What Can You Expect During Your Pregnancy
If you have high blood pressure and are pregnant, you can expect to be closely monitored by your healthcare provider. You will likely have more prenatal visits than women who do not have hypertension, and you may be on bedrest at times. Delivery may also need to be induced early. Hypertension does not have to prevent you from having a successful pregnancy, but it is important to be aware of the risks and work with your healthcare provider to develop a plan that will help keep you and your baby healthy.
How Is Blood Pressure Measured
Blood pressure is shown as 2 numbers:
- The top number is the highest pressure in your arteries when your heart pumps blood to the rest of your body.
- The bottom number is the lowest pressure when your heart rests between heartbeats.
Blood pressure is normally written as the top number over the bottom number, such as 120/80.
High blood pressure may be considered to be 140/90 mmHg or higher. However, it is difficult to give an example of a high blood pressure reading, because it depends on the individual. The level of blood pressure that is high for you depends on lots of different factors and your overall risk of heart attack or stroke. Generally, the lower your blood pressure, the better. If you have a history of heart disease, diabetes or a high risk of heart attack or stroke, it’s recommended you lower your blood pressure to less than 130/80. See who needs to get their blood pressure checked?
Potential Complication: Gestational Hypertension
When you’re pregnant, it’s common to have high blood pressure. Up to 8% of pregnant women in the U.S. have high blood pressure, usually during their first pregnancies. If you first develop it when you’re expecting, it’s called gestational hypertension or pregnancy-induced hypertension .
Most women with gestational hypertension have healthy pregnancies and healthy babies. But, high blood pressure during pregnancy can be a sign of other conditions that can be much more harmful. That’s one reason why seeing your doctor early and often is so important in keeping you and your baby healthy.
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Who Is At Risk For Preeclampsia
You are at higher risk of preeclampsia if you:
- Had chronic high blood pressure or chronic kidney disease before pregnancy
- Had high blood pressure or preeclampsia in a previous pregnancy
- Have obesity
- Damage to your kidneys, liver, brain, and other organ and blood systems
- A higher risk of heart disease for you
- Eclampsia, which happens when preeclampsia is severe enough to affect brain function, causing seizures or coma
- HELLP syndrome, which happens when a woman with preeclampsia or eclampsia has damage to the liver and blood cells. It is rare, but very serious.
Antihypertensive Medications That Are Not Safe During Pregnancy
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Some medicines used to treat high blood pressure should not be taken during pregnancy as they may harm a developing baby. |
Examples of blood pressure medicines that should not be taken during pregnancy are:
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Does Blood Pressure Remain High After The Birth
High blood pressure in pregnancy usually disappears once the baby is born. However, there may still be some complications during the first few days after the birth and you will need to be monitored carefully for several weeks.
Women who had high blood pressure due to another condition will need to see their doctor to make sure their blood pressure returns to safe levels.
Cardiovascular Findings In Preeclampsia
Home and ambulatory blood pressure measurements are increasingly being used in the pregnant population. Assuming the blood pressure device is accurate , the measurements may provide valuable additional data regarding hypertension severity and control during pregnancy.
In most normal pregnancies, the woman has some lower extremity edema by the third trimester. In contrast, a sudden worsening in dependent edema, edema in nondependent areas , or rapid weight gain suggest a pathologic process and warrant further evaluation for preeclampsia. Preeclampsia is a multisystem disease with various physical signs.
Women should be allowed to sit quietly for 5-10 minutes before each blood pressure measurement. Blood pressure should be measured in the sitting position, with the cuff at the level of the heart. Inferior vena caval compression by the gravid uterus while the patient is supine can alter readings substantially, leading to an underestimation of the blood pressure. Similarly, blood pressures measured in the left lateral position may yield falsely low values if the blood pressure is measured in the higher arm, unless the cuff is carefully maintained at the level of the heart.
Maternal SBP greater than 160 mm Hg or DBP greater than 110 mm Hg denotes severe disease depending on the gestational age and maternal status, delivery should be considered for sustained pressures in this range.
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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 youre taking. He or she may say its okay to continue that medicine. But if the medicine isnt 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. He or she 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.
