Hypertension, or high blood pressure, during pregnancy is not an uncommon issue. Between 5.8 and 8.3% of women age 20 to 44 experience hypertension while pregnant, according to data from the Centers for Disease Control and Prevention. Unfortunately, this percentage is growing, mostly due to the continued obesity epidemic in the United States.
High blood pressure can have dire consequences for both expectant mothers and their babies. When blood pressure is uncontrolled, it may lead to preeclampsia (high blood pressure that leads to damage to another organ system, usually the liver and kidneys during pregnancy) and eclampsia (a severe complication of preeclampsia that results of seizures and convulsions before, during or after pregnancy), which are life-threatening conditions. Furthermore, women who experience high blood pressure during their pregnancies are more likely to deliver preterm babies and babies with low birth weights than women with normal blood pressure values.
Fortunately, women can take several effective measures to control and reduce their blood pressure during pregnancy. Here are useful pieces of advice and facts about pregnancy hypertension.
What is High Blood Pressure?
Normal blood pressure should be no higher than 120/80 mmHg. If a woman consistently has blood pressure readings higher than this number while at rest, she will likely be diagnosed with hypertension. Of course, a woman may have hypertension before she becomes pregnant. In this case, the condition is called chronic hypertension.
Doctors have named hypertension as a “silent killer” because it often causes no obvious symptoms. While there may be apparent signs of extremely high blood pressure or hypertension that has caused organ damage, most cases of hypertension are only revealed by blood pressure checks. This fact is one reason why prenatal visits to an OB-GYN are so vital.
Blood pressure readings are performed at each prenatal visit to help ensure the expectant mother has healthy blood pressure. Furthermore, these visits are an opportunity for counseling on ways to reach or maintain normal blood pressure.
What is Preeclampsia and Eclampsia?
When a woman who has previously had normal blood pressure values develops hypertension after the 20th week of pregnancy, the condition is called gestational hypertension. Preeclampsia is gestational hypertension with evidence of organ damage. Preeclampsia presents a risk to the health and life of the mother and child. In fact, preeclampsia is the most common cause of preterm births.
If the pregnancy has progressed far enough, women with preeclampsia may need induction of labor. Medications may be able to help with preeclampsia, and all women with preeclampsia require close monitoring.
The top risk factors for preeclampsia are:
- Maternal age under 20 or older than 35
- Preeclampsia in a previous pregnancy
- Women with chronic hypertension
- Women carrying multiple fetuses
- Maternal obesity with a Body Mass Index of 30 or greater
- Sickle cell disease
Eclampsia is a more severe form of preeclampsia. Although eclampsia is rare among women in the US, it is an extremely serious condition. In eclampsia, maternal blood pressure has become so high that brain damage occurs, and seizures and/or coma ensue.
Prevention Starts Before Pregnancy
You can go a long way toward preventing hypertension and related problems during your pregnancy by scheduling a visit with your OB-GYN before you even attempt to become pregnant. During this visit, your OB-GYN will perform a physical examination and review your medical history. They will let you know if your blood pressure is normal and review any risk factors for hypertension you may have.
If you are overweight, now is the time to get down to a healthy weight. Your OB-GYN will also review your nutritional requirements and recommend a healthy diet that’s right for you during pregnancy.
In addition, the American College of Obstetricians and Gynecologists (ACOG) recommends taking a daily low-dose aspirin (81-mg) to help prevent the onset of preeclampsia. This is typically prescribed late in the first trimester for women with a history or risk factors of preeclampsia. As always, patients should defer to their OB-GYN before taking any kind of medication during pregnancy.
Even if you already take medication for hypertension, you should still work with your OB-GYN and primary care provider to reduce your blood pressure before you become pregnant. Several classes of common anti-hypertensive medications cannot be taken by pregnant women due to potential harm to the fetus, so you may need medication adjustments. As a reminder, it’s important to keep every member of your healthcare team apprised of the drugs you take, including over-the-counter medications.
If you are already at a healthy weight, be sure that you continue to exercise appropriately before and during your pregnancy. A sedentary lifestyle may increase the risk of gestational hypertension, so it is important that you stay active and maintain a healthy diet even if you are not overweight.
Once you become pregnant, keeping up with your scheduled prenatal OB-GYN visits will be your best defense against developing hypertension. With gestational hypertension and preeclampsia potentially not producing any obvious symptoms, these conditions are often first diagnosed during a regularly scheduled prenatal appointment.
To request an appointment with Dr. John Garofalo, OB-GYN, in his Norwalk, CT based practice, please click here.
About the Connecticut OBGYN Practice
Dr. John Garofalo, M.D., is a CT OBGYN based in Fairfield County, providing care for Norwalk, Darien, New Canaan, Weston, Rowayton and the surrounding areas. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.
Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Women undergoing signs and symptoms of menopause can make an appointment with Laury for Hormone Replacement Therapy. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.