High Blood Pressure in Pregnancy
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High blood pressure in pregnancy is one of the most delicate pregnancy complications that directly affect the growing baby’s health and well-being.

A blood pressure reading of 140/90 mmHg or above, at more than 2 occasions is referred to as high blood pressure. The reading of 140 is called systolic – taken when the heart pumps blood to the peripheral organs while the bottom reading of 90 mmHg is called diastolic - obtained when the heart receives and gets filled with blood.

Chronic hypertension is often used to describe a pre-existing state of high blood pressure in a pregnant woman before the time she got pregnant or a condition of diagnosed hypertension within the first 20 weeks of pregnancy.

Although high blood pressure in pregnancy is associated with a number of complications in the developing baby, adequate blood pressure control often avert most possible complications.

How can High Blood Pressure affect Pregnancy progression?

High blood pressure increases the risk of a number of fetal complications by interfering with blood supply to the baby via placenta, given rise to increased resistance in blood flow to the baby thus resulting in lower than required blood supply.

Insufficient blood supply implies the growing baby will receive less nutrients and oxygen with possible consequences such as:

  • Intrauterine growth restriction (IUGR) that refers to growth retardation in the baby.
  • Pre-mature delivery of the baby, referring to onset of active labor before 34 weeks of gestation.
  • Abruption of placenta, a complication of severely high blood pressure in pregnancy that may lead to separation of placenta before delivery of the baby. It’s a life-threatening situation and often associated with a very high number of fetal deaths.
  • Still birth, in which pregnancy may continue normally until full term, and then the baby is delivered dead. This is mostly because the growth-restricted baby may be incapable of bearing the pressure of delivery through vaginal birth canal.

However, all these complications are seen in women who have poorly controlled high blood pressure in pregnancy.

What maternal factors increase the risk of complications in developing baby?

  • If maternal blood pressure in pregnancy is very high for most part of the pregnancy.
  • If chronic high blood pressure has led to systemic damage to vital organs of the pregnant mom such as the kidney and heart.
  • If such woman has developed pre-eclampsia in pregnancy. Pre-eclampsia is a state of high blood pressure that is associated with appearance of protein in urine leading to edema or swelling of the pregnant woman body. This may possibly increases the risk of liver damage and seizure activity in the expecting mom (eclampsia).
  • Co-existence of other maternal issues like diabetes, anemia and others.
  • Old Age. High blood pressure is one of the common pregnancy complications in older women, over 35, especially in first pregnancy.
  • Other factors that increase the risk of pregnancy high blood pressure include overweight or obesity, multiple pregnancy etcetera.

How can I Prevent Complications due to High Blood Pressure in Pregnancy?

If you’re a confirmed patient of high blood pressure, your healthcare provider may change your regimen a bit to avoid drug-induced complications in your baby.

The key to avoid any complication during pregnancy is to stick to your therapy and see your doctor for regular medical and antenatal check-ups.

Keep up with all the tests and investigations your doctor may advise from time to time especially urine tests, EKG and eye examination.

Most importantly, blood pressure testing is crucial as most pregnant women develop low blood pressure due to changes in the amount and activity of different pregnancy hormones. If your blood pressure is low during pregnancy, your doctor may taper-off or temporarily stop your anti-hypertensive therapy.

Don’t stop any medication on your own and don’t exercise during pregnancy without supervision if you suffer high blood pressure in pregnancy.

Any decision on safe or unsafe medication or lifestyle must be in strict consultation with your doctor. Once again, keep up with all your antenatal check-ups and discuss with your physician regarding any warning signs you may notice.

How can I monitor high blood pressure in pregnancy and its complications?

For all hypertensive expecting moms, frequent antenatal check-ups are very important in preventing maternal or fetal complication as well as monitoring the growth and development of your baby.

You may have to undergo repeated ultrasound examination in second and third trimesters of pregnancy followed by fetal stress and non-stress testing including bio-physical profile testing in late third trimester in order to ascertain your baby is under no stress or distress.

Moreover, you’ll also have to modify your lifestyle as well. Smoking and alcohol consumptions are strictly prohibited in expecting moms with the illness of high blood pressure in pregnancy.

Generally, it’s advised you consume low salt in your diet throughout pregnancy and ideally maintain a hypertensive pregnancy diet plan in consultation with a registered dietitian.

Research studies have shown that intake of calcium supplements or foods may help to control blood pressure, alleviate hypertension and pre-eclampsia. But high salt and caffeine consumption interferes with the absorption of calcium by your body, so keep their consumption low.

What are the warning signs of high blood pressure in pregnancy?

Here are the warning signs you must beware. Report immediately to your healthcare provider if:

  • You notice a decrease in frequency of fetal movements.
  • Severe throbbing headache with or without nausea, abdominal pain, vomiting or palpitation
  • Increase in swelling or puffiness of face, legs or body (more than normal).
  • Changes in the visual field like blurry vision, sparks of light or light sensitivity (photo-phobia)

Although pregnancy high blood pressure is associated with a number of complications, but if proper antenatal care is provisioned, the risk of complications may decline significantly and many expecting moms who suffer high blood pressure in pregnancy will end up having uneventful pregnancy.

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