High Blood Pressure During Pregnancy – What is the Risk?
Nearly about 10 to 12% of pregnant women may suffer from hypertension during pregnancy. Hypertension is the main cause of maternal deaths in pregnant women in India as nearly 12 to 15% of pregnant women succumb to it and high blood pressure accounts for nearly about 23% deaths across the world. Overall 10 to 12% of pregnancy-related complications in India are due to hypertension during pregnancy. Therefore, managing high blood pressure during pregnancy is very important.
What is high blood pressure?
Blood pressure higher than 140/90 mm Hg is considered as hypertension or high blood pressure. If hypertension extends beyond 20 weeks of pregnancy severe complications like preeclampsia may develop. High blood pressure can develop before pregnancy or after becoming pregnant. If high blood pressure is present before pregnancy without manifestations of any symptoms, then it is chronic hypertension; if it develops 20 weeks after pregnancy, then it is gestational hypertension and if the chronic blood pressure that worsens during pregnancy with the appearance of protein in urine then it is chronic hypertension with superimposed preeclampsia. Both gestational and chronic hypertension may lead to high blood pressure with the signs of internal organ damage (preeclampsia), which may lead to severe complications both for the baby and the mother. Therefore, high blood pressure if not managed properly may lead to fetal, neonatal and maternal morbidity and mortality.
Causes: The causes of high blood pressure during pregnancy are many and a few of them include obesity or being overweight, alcohol abuse, smoking, sedentary lifestyle, family history, age, first pregnancy and carrying two babies.
Symptoms of high blood pressure during pregnancy: headache, nausea, less amount of urine, rapid heartbeat, abdominal pain, ringing in ears, blurred vision, double vision, vomiting, swollen hands and feet, dizziness and fever
Preeclampsia symptoms: upper abdominal pain, severe headache, severe nausea, vomiting, proteinuria, blurred vision, less urine output, thrombocytopaenia – low platelets count, shortness of breath, pain in the ribs on the right side, accumulation of fluid in the lungs, liver dysfunction, and kidney problems.
It is difficult to ascertain whether high blood pressure during pregnancy is due to gestational hypertension, preeclampsia or chronic hypertension. Medical history, clinical examination, symptoms and some laboratory investigations may help confirm the diagnosis.
The blood pressure of a pregnant woman is checked during every visit to a doctor. A sharp increase in blood pressure is an early sign of pregnancy-induced hypertension. If the physician notices that the blood pressure is high, then they may recommend the pregnant woman to visit the clinic at regular intervals.
If a woman has chronic hypertension, these tests are recommended: CBC count, a spot urine protein/creatinine ratio, a urine dip for protein, 24-hr urine for creatinine clearance, BUN, liver enzymes, creatinine, etc. When there is a risk of superimposed preeclampsia, bilirubin, thyroid-stimulating hormone, uric acid, calcium, sodium, potassium, glucose, 24-hr urinary protein, glycosylated haemoglobin and albumin may also be ordered.
Available Treatment plans
Hypertension management depends on the type of blood pressure, age and associated risk factors. It includes both pharmacological and non-pharmacological management including dietary control, lifestyle modification, activities, rest and medication.
Indulge yourself in daily physical activity or exercise recommended by your obstetrician and physiotherapist, avoid alcohol, tea coffee and any other beverage containing caffeine; take rest, elevate feet while sitting and lying, consume less salt; drink plenty of water, avoid junk foods and fried foods and enhance protein intake, get your routine health check-ups done promptly.
Take the medicines and supplements prescribed by your physician. Go for Yoga and meditation as they minimize stress.
Dr T. Rajeshwari Reddy
MBBS, MS (OBG), DES (Germany), FAMS (New Delhi), PGPMAX (ISB)
Consultant Obstetrician, Gynaecologist & Laparoscopic Surgeon
Department of Obstetrics and Gynaecology