Introduction
Pregnancy is an exciting and life-changing journey, but it can also present its own set of challenges. One such challenge is the development of high blood pressure, or hypertension, during pregnancy. By understanding the risks, symptoms, and management of hypertension in pregnancy, you can take proactive steps to ensure your and your baby’s health and well-being. This article aims to provide you with essential information to help you navigate this complex issue.
Types of Hypertension in Pregnancy
There are three main types of hypertension that can affect pregnant women:
- Chronic hypertension: High blood pressure that exists before pregnancy or develops before 20 weeks of gestation.
- Gestational hypertension: High blood pressure that develops after 20 weeks of pregnancy without the presence of protein in the urine.
- Preeclampsia: A more severe form of hypertension in pregnancy that is accompanied by protein in the urine and can affect other organs.
Causes and Risk Factors
While the exact cause of hypertension in pregnancy remains unclear, certain factors can increase your risk:
- First-time pregnancies
- A personal or family history of hypertension or preeclampsia
- Pre-existing medical conditions, such as diabetes or kidney disease
- Obesity
- Advanced maternal age (over 35)
- Multiple pregnancies (twins, triplets, etc.)
- A long gap between pregnancies (10 years or more)
Symptoms and Warning Signs
Some pregnant women with hypertension may not experience any symptoms, highlighting the importance of regular prenatal care and monitoring. However, potential warning signs include the following:
- High blood pressure
- Swelling (oedema), especially in the face and hands
- Protein in the urine (proteinuria)
- Severe headache
- Vision problems, such as blurred vision or sensitivity to light
- Upper abdominal pain, usually on the right side
- Nausea or vomiting
- Sudden weight gain
- Shortness of breath
- Decreased urine output
Complications for Mother and Baby
Hypertension in pregnancy can pose risks to both the mother and baby. Maternal complications can include:
- Kidney or liver damage.
- Eclampsia (seizures).
- Stroke.
- HELLP syndrome (a severe form of preeclampsia).
- Placental abruption.
- An increased risk of future cardiovascular disease.
Potential complications for the baby include restricted growth, low birth weight, premature birth, respiratory problems, intrauterine growth restriction (IUGR), and stillbirth in severe cases.
Management and Treatment
The management and treatment of hypertension in pregnancy involve regular prenatal care, blood pressure monitoring, blood and urine tests, medications to control blood pressure, and fetal monitoring. Depending on the severity of the condition and the gestational age of the baby, the healthcare provider may recommend induction or a cesarean section for delivery. Postnatal care and follow-up are essential to monitor the health of both mother and baby.
Prevention and Reducing Risks
While not all cases of hypertension in pregnancy can be prevented, there are steps you can take to reduce your risks:
- Maintain a healthy weight
- Eat a balanced diet rich in fruits, vegetables, and whole grains
- Engage in regular physical activity
- Avoid smoking and alcohol
- Manage pre-existing medical conditions, such as diabetes or high blood pressure
- Attend regular prenatal care appointments and monitoring
Low-dose aspirin therapy may be recommended for women at high risk of developing preeclampsia. Consult your healthcare provider before starting aspirin therapy to ensure it is safe and appropriate for you.
Conclusion
Being well-informed and proactive in managing hypertension in pregnancy is crucial for the health of both you and your baby. By understanding the risks, symptoms, and management strategies, you can take charge of your pregnancy journey and work closely with your healthcare provider to make informed decisions.
Remember to attend regular prenatal care appointments and follow your healthcare provider’s advice to monitor and manage your blood pressure. If you experience any unusual symptoms or have concerns about your health, do not hesitate to contact your healthcare team for support and guidance.
At Sugabi Clinic, we are committed to providing individualised care and support for women during their pregnancy journey. By empowering our patients with knowledge, we hope to contribute to a healthy and positive pregnancy experience for both mother and baby. Visit www.sugabi.lk for more information on pregnancy-related conditions, advice, and resources.
References:
- National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management [Internet]. NICE; 2019 [cited 2023 Apr 4]. Available from: https://www.nice.org.uk/guidance/ng133
- Royal College of Obstetricians and Gynaecologists. Reducing the risk of venous thromboembolism during pregnancy and the puerperium [Internet]. RCOG; 2015 [cited 2023 Apr 4]. Available from: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg37a/
- Brown MA, Magee LA, Kenny LC, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice [Internet]. BJOG. 2018 [cited 2023 Apr 4];125(7):803-16. Available from: https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.15082
- Tommy’s. Pre-eclampsia [Internet]. Tommy’s; [cited 2023 Apr 4]. Available from: https://www.tommys.org/pregnancy-information/pregnancy-complications/pre-eclampsia
- Tommy’s. Gestational hypertension [Internet]. Tommy’s; [cited 2023 Apr 4]. Available from: https://www.tommys.org/pregnancy-information/pregnancy-complications/gestational-hypertension
- American College of Obstetricians and Gynecologists. Gestational hypertension and preeclampsia [Internet]. ACOG; [cited 2023 Apr 4]. Available from: https://www.acog.org/womens-health/faqs/gestational-hypertension-and-preeclampsia
- World Health Organization. Hypertensive disorders during pregnancy [Internet]. WHO; [cited 2023 Apr 4]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertensive-disorders-during-pregnancy
