Hypertension During Pregnancy

Pregnancy complicated hypertension
Hypertension is the most common complication during pregnancy. Normally there is a fall in blood pressure from 5 weeks to the middle of the second trimester during pregnancy. Blood pressure more than 140 mm hg systolic , 90 mm hg diastolic is considered as hypertension and there are 4 different types of hypertension during pregnancy:
Gestational hypertension: Hypertension developing after 20 wks with no loss of proteins in urine.
Chronic hypertension: Hypertension developing before 20 wks or you are having undiagnosed high b.p. before pregnancy which is diagnosed during prenatal visit or first visit.
Preeclampsia: Hypertension developing after 20 wks with loss of proteins in urine. Preeclampsia superimposed chronic hypertension: pt with known hypertension who develops proteinuria during pregnancy.

Risk Factors That Develop Hypertension During Pregnancy Include:

    • Being overweight or obese.
    • Not getting enough physical activity.
    • Smoking.
    • Drinking alcohol.
    • First-time pregnancy.
    • A family history of pregnancy-related hypertension.
    • Carrying more than one child.
    • Age (over 35).
    • Assisted reproductive technology (such as in vitro fertilization, or IVF).
    • Having diabetes or certain autoimmune disease.

Symptoms Of Hypertension:

    • High blood pressure.
    • Too much protein in your urine (called proteinuria).
    • Swelling in your face and hands. Your feet may also swell. As many women have swollen feet during pregnancy, it may not be a sign of a problem. Best to talk to your obstetrician.
    • Headache that does not go away.
    • Vision problems, including blurred vision or seeing spots.
    • Pain in your upper right abdomen.
    • Trouble breathing.

Complications Of Hypertension During Pregnancy:

    • Placental abruption, where the placenta separates from the uterus.
    • Poor fetal growth, caused by a lack of nutrients and oxygen.
    • Preterm birth.
    • A low birth weight baby.
    • Stillbirth.
    • Damage to your kidneys, liver, brain, and other organ and blood systems.
    • A higher risk of heart disease.
    • 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 is a serious complication.

Treatment Of Hypertension During Pregnancy:
Delivering the baby can often cure preeclampsia and gestational hypertension. When making a decision about treatment, there are several factors that your provider should consider. They include how severe it is, the weeks of pregnancy, and the potential risks to you and your baby.
The factors are listed:

      • If you are more than 37 weeks pregnant, your provider will likely want to deliver the baby.
      • If you are less than 37 weeks pregnant, your health care provider will closely monitor you and your baby which include blood and urine test. Monitoring for the baby often involves ultrasound, heart rate monitoring, and checking on the baby's growth. You may need to take medicines, to control your blood pressure and to prevent seizures. Some women also get steroid injections, to help the baby's lungs mature faster. If the preeclampsia is severe, your provider may want you to deliver the baby early. Note that you may need admission during pregnancy for evaluation and to monitor your B.P.

The symptoms usually go away within 6 weeks of delivery. In rare cases, symptoms may not go away, or they may not start until after delivery (postpartum preeclampsia).


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