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Blood pressure is the force of blood pushing against the walls of the arteries, the vessels carrying blood from the heart to the rest of the body. High blood pressure (hypertension) raises the risk of heart disease, heart attack and stroke — and during pregnancy it can cause problems for both parent and baby. That is why it should be treated before, during and after pregnancy.
The types
| Type | What it is |
|---|---|
| Gestational hypertension | high blood pressure that starts after 20 weeks of pregnancy, usually with no other symptoms. Often harmless and gone within 12 weeks after birth, but it raises the risk of high blood pressure later; if severe, it can lead to preterm birth or low birth weight, and some people go on to develop preeclampsia |
| Chronic hypertension | high blood pressure that began before pregnancy or before 20 weeks. Some people have had it for years without knowing until a prenatal check. It can also lead to preeclampsia |
| Preeclampsia | a sudden rise in blood pressure after 20 weeks, usually in the last trimester, often with signs of damage to organs such as the liver or kidneys — for example protein in the urine. It can be serious or even life-threatening |
| Eclampsia | preeclampsia severe enough to affect the brain, causing seizures or coma |
| Postpartum preeclampsia | preeclampsia that, rarely, begins after delivery; with seizures it is postpartum eclampsia |
| HELLP syndrome | preeclampsia or eclampsia with damage to the liver and blood cells — rare but very serious |
Who is at higher risk
- chronic high blood pressure or chronic kidney disease before pregnancy
- high blood pressure or preeclampsia in an earlier pregnancy
- obesity
- being under 20 or over 40
- carrying more than one baby
- being African American
- a family history of high blood pressure in pregnancy
- conditions such as diabetes or lupus
Warning signs
High blood pressure itself usually has no symptoms; it is found when a provider measures it. Preeclampsia can also cause:
- too much protein in the urine (proteinuria)
- swelling of the face and hands (swollen feet alone are common in pregnancy and may not mean a problem)
- a headache that won’t go away
- vision problems — blurring or seeing spots
- pain in the upper right belly
- trouble breathing
Eclampsia can also bring seizures, nausea or vomiting and low urine output; HELLP syndrome can add easy bleeding or bruising, extreme fatigue and liver failure.
Possible complications
- placental abruption — the placenta pulling away from the uterus
- poor fetal growth from too little oxygen and nutrients
- preterm birth and low birth weight
- damage to the kidneys, liver, brain and other organs and blood systems
- a higher risk of heart disease for the parent
Diagnosis
Blood pressure and urine are checked at every prenatal visit. A reading of 140/90 or higher, especially after 20 weeks, usually leads to blood tests and other lab tests, such as a check for extra protein in the urine.
Treatment
With high blood pressure, parent and baby are monitored closely. You may need to:
- check your blood pressure at home
- count the baby’s kicks each day
- adjust your physical activity, as your provider advises
- take blood pressure medicine that is safe for the baby
- take aspirin from the second trimester, if you are at risk of preeclampsia and your provider recommends it
- see your provider more often to track the baby’s growth and heart rate
Eclampsia, HELLP syndrome or severe preeclampsia usually mean a hospital stay, often with medicines, and sometimes early delivery. That decision weighs how severe the condition is, the risks to parent and baby, and how far along the pregnancy is — aiming to lower the parent’s risk while giving the baby as much time as possible to mature. Preeclampsia symptoms can continue after delivery but usually clear within 6 weeks.
Sources
Based on "High Blood Pressure in Pregnancy," MedlinePlus, U.S. National Library of Medicine; a work of the United States government in the public domain.
Лицензия: CC0 1.0 (общественное достояние) · По материалам medlineplus.gov
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