Hypertension in Pregnancy causes Symptoms and Treatment

Hypertension during pregnancy can cause serious even life-threatening complications for an unborn baby and its mother. Hypertension in pregnancy can lead to a decreased flow of blood to the placenta. The placenta may become detached from the uterus, causing oxygen deprivation to the baby and heavy bleeding in the mother. Hypertension can also lead to premature delivery and the mother’s risk of cardiovascular disease later on. Excellent prenatal care along with early detection are critical when a woman experiences hypertension during a pregnancy.

Blood pressure is described as “a measure of how hard your blood pushes against the walls of your arteries.” Hypertension occurs when that force becomes too hard. Blood pressure is measured by two numbers – the systolic top number indicates the pressure as the heart pumps blood, and the diastolic bottom number indicates the pressure as the heart relaxes and fills with blood. High blood pressure is present when the top number is over 140 or the bottom number is over 90, or both.

According to the Mayo Clinic, there are three basic types of hypertension that can occur during a woman’s pregnancy:
 
1)     Chronic hypertension

Chronic hypertension occurs before 20 months into the pregnancy and can continue for at least 12 weeks after the birth. Chronic hypertension can also be present prior to the pregnancy, often undetected until the first prenatal exam.

2)     Gestational hypertension

Gestational hypertension develops during the pregnancy, usually about 20 weeks into the pregnancy, and typically disappears once the baby is born. Protein is not present in the urine as it is with preeclampsia.

3)     Preeclampsia

Preeclampsia typically occurs after 20 weeks into the pregnancy, usually when the mother has either chronic or gestational hypertension. Protein is also present in the urine.

Preeclampsia, also called toxemia or pregnancy-induced hypertension (PIH), is potentially life-threatening if left untreated. Women at risk for developing preeclampsia include first-time mothers, a family history of preeclampsia, women experiencing multiple-baby pregnancies, teen mothers, women over 40 and women with pre-existing high blood pressure or kidney disease.

Causes of hypertension during pregnancy:

Research remains inconclusive on the exact causes of hypertension in pregnancy. Following are several theories being considered:

1)     For hypertension – underlying conditions may increase the risks of hypertension including obesity, polycystic ovary syndrome and diabetes. These same conditions may also increase the risks of developing preeclampsia.

2)     For preeclampsia –

*     A poorly developed placenta –  a placenta without the normal amount of blood vessels developed in the uterus wall can cause inadequate blood flow in the placenta and lead to hypertension.

*     Family history – genetics including a family history of preeclampsia can put a woman at higher risk of developing preeclampsia.

*     Abnormal immune system response – a mother may experience an abnormal immune response to the father’s sperm, either during her first pregnancy or during a following pregnancy with a different father. An immune response may be triggered by an antigen from the father, resulting in narrowing of the blood vessels throughout the body, leading to high blood pressure.

*     Biochemical factors – a biochemical factor may cause the blood vessels to narrow and lead to high blood pressure, such as the body’s reaction to a poorly functioning placenta.

*     Disease – diseases such as diabetes, lupus and pre-existing high blood pressure can lead to blood vessel problems and increase the risk of preeclampsia.

Symptoms of hypertension during pregnancy:

1)     Hypertension can range from mild with little or no symptoms as with chronic or gestational hypertension to severe hypertension or preeclampsia with many symptoms.

2)     Mildly elevated blood pressure often goes undetected until a prenatal exam is conducted. Elevated blood pressure may cause some headaches, vision problems and shortness of breath.
 
3)     Preeclampsia

The American Pregnancy Association lists the following symptoms for preeclampsia:

*     water retention
*     high blood pressure
*     protein in the urine
*     headaches
*     blurred vision
*     inability to tolerate bright light
*     fatigue
*     nausea/vomiting
*     urinating small amounts
*     pain in upper right abdomen
*     shortness of breath
*     tendency to bruise easily

Additional symptoms of preeclampsia may include:

*     Sudden weight gain (five or more pounds a week), and swelling (edema), especially in the face and hands. Swelling can also occur during normal pregnancies.

*     HELLP – many of the above-mentioned symptoms may indicate a life-threatening liver disorder called HELLP (hemolysis elevated liver enzymes and low platelet.)

*     Eclampsia – seizures caused by severe preeclampsia, leading to drastic reduction of oxygen to the fetus, potentially life-threatening for both mother and baby.

Treatment for hypertension and preeclampsia:

1)     Treatment options vary, depending on the stage of the pregnancy. If the due date is close and the baby is sufficiently developed, delivery may be induced, especially when continuing the pregnancy could prove harmful to the mother or the baby. Although vaginal births are preferred, in certain instances a caesarean may be recommended. If the mother is not close to her due date and the situation isn’t considered an emergency, the physician may recommend:

*     Rest while lying on the left side to lessen the baby’s weight on the major blood vessels
*     Increased prenatal checkups
*     Reduced salt intake
*     8 glass of water a day
*     Medication

2)     In severe cases of preeclampsia, hospitalization may be recommended as well as medication. As taking medication during pregnancy can pose risks to the baby, it should only be taken when necessary and only as prescribed by a physician. Follow-up care after delivery will depend on the severity of the hypertension and the health of the mother and the baby.

Preventing hypertension during pregnancy:

The American Pregnancy Association offers several tips for preventing or controlling pregnancy-induced hypertension including a low-salt diet, 6-8 glasses of water a day, little to no fried or junk food, plenty of rest, moderate exercise, avoidance of alcoholic and caffeinated beverages and elevated feet several times a day.

Excellent prenatal care is essential for a healthy pregnancy. Pregnancies involving hypertension, whether mild or severe, require close monitoring. With adequate prenatal care and healthy lifestyle habits, both mother and baby should experience a happy, healthy pregnancy and delivery.