High blood pressure during pregnancy: Causes and remedies

High blood pressure during pregnancy

High blood pressure among pregnant women is a common ailment that can put the child at risk and can also cause multiple complications during delivery. It is estimated that 1 in every 12 to 17 pregnant women in the United is affected by high blood pressure or hypertension. As per medical standards, blood pressure levels greater than or equal to 140/90 mm Hg can be considered as high. This is the pressure that the blood exerts on the walls of the arteries every time the heart pumps. Some women suffer from chronic high blood pressure which is already present before pregnancy. The other common condition is gestational hypertension, where high blood pressure develops in the second half of pregnancy. This goes away after delivery, but in some cases, there remains a risk of developing hypertension in the future.

High blood pressure can give rise to complications, but it is not a dangerous condition and can be effectively handled with the right amount of medical care. Apart from complicating the pregnancy, this condition can also increase the risk of stroke, heart attack and other health problems. In normal cases, a woman’s blood pressure drops during the second trimester and returns to normal after giving birth. On the other hand, gestational hypertension starts from the second or third trimester. In some cases, high blood pressure can be a sign of preeclampsia, which is a dangerous condition for both the mother and the child.

Adverse effects of hypertension during pregnancy

Hypertension can have the following adverse effects on a pregnant woman

Decreased blood flow

It can cause decreased blood flow to the placenta, which can result in the baby receiving less oxygen and fewer nutrients. This can lead to slow growth, low birth weight and even premature birth in some scenarios. This can also read to the reduced growth of the baby.

Preeclampsia

Placental abruption or preeclampsia increases the risk of the placenta separating from the inner wall of the uterus much before delivery. This can lead to heavy bleeding, which can be life-threatening for the mother as well as the child.

If not controlled, hypertension can result in injury to the brain, heart, lungs, kidneys, liver and other major organs.

In some cases, premature delivery might be necessary to avoid any life-threatening conditions arising from high blood pressure.

Preeclampsia can increase the overall risks of health conditions like high blood pressure, stroke, heart disease and cardiovascular kidney disease in the future.

The types of high-pressure conditions during pregnancy

These are some of the common scenarios of high blood pressure during pregnancy.

Gestational hypertension

In general gestational hypertension occurs after 20 weeks of pregnancy. There is no protein detected in the urine or any change in liver function in this condition. It is temporary in general and goes away after childbirth. In some cases, gestational hypertension can lead to preeclampsia.

Chronic hypertension

This is the type of high blood pressure that was present before pregnancy, or it was developed within the first half of pregnancy. Since the condition does not have any particular symptoms, it is difficult to determine when it began. This condition can result in an abnormal amount of protein in their urine, along with certain changes in liver function.

Preeclampsia

Preeclampsia is an advanced stage of gestational hypertension, and it is associated with signs of damage to other organ systems. This can include the kidneys, liver and the brain. If left untreated, preeclampsia can be fatal for both the mother and baby, and can even lead to seizures. Previously, preeclampsia was diagnosed through a blood and urine test, but currently, the condition can occur even without the trace of protein in the urine. Some symptoms that can accompany the condition are listed below.

• high blood pressure
• proteinuria
• excessive swelling of the face and hands and weight gain due to fluid retention
• headaches
• dizziness
• irritability
• shortness of breath
• abdominal pain
• nausea and vomiting
• sensitivity to light

The effects of high blood pressure

The first number provided in a blood pressure reading is the pressure when the heart contracts and is called the systolic blood pressure. The second number is the pressure when the heart relaxes, and it is called the diastolic blood pressure. In general, hypertension can be classified into three categories based on the measurements. Blood pressure measurements give two figures. These are mentioned as follows.

• A mild level of blood pressure when the readings are between 140/90 and 149/99 mm of Hg.
• A moderate high blood pressure when the readings are between 150/100 and 159/109 mm of Hg.
• In case the levels are around 160/110mm of Hg or higher, it is classified as very high or severe blood pressure.

Effects on the mother

As per the latest studies, high blood pressure during pregnancy can increase the risk of health complications later in life. These include higher risks for ischemic heart disease, myocardial infarction (heart attack), heart failure and ischemic stroke. If it is not controlled, there may be higher risks of developing preeclampsia and gestational diabetes. HELLP syndrome is another rare but life-threatening condition that affects the liver, and is considered as an advanced form of preeclampsia. This condition has various stages that involve breaking down of red blood cells, liver damage and a drop in the platelet level. The other complications arising for hypertension during pregnancy include chances of stroke, placental abruption and preterm delivery.

Effects on the baby

High blood pressure can have multiple adverse effects on the baby. This includes reduced and restricted growth and can even lead to the death of the infant. Due to the effect of high blood pressure on the blood vessels of the mother, the flow of nutrients into the placenta can decrease. This can lead to low birth weight and poor health conditions for the baby. Severe conditions can include scenarios where breathing difficulties may arise due to the improper growth of the lungs.

