High Blood Pressure In Pregnancy

  • A first or second pregnancy
  • A patient older than 40
  • A very young patient
  • An African American patient
  • Low socioeconomic status
  • Personal or family history of hypertension in pregnancy
  • A different father for this fetus than the previous one
  • Problems with high blood pressure before pregnancy
  • Chronic kidney problems
  • A patient who suffers from diabetes
  • Twin pregnancy

Many of these risk factors cannot be controlled. However, good prenatal care -- always seeing your doctor as scheduled and having your blood pressure checked regularly -- is a way to protect yourself. If you need blood pressure-lowering medications, take them as prescribed. Furthermore, telling your doctor about unusual or severe swelling or sudden weight gain is important. Weight gain of greater than 2 pounds per week is of concern. Symptoms like persistent headache, blurred vision and upper abdominal pain are often present late in the disease process. However, if you have any of these symptoms, you should report them to your doctor immediