Gestational Hypertension: Manage High BP in Pregnancy

Key Takeaways:

1. Gestational hypertension may happend after 20 weeks of pregnancy and affects 6-8% of pregnant women.

2. Risk factor and causes of gestational hypertension include age, previous history, family background, diabetes, immune conditions, kidney issues, multiple pregnancies, and ethnicity increase risk.

3. Complications that may occur are placental abruption, premature birth, C-section, and preeclampsia.

4. Signs and Symptoms are increased blood pressure, swelling, sudden weight gain, visual changes, nausea, abdominal discomfort, and altered urination patterns.

Introduction

Gestational hypertension is high BP that starts after 20 weeks of pregnancy. It may cause complications for both the mother and the child.

About 6 to 8% of women develop high BP during pregnancy. However, gestational hypertension is preventable and treatable with the proper awareness and help.

Define gestational hypertension

Gestational hypertension is a condition where high blood pressure arises after the 20th week of pregnancy. It is also called pregnancy-induced hypertension (PIH). It resolves shortly after childbirth.

Gestational hypertension can progress to preeclampsia, particularly in specific demographic groups such as

  • First-time young mothers
  • Women over 35
  • Those with chronic hypertension
  • African-American women
  • Women with diabetes

PIH Diagnosis involves blood pressure readings exceeding 140/90 mm Hg post the 20th week of pregnancy, without proteinuria (excess protein in the urine).

 gestational hypertension

Causes of pregnancy induced hypertension

While the exact cause of gestational high blood pressure is unknown, certain factors increase your risk. These factors include:

  1. Age: Being under 20 or over 40.
  2. Previous History: Having gestational hypertension or preeclampsia in prior pregnancies.
  3. Family Background: A family history of gestational hypertension.
  4. Diabetes: Pre-existing diabetes or gestational diabetes.
  5. Immune System Conditions: Disorders like lupus affecting the immune system.
  6. Kidney Issues: Pre-existing kidney disease.
  7. Multiple Pregnancies: Expecting twins, triplets, or more.
  8. Ethnicity: Higher prevalence among Black individuals.

High blood pressure complications during pregnancy

Pregnant women with hypertension can have normal pregnancies. However, they are at a higher risk of complications. These may include-

  • Placental abruption: When a placenta separates from the uterus earlier than expected.
  • A premature birth: The act of giving birth before the due date.
  • Cesarean section (C-section): Delivery of the baby through a surgical incision in the belly and uterus.
  • Preeclampsia: Preeclampsia involves high blood pressure, along with signs such as protein in the urine and dysfunction in the liver and kidneys.

If you already have hypertension, you should consult your doctor about these risks and possible surveillance during pregnancy.

If you develop gestational hypertension, it increases your risk of developing hypertension in the future.

Signs and symptoms of hypertension during pregnancy

Often, hypertension doesn't have any visible symptoms. However, the symptoms can differ among individuals. Hence, some women with gestational hypertension may experience noticeable signs.

Common symptoms of high blood pressure in pregnancy:

  1. Increased blood pressure: Reading higher than 140/ 80 mm Hg measured on 2 or more occasions.
  2. Edema (swelling): Swelling, particularly in the extremities.
  3. Weight gain: Sudden and unexplained weight gain.
  4. Visual changes: Blurred or double vision.
  5. Nausea and vomiting: Persistent nausea and vomiting could indicate hypertension.
  6. Abdominal discomfort: Pain around the stomach or in the right-sided upper abdomen.
  7. Urination patterns: Peeing small amounts at a time.

What are the different forms of high blood pressure during pregnancy?

During pregnancy, high blood pressure can be of three types. Understanding the specific type is crucial for tailored care and effective management. Correct identification ensures a healthy outcome for both you and your baby.

1. Chronic Hypertension in Pregnancy

Chronic hypertension is high blood pressure that is already present before pregnancy, diagnosed within the first 20 weeks of gestation, or not resolved after 12 weeks of giving birth. This type of hypertension is present in about 5% of all pregnancies.

2. Gestational Hypertension

Gestational hypertension is a new onset that starts after 20 weeks of pregnancy.

3. Preeclampsia

Preeclampsia is characterized by the development of hypertension and protein in the urine after 20 weeks of gestation. It causes for 2% to 8% of pregnancy-related complications worldwide.

The symptoms of preeclampsia are-

  • Protein in urine
  • Hands or face swelling
  • Headache that won't go away
  • Changes in vision or spots in the eye
  • Upper abdominal or shoulder pain
  • A feeling of nausea and vomiting (especially during pregnancy's second half)
  • Gaining weight suddenly
  • Breathing problems
different forms of high blood pressure during pregnancy
Image credit: Markers of Cardiovascular Risk Associated with Pregnancy - Scientific Figure on ResearchGate.

How does gestational hypertension affect the baby?

Having hypertension during pregnancy doesn't only affect the mother but also risks the developing baby.

High blood pressure makes it challenging for the baby to receive enough oxygen and nutrients. It could lead to your baby having a lower-than-average weight because of growth restrictions. It may also result in early delivery.

