort. While your doctor, midwife and healthcare staff will do everything possible to help you manage your blood pressure, you can also be proactive by taking some of the following steps:
- Be sure to keep all of your prenatal appointments.
- Take your blood pressure medication as prescribed.
- Stay active. Follow your doctors recommendations for physical activity.
- Stick to a healthy diet. If you need some tips on healthy eating, ask for help or refer to reputable online resources like the CDC website.
- Avoid smoking and alcohol
- If possible, buy a cheap at-home blood pressure measuring device. These can be purchased at most stores and pharmacies.
High blood pressure in pregnancy has become much more common. But with good management and by following the steps listed above you can increase the chance of having a safe and happy pregnancy.
References
https://www.cdc.gov/nchs/fastats/hypertension.htm
https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20046098
https://www.cdc.gov/bloodpressure/pregnancy.htm