High Blood Pressure Risks In Pregnancy
Hypertension that occurs during pregnancy complicates up to 10% of all pregnancies. There can be very serious complications to you or your baby when you have high blood pressure in pregnancy. Preeclampsia is a condition that occurs only during pregnancy and involves new onset of high blood pressure in pregnancy, usually after 20 weeks. If you do not have protein in the urine, this condition is usually referred to as gestational hypertension if you have protein in the urine it is referred to as preeclampsia.
Women who are having their first baby, have had preeclampsia in a previous pregnancy, have chronic hypertension, are having twins or triplets, are pregnant from in-vitro fertilization, are older than 40, or have diabetes are all at a higher risk for developing high blood pressure in pregnancy. For this reason, it is important to attend your prenatal visits. Your doctor may order additional blood and urine tests to help you have a successful pregnancy.
The treatment for preeclampsia at full term is to deliver your baby, which will improve your health. However, that is not always the safest plan for the health of the baby. When these conditions develop too early in pregnancy, your OB provider will decide a treatment plan, which could include outpatient or inpatient observation, blood work or delivery. Medications to help lower your blood pressure may also be recommended.
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Commonly Prescribed Antihypertensives In Pregnancy
Commonly used blood pressure medicines during pregnancy include:
When deciding whether or not to take antihypertensives during pregnancy, your doctor will discuss with you how necessary the medication is to your health against the possible risks to you or your baby, some of which will depend on how many weeks pregnant you are.
High Blood Pressure During Pregnancy: Home Remedies
If you suffer from high blood pressure during pregnancy, it is usually treated with medication. However, you can also additionally try to keep your blood pressure down with natural remedies. Vitamin D helps to keep blood pressure under control, a deficiency of this vitamin can cause blood pressure to rise. To absorb natural vitamin D you should spend a few minutes a day in the sun. But remember to avoid the sun or provide adequate protection in the blazing heat. It is helpful to combine sunbathing with a walk.
This is because exercise not only alleviates some of the concomitant complaints of pregnancy but also has an effect on your well-being and your blood pressure. Drinking plenty of fluids is very important during pregnancy. Especially peppermint tea is said to have a lowering effect on blood pressure. Garlic and onion are also said to help lower blood pressure.
In addition, many advise changing to a low-salt diet. As well as to make sure to eat plenty of fruits and vegetables. There are many home remedies that are supposed to help lower blood pressure with the addition of various oils or herbs. But talk to your midwife first before taking such natural remedies, because not all herbs or oils are tolerated during pregnancy. Some women also like to resort to Schüssler salts to keep their blood pressure low.
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What Is Considered High Blood Pressure During Pregnancy
A blood pressure that is greater than 130/90 mm Hg or that is 15 degrees higher on the top number from where you started before pregnancy may be cause for concern.
High blood pressure during pregnancy is defined as 140 mm Hg or higher systolic, with diastolic 90 mm Hg or higher.
Early in pregnancy, usually from 5 weeks to the middle of the second trimester, a pregnant womans blood pressure may actually decrease. This is because pregnancy hormones can stimulate blood vessels to widen. As a result, the resistance to blood flow isnt as high.
High Blood Pressure During Pregnancy: What Helps
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If high blood pressure occurs during pregnancy, it is referred to as pregnancy-induced hypertension or gestational hypertension. Both mean that high blood pressure occurs only conditionally due to the pregnancy and usually subsides after birth. This is usually the case from the 20th week of pregnancy.
If you already have high blood pressure before the 20th week of gestation, it is likely that you already had it before pregnancy and your doctor will refer to this as chronic hypertension. To determine high blood pressure, it is measured. This is done twice in succession. If the value is above 140/90 in each measurement, it is elevated blood pressure.
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Estoy Predispuesto A Desarrollar La Preeclampsia
La preeclampsia es la presión arterial alta que se produce exclusivamente en el embarazo. Por lo tanto, aún qué si hipertensión crónica esté bajo control antes de que usted esté embarazada, es posible que más adelante pueda desarrollar preeclampsia. Si usted tiene hipertensión crónica, es más propensa a desarrollar la preeclampsia, pero eso no significa necesariamente que lo hará. También, en caso de que usted desarrollé preeclampsia, el médico puede recomendar inducir el parto antes de su fecha de parto para prevenir más complicaciónes. Si la preeclampsia es grave, el médico puede recomendar un parto por cesárea.
