High blood pressure can strike women before pregnancy and during pregnancy. Pregnant women who already have high blood pressure (hypertension), since or before pregnancy, need special treatment from a doctor. Here are some types of hypertension in pregnancy:
- Gestational hypertension. Occurs after 20 weeks of gestation. No excess protein was found in the urine or signs of organ damage. Some women with gestational hypertension later develop preeclampsia.
- Chronic hypertension. Occurs before pregnancy or before 20 weeks of gestation. Because it does not have specific symptoms, high blood pressure may be difficult to determine where it started.
- Chronic hypertension with preeclampsia. This condition occurs in women with chronic high blood pressure before pregnancy. The high directional pressure then worsens and there is protein in the urine and other health complications during pregnancy.
- Preeclampsia. In some cases, chronic hypertension or gestational hypertension can turn into preeclampsia. Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, usually after 20 weeks of gestation. If left untreated, preeclampsia can cause serious, even fatal, harm to both mother and baby. In the past, preeclampsia was only diagnosed if a pregnant woman had high blood pressure and there was protein in her urine. However, recent research has found that pregnant women are still at risk of developing preeclampsia even though there is no protein in their urine.
High blood pressure during pregnancy is at risk of causing the following conditions:
- Reduced blood flow to the placenta. If the placenta does not get enough blood, the baby will be deprived of oxygen and nutrients. As a result, the baby's growth slows down, loses weight, or is at risk of premature birth. Prematurity can cause breathing problems for babies.
- Placental abruption. Preeclampsia increases the risk of placental abruption, a condition in which the placenta detaches from the uterine wall before delivery. Severe solutions can cause heavy bleeding and damage to the placenta which can threaten the safety of the mother and baby.
- Premature birth. For medical reasons, premature birth is necessary to prevent complications that can be life threatening.
- Cardiovascular disease. Preeclampsia increases the risk of heart and blood vessel (cardiovascular) disease in the future. This risk is greater for pregnant women who have had preeclampsia more than once or have had preterm labor. To minimize this risk, try to maintain an ideal body weight after giving birth, consume fruits and vegetables, exercise regularly, and avoid smoking.
Preeclampsia sometimes presents without symptoms. High blood pressure as a symptom of preeclampsia may come on slowly but more often attacks suddenly. Make sure you always monitor your blood pressure during pregnancy because the first symptom of preeclampsia is generally an increase in blood pressure. Check blood pressure by taking two samples at an interval of 4 hours. Abnormal blood pressure ranges are at mercury levels of 140/90 millimeters (mm Hg) or more.
Other symptoms of preeclampsia include:
- Excess protein is found in the urine (proteinuria) or signs of kidney problems
- Severe headache
- Vision problems, including temporary loss of vision function, blurred vision, or sensitivity to light
- Upper abdominal pain, usually under the ribs on the right
- Nausea or vomiting
- Decrease in the amount of urine
- Decrease in the number of platelets in the blood (thrombocytopenia)
- Liver disfunction
- Shortness of breath, which is caused by fluid in the lungs
Short weight gain and swelling (edema) in the face and hands are suspected symptoms of preeclampsia. However, this symptom cannot be used as a benchmark because many pregnant women with healthy medical conditions also experience these symptoms.
Medicines taken during pregnancy can affect the development of the baby. Although considered safe, some blood pressure-lowering drugs, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and renin inhibitors, should generally be avoided during pregnancy.
However, treatment is still important. The risk of heart attack, stroke, and other problems associated with high blood pressure doesn't just go away during pregnancy.
If needed, the doctor will prescribe the safest drugs at the correct dosage. Therefore, make sure you take the drug according to the rules of use. Do not stop taking your medication or adjust your dose yourself.
You can also see medical personnel and other health teams, such as a family doctor or a cardiologist. Doctors and experts will evaluate how well the mother controls high blood pressure and recommend further treatment that may need to be done before pregnancy. For those who are overweight, your doctor may recommend that you go on a diet before becoming pregnant.
During pregnancy, it is normal for you to go back and forth to health services. At each visit, your weight and blood pressure will be checked, and even more frequent blood and urine tests will be performed.
Meanwhile, for babies in the womb, doctors will often perform ultrasound examinations to monitor the baby's growth and development, for example by recording the fetal heart rate. Your doctor may recommend that you monitor your baby's active movements on a daily basis.
Taking care of yourself is the best way to care for a baby, for example in the following ways:
- Get regular health checks. Visit your doctor regularly during pregnancy.
- Take blood pressure medication as directed by your doctor. The doctor will prescribe the safest drug with the most appropriate dose.
- Stay active. Follow a variety of physical activities recommended by your doctor.
- Eat healthy foods. Choose low sodium foods.
- Know your limits. Avoid smoking, alcohol and illegal drugs. Consult with your doctor before taking certain medications.
Although various studies have been conducted, so far researchers have not found the most effective way to prevent preeclampsia. Your doctor may give you a low daily dose of aspirin (between 60-81 milligrams) starting at the end of the first trimester if the mother has had preterm labor (before 34 weeks of gestation), or has had preeclampsia several times in a previous pregnancy.
To avoid complications, your doctor may recommend an induced labor a few days before your expected due date. Induction may be required early if the mother shows symptoms of preeclampsia or other complications. In severe cases of preeclampsia, the doctor will give you medication during labor to help prevent seizures. Do not rule out a caesarean section.
After the baby is born, mothers are encouraged to breastfeed even if they have high blood pressure or are even on medication. Discuss dosage adjustments or alternative blood pressure medications with your doctor. The doctor may advise the mother not to breastfeed shortly after taking the medicine.
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