Monitoring the fetus is equally essential. To monitor the fetus, doctors may perform various tests like:

  • Ultrasound: To visualize and track fetal development.
  • Nonstress test: Evaluates the baby's heart rate in response to movements.
  • Biophysical profile: Combination of a nonstress test with an ultrasound for a comprehensive assessment.
  • Doppler ultrasound: It measures blood flow in the baby's vessels.
  • Fetal movement counting: Monitoring kicks and movements to assess the baby's well-being.

How is hypertension during pregnancy diagnosed?

During prenatal appointments, your provider monitors your blood pressure. If they detect a higher-than-normal reading, they may check again at later appointments.

If your BP is consistently high after 20 weeks of pregnancy, your doctor may diagnose you with gestational hypertension.

If high BP persists, your doctor may conduct additional tests.

An image representing how is hypertension during pregnancy diagnosed
Image credit: Blood–Brain Barrier Dysfunction in Hypertensive Disorders of Pregnancy - Scientific Figure on ResearchGate.

Normal blood pressure range during pregnancy chart

During pregnancy the normal BP range should not surpass 120/80 mm Hg during pregnancy.

Table 1

Blood Pressure Category


Systolic BP Range


Diastolic BP Range


Normal


< 120 mm Hg


< 80 mm Hg


Elevated

120-129 mm Hg


< 80 mm Hg


Stage 1 Hypertension

130-139 mm Hg


80-89 mm Hg


Stage 2 Hypertension


≥ 140 mm Hg


≥ 90 mm Hg

Pregnancy hypertension treatment

Your doctor will closely observe your blood pressure and symptoms. They may also ask for more frequent prenatal visits to assess signs of preeclampsia.

The treatment plan may include:

  1. Home blood pressure monitoring: Monitoring BP at home can provide valuable data for your healthcare team.
  2. Medication: If necessary, your provider may prescribe medication to lower your BP.
  3. Hospitalization: In severe cases, hospitalization may help closely monitor and manage your condition.

Treatment aims to stabilize blood pressure to minimize complications for both you and the baby.

Additionally, your doctor may conduct regular blood and urine lab tests to track the condition's progression.

How to prevent high blood pressure during pregnancy

The precise cause of high blood pressure during pregnancy is unknown. However, a proactive approach can mitigate risk. Here's how you can take charge of your health.

  • Maintain a healthy lifestyle
    • Weight management: Aim for a healthy weight before and during pregnancy.
    • Nutritious diet: Eat a DASH diet in gestational hypertension to support your health.
  • Stay active
    • Regular exercise: Participate in activities like walking, biking, or yoga several times weekly.
  • Healthy habits
    • Avoid smoking: Smoking poses risks to both you and your baby.
    • Limit alcohol: Do not consume alcoholic beverages during pregnancy.
  • Prioritize rest
    • Adequate sleep: Ensure you get plenty of rest to support your body's needs.
  • Consult your Doctor
    • Regular check-ups: Attend regular prenatal check-ups to monitor your health.
    • Risk assessment: If you're at risk for high blood pressure, your provider may recommend measures to reduce it.
  • Communication
    • Discuss concerns: Openly communicate any concerns about your blood pressure or risk for developing hypertension with your doctor.
    • Education: Educate yourself about warning symptoms, enabling early recognition and timely intervention.

FAQs

Is 140/100 bp normal during pregnancy?

No, a 140/100 mm Hg blood pressure reading is not normal during pregnancy; it is hypertension.

If you experience such levels, consult your healthcare provider promptly. They will assess you and provide for appropriate management to ensure a healthy pregnancy.

How to keep blood pressure down during pregnancy?

You can maintain healthy blood pressure during pregnancy by:

  1. Eating well and staying active.
  2. Watching salt intake.
  3. Attending regular check-ups.
  4. Managing stress.
  5. Avoiding harmful substances.
  6. Getting enough rest.
  7. Stay informed about warning signs (refer to the above section) and regularly consult with your doctor.

Conclusion

Whether adopting a healthy lifestyle, attending regular check-ups, or staying informed about complications, every step you take contributes to a healthier pregnancy.

Stay vigilant, communicate openly with your doctor, and understand and manage gestational hypertension effectively. A healthy lifestyle and regular check-ups and tests lay the foundation for a healthy pregnancy.

However, It can be pretty bothersome to go out to take a lab test when you are pregnant. Hence, the Aware Health Rewards App offers convenient home lab tests from the best labs nationwide.

You can book any test, and a lab representative will come to your doorstep to get the sample. All our lab partners are ISO and NABL-certified. Therefore, we ensure the highest quality standard.

Along with lab tests, you can track your BP, track any medications, and generate a customized diet plan to help you stay healthy.

To make your pregnancy a little easier, download the Aware app now!

About the author: 

Lucky Mehtani
, B. Pharm, a licensed Pharmacist, merges his healthcare expertise and passion for writing to enhance India's heart health. Through insightful blogs, he provides well-researched information on managing chronic lifesyle condition to prevent heart attacks and strokes.
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