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.
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Does It Matter When You Take Blood Pressure Medicine
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Can I Lower My Risk
Although there isn’t a way to prevent gestational hypertension, you can do everything in your power to keep yourself and your babies as healthy as possible throughout your pregnancy. Healthy lifestyle choices can help control your blood pressure. And if you work closely with your doctor, you may help catch any problems early. That gives you the best chance for a healthy outcome.
See your doctor. As soon as you think you might be pregnant, see your doctor. And be sure to go to all your scheduled prenatal appointments. Discuss ways you can lessen problems from high blood pressure.
Your doctor will test your blood pressure throughout your pregnancy and may have you monitor it at home.
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Take prenatal vitamins. You need more nutrients during pregnancy. According to some studies, two of these nutrients — folic acid and calcium — may lower your risk for gestational hypertension. Either way, you should take a prenatal vitamin with these two nutrients, among others, every day. This helps prevent birth defects and helps keep you and your baby healthy.
Eat healthy foods. Make sure the foods you choose are nutritious. Try to put fruits, veggies, whole-grain breads, lean meats, and low-fat dairy products on your plate every day. Ask your doctor whether you should lower your salt intake. And learn what a healthy weight gain is for you during pregnancy.
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How High Blood Pressure Impacts Labour And Birth
If you have high blood pressure, both you and your baby will be closely monitored during the pregnancy. During labour, the babys heart will be continuously monitored and you may have an intravenous drip to give you fluid and medication. If your condition seems to be worsening during labour, you may need an emergency caesarean.
If you have pre-eclampsia, it will normally be recommended that you have the baby in a large maternity hospital which can provide expert care for both mother and baby. It may mean the baby is born early or is smaller than expected.
Low Blood Pressure Complications
While many women who have low blood pressure prior and during pregnancy do not have any related issues, there are some complications to be aware of.
Some symptoms of low blood pressure include:
- Blurred vision
- Nausea
- Rapid or shallow breathing
One of the most concerning complications is dizziness because it can lead to fainting, falling, and injury, secondary to the fall. Additionally, research has shown a link between low blood pressure and increased symptoms of morning sickness.
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What Steps Can I Take To Have A Safe Delivery With High Blood Pressure During Pregnancy
Steps that patients with high blood pressure during pregnancy can take to help the chances of having a safe and healthy delivery include:
- Taking any blood pressure medication as prescribed
- Going to all of your prenatal visits
- Having an early delivery if it is needed
- Maintaining a healthy diet
- Following your healthcare providers instructions regarding activity and exercise
What Causes High Blood Pressure During Pregnancy
Its not clear whats behind every case of high blood pressure during pregnancy, but there are some risk factors, including a history of long-term high blood pressure or chronic kidney disease. You might also be more at risk if youre Black, youre carrying multiple babies, you have type 1 or 2 diabetes, youre younger than 20 years of age or older than 40, or youre obese.
Another cause of an above-normal blood pressure reading may be a case of “white-coat hypertension” a pretty common phenomenon , where blood pressure temporarily spikes because you get nervous or worried in medical settings.
Still, if your doctor notices your blood pressure is above 140/90 on two separate visits, whether youre just anxious when that cuff is placed on your arm or you have one of the above-mentioned risk factors, he’ll likely diagnose you with gestational hypertension.
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Treatments For High Blood Pressure
Your doctor or midwife will check your blood pressure regularly. If you have high blood pressure, it is important to:
- exercise regularly
- make sure you are a healthy weight
If high blood pressure is caused by a medical condition such as kidney disease, its important to talk to your doctor about what medications are safe to take during pregnancy.
Pre-eclampsia can be managed with medication and close monitoring of both you and the baby. However, it can become worse very quickly. If this happens, you may need to go to hospital or have the baby delivered early.