Diagnosis of high blood pressure during pregnancy

High blood pressure is usually detected during a prenatal check-up which is something pregnant women should not miss. During a check-up, the blood pressure levels are checked to find whether there has been a sudden increase. A urine sample is also tested to check for signs of protein. Excessive protein in the urine can be a sign of kidney damage which can be related to preeclampsia. The weight is also checked as rapid weight gain is also another sign of preeclampsia. If high blood pressure is found, there will be regular check-ups to monitor the condition of the mother and the baby. This can include the following steps.

• Using an electronic foetal heart monitoring device to record the heart rate of the baby.
• Foetal ultrasound check is done on the baby, the placenta, and also on the amniotic fluid.
• In some cases, a Doppler ultrasound is used to check the overall functionality of the placenta.

In case the diagnosis reveals that the patient is at high risk for pre-eclampsia, other tests can be conducted. This can include blood tests to check for any signs of kidney damage along with a creatinine clearance test to check kidney functionality. If you have been consuming blood pressure controlling medicines from before the pregnancy, you should inform the doctor immediately about the same. This is because some medicines interfere with the blood flow to the placenta and are not safe for consumption during pregnancy. In some cases, a woman’s blood pressure can fall during the first half of the pregnancy. The doctor can take her off the medication during this period, but she is monitored closely for any rise in the blood pressure levels.

What causes pre-eclampsia in women?

The exact cause behind the occurrence of pre-eclampsia is not known. The following factors are considered to be capable of presenting higher risks.

• Occurrence of pre-eclampsia in a past pregnancy
• Being pregnant with more than one foetus
• Chronic hypertension
• Kidney disease
• Diabetes mellitus or high blood sugar
• Autoimmune conditions, such as lupus 

Risk factors that can place women at moderate risk include the following

• Being pregnant for the first time
• Having a body mass index (BMI) over 30
• A family history of pre-eclampsia (mother or sister)
• Being older than 35
• Being African American

Treatments for Preeclampsia

The right treatment for preeclampsia is very important, and it should commence as soon as the condition is diagnosed. The treatment is dependent on various factors like the severity of the condition, the associated risks and how many weeks pregnant the patient is. In many cases, the process of delivery can cure preeclampsia. If pregnancy has progressed for more than 37 weeks, the doctor can suggest the delivery of the baby. If the patient is less than 37 weeks pregnant, the condition is closely monitored with blood and urine tests. In case preeclampsia is severe, the doctors can also suggest an early delivery. Medicines can be given to control blood pressure levels and prevent the occurrence of seizures. In some cases, steroids are used to ensure that the lungs of the baby grow at the normal route.

Steps to prevent high blood pressure during pregnancy

 In case you are suffering from chronic hypertension, the following steps can be taken to reduce the risks during pregnancy.

Pre-conception check-up

You can opt for a preconception check-up that can help in taking care of health conditions that may affect the pregnancy. This will also help to control the conditions in the best possible manner.

Medical consultation

You can take advice from your doctor about using birth control methods to prevent pregnancy until the blood pressure levels come under normal values.

Weight management

If you are suffering from obesity, then take the right methods to bring your weight under control. It is necessary to ensure that whatever weight you gain during pregnancy should be within the normal limits.

Physical exercise

Follow a healthy lifestyle which involves staying active with the right level of exercise as advised by the doctor. Following a consistent physical routine can also have a positive impact on the health of the baby. If you are not into exercising, activities like walking and swimming can be good options to stay healthy. 

Healthy diet

Eating the right kind of food is also an important part step to avoid high blood pressure. Some studies have indicated that dietary fibres can reduce blood pressure levels. Foods like legumes, vegetables, proteins and whole grains can help in achieving this. Food items like prunes, raisins, kidney beans, tomatoes and bananas contain potassium which helps reduce blood pressure levels.

While sodium is an essential element needed for the body, excess intake can cause hypertension. You can reduce the consumption of processed foods and fast foods that contain high amounts of sodium. 

Smoking cessation

Smoking is a major reason behind high blood pressure as it causes significant damage to the walls of the blood vessels. Saying no to smoking is an important step to prevent high blood pressure. Alcohol consumption can also affect blood pressure levels, and it is best to avoid that during pregnancy.

Stress management

Stress is something that can elevate blood pressure levels and causes distress to the body. Hence avoiding anxiety and keeping the body and mind relaxed is an important step that can be taken. Practicing meditation, yoga, and other relaxation techniques can be useful in this regard.

Conclusion

High blood pressure or hypertension during pregnancy can be fatal and life-threatening if it is left untreated. It can also cause damage to the infant if the right steps are not taken. However, in most cases, it does not lead to major complications, and the pressure levels go back to normal after childbirth. The condition can be handled effectively, and the safety of the mother and the baby can be ensured once it is detected. In case there is any risk of life-threatening health complications, the doctors closely monitor the pregnancy. So women with high blood pressure should not miss the prenatal evaluation sessions. They must report or inform any abnormal signs and symptoms they notice to the doctor. This helps ensure their complete safety.

References

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