Gestational Hypertension
Gestational hypertension happens when you only have high blood pressure during pregnancy and do not have protein in your urine or other heart or kidney problems. It is typically diagnosed after 20 weeks of pregnancy or close to delivery. Gestational hypertension usually goes away after you give birth. It is also known as pregnancy induced hypertension(PIH). Hypertension during pregnancy affects about 6-8% of pregnant women.
Symptoms –
Symptoms can occur a bit differently in each pregnancy.
The main symptom is high blood pressure in the second half of pregnancy. But some women don’t have any symptoms.
High blood pressure in pregnancy can lead to other serious issues. These can include preeclampsia. You should watch for signs of high blood pressure. They can include –
• Headache that doesn’t go away
• Edema (swelling)
• Sudden weight gain
• Vision changes, such as blurred or double vision
• Nausea or vomiting
• Pain in the upper right side of your belly, or pain around your stomach
• Making small amounts of urine
Causes –
The exact cause of hypertension during pregnancy is unknown. Certain conditions or factors may increase your risk
Risk Factors –
You may be more likely to develop high blood pressure during pregnancy if you:
• Are under age 20 or over age 40.
• Have had gestational hypertension or preeclampsia during past pregnancies.
• Have a family history of gestational hypertension.
• Have diabetes or gestational diabetes.
• Have an immune system disorder, such as lupus.
• Have kidney disease.
• Are expecting multiple babies (twins, triplets or more).
Complications –
High blood pressure during pregnancy poses the following complications-
• Less blood flow to the placenta. If the placenta doesn’t get enough blood, the fetus might receive less oxygen and fewer nutrients. This can lead to slow growth (intrauterine growth restriction), low birth weight or premature birth. Babies born early can have breathing problems, increased risk of infection and other complications.
• Placental abruption. In this condition, the placenta separates from the inner wall of the uterus before delivery. Preeclampsia and high blood pressure increase the risk of placental abruption. Severe abruption can cause heavy bleeding, which can be life-threatening for you and your baby.
• Intrauterine growth restriction. High blood pressure might result in slowed or decreased fetal growth.
• Injury to other organs. Poorly controlled high blood pressure can result in injury to the brain, eyes, heart, lungs, kidneys, liver and other major organs. In severe cases, it can be life-threatening.
• Premature delivery. Sometimes an early delivery is needed to prevent life-threatening complications from high blood pressure during pregnancy.
• Future cardiovascular disease. Having preeclampsia might increase the risk of future heart and blood vessel (cardiovascular) disease. The risk of future cardiovascular disease is higher if you’ve had preeclampsia more than once. It’s also higher if you’ve had a premature birth due to having high blood pressure during pregnancy.
Diagnosis –
If your provider sees any changes in your usual blood pressure readings or gets a higher-than-normal reading, they may suspect you have hypertension. Checking your blood pressure later in the appointment for a more normal reading is the first course of action. If your blood pressure doesn’t stabilize, your provider may perform additional tests.
Other than additional blood pressure readings, your provider may also:
• Check your urine for protein.
• Check you for swelling.
• Perform blood tests to check liver and kidney function and blood clotting factors.
Treatment –
Treatment depends on how close you are to your due date. If you are close to your due date and the baby is developed enough, your health care provider may want to deliver your baby as soon as possible.
If you have mild hypertension and your baby is not fully developed, your doctor will probably recommend the following –
• Rest, lying on your left side to take the weight of the baby off your major blood vessels.
• Increase prenatal checkups.
• Consume less salt.
• Drink 8 glasses of water a day.
If you have severe Hypertension, your doctor may try to treat you with blood pressure medication until you are far enough along to deliver safely.
Self-care
Taking good care of yourself is the best way to take care of your baby. For example:
• Keep your prenatal appointments. Visit your health care provider on a regular basis throughout your pregnancy.
• Take your blood pressure medication and low-dose daily aspirin as prescribed. Your health care provider will prescribe the safest medication at the most appropriate dose.
• Stay active. Follow your health care provider’s recommendations for physical activity.
• Eat a healthy diet. Ask to speak with a dietitian if you need help planning meals.
• Know what’s off-limits. Avoid smoking, alcohol and illegal drugs. Talk to your health care provider before taking nonprescription medications.
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