Hypertension in pregnancy


pregnancy

Blood pressure is a parameter that is checked in every antenatal visit. This is because high blood pressure with protein in urine comprises a condition called pre-eclampsia, which is quite serious in pregnancy.

How common is high BP in pregnancy?

Almost one in 20 women in their first pregnancy suffer from this condition.

If your BP recording is higher than your normal and stays high for several checks, then your doctor may be concerned about pre-eclampsia. If you already have high blood pressure prior to conception, your doctor will prescribe pregnancy-safe BP lowering medications to keep it under control.

How high is the BP recording in pre-eclampsia?

Generally speaking, the average BP range for a healthy young woman is 110/70 to 120/80. If your BP is above 140/90 on at least two occasions within a week, and you usually have normal BP, your doctor will make a diagnosis of pre-eclampsia. A regular check of BP will help your doctor to determine what’s normal for you, as a single high reading may not be of much consequence, which could be because of some immediate stressing factor.

The change in the BP in the last few months as compared to the BP at the beginning of pregnancy is also very important. So, the absolute value is important, but also the change in BP and the overall trend.

What is the relationship between High BP and protein in the urine?

If your BP is higher than normal, your doctor will want to know if there is protein in your urine, in which case you might be in the early stages of pre-eclampsia. Pre-eclampsia can decrease blood flow to placenta – thereby reducing supply of oxygen and nutrients to baby, hampering its growth. This can also increase the chances of preterm labour. In severe cases of high BP, it may pose health hazards to the mother such as heart attack or stroke. Placental separation from the uterine wall (abruption placentae) is another complication that can occur leading to heavy bleeding and shock putting both mother and baby to danger.

In general, when high BP and protein in the urine are present as a combination, it is more of concern.

What are the other symptoms of pre-eclampsia?

If you do have pre-eclampsia, keep a watch for sudden persistent headache, blurred vision, vomiting, sudden swelling (edema) of hands and feet. These could mean a worsening of the condition and may lead to a high risk pregnancy. If your BP shoots up, hospitalization may be required to control it while your baby is being monitored for signs of reduced blood flow and growth.

What is eclampsia?

The presence of seizures / fits in the absence of a known neurological cause, in a pregnant woman with high Bp and protein in the urine is called eclampsia. This is a serious complication and would necessitate delivery.

How long will my BP take to get to normal after delivery?

Your BP should back to normal once baby is born or it may take a few weeks. Your BP will be checked regularly during your stay in the hospital and then by your doctor in subsequent post natal visits.

Pre-pregnancy care for women with high BP

In case your BP is high and you want to get pregnant, your doctor may advise you to lose excess weight using diet and exercise to lower BP. Taking blood pressure medications prescribed by your doctor to control BP helps too. If you smoke, then this is the best time to quit smoking as it is very harmful for your future pregnancy and baby.

Do not use table salt, and avoid items like pickles, chutneys, papads and other preserved food that are very high in salt. Eat a diet rich in fresh produce, beans, whole grains which will provide a range of vitamins and antioxidants and do a non-strenuous form of exercise everyday such as walking or swimming.