High blood pressure in pregnancy

High blood pressure, also known as hypertension, can develop during pregnancy and may lead to complications if not properly managed. Here to tell us all about is leading obstetrician and sub-specialist in foetal and maternal medicine, Dr Emma Shawkat.

What is high blood pressure in pregnancy?

It occurs when the force of blood against the artery walls is too high, which can strain the heart and damage blood vessels. While some women may already have hypertension before becoming pregnant, others develop it during pregnancy. When this happens, it is classified as gestational hypertension or pre-eclampsia.

What are the types of high blood pressure in pregnancy?

• Chronic hypertension: High blood pressure that existed before pregnancy or develops before 20 weeks of pregnancy.
• Gestational hypertension: High blood pressure that develops after 20 weeks of pregnancy, with no signs of organ damage.
• Pre-eclampsia: A serious condition that usually occurs after 20 weeks, characterised by high blood pressure and signs of damage to other organ systems, particularly the liver and kidneys.

What are the symptoms of pre-eclampsia?

Pre-eclampsia is a dangerous condition that requires immediate medical attention. Its symptoms may include:

• Severe headaches
• Vision changes (e.g., blurred vision, seeing spots)
• Swelling in the hands, face, or feet
• Pain in the upper abdomen
• Shortness of breath

In some cases, women may have no symptoms, so regular monitoring of blood pressure during pregnancy is essential.

How is high blood pressure in pregnancy diagnosed?

High blood pressure in pregnancy is typically diagnosed during routine prenatal visits, where blood pressure readings are taken. If a woman’s blood pressure exceeds 140/90 mmHg on two separate occasions, it may indicate gestational hypertension or pre-eclampsia. Additional tests may include:

• Urine tests to check for protein (a sign of pre-eclampsia)
• Blood tests to assess kidney and liver function
• Ultrasounds to monitor the baby’s growth
• Non-stress tests to evaluate the baby’s heart rate

What are the risks of high blood pressure in pregnancy?

If left untreated, high blood pressure can lead to complications for both mother and baby, such as:

• Preterm birth: Babies may need to be delivered early if blood pressure becomes too high.
• Low birth weight: Reduced blood flow to the placenta can slow the baby’s growth.
• Placental abruption: The placenta may detach from the uterine wall prematurely, leading to heavy bleeding.
• Organ damage: Pre-eclampsia can cause damage to the mother’s liver, kidneys and other organs.
• Eclampsia: A severe form of pre-eclampsia that causes seizures and can be life-threatening for both mother and baby.

How is high blood pressure in pregnancy treated?

Treatment depends on the severity of the hypertension and the stage of pregnancy. In mild cases, blood pressure may be monitored closely without immediate intervention. However, more serious cases may require medication to lower blood pressure, bed rest, or hospitalisation. If pre-eclampsia or eclampsia is diagnosed, early delivery of the baby may be necessary to prevent further complications.

Management tips for high blood pressure during pregnancy include:

• Monitoring blood pressure regularly
• Following a balanced diet low in salt
• Engaging in light exercise (if approved by a doctor)
• Taking prescribed medication, if necessary
• Attending all prenatal appointments

Can high blood pressure in pregnancy be prevented?

While some risk factors for high blood pressure, such as genetics and pre-existing conditions, cannot be changed, certain lifestyle choices may help reduce the risk. Maintaining a healthy weight, staying physically active, and eating a balanced diet can all contribute to better overall health during pregnancy. Regular prenatal check-ups are crucial for early detection and management of hypertension.

If you have a history of high blood pressure or pre-eclampsia, it’s important to work with your healthcare provider to create a plan for managing your blood pressure throughout your pregnancy.

Are you concerned about high blood pressure in pregnancy? Arrange a consultation with Dr Shawkat via her Top Doctors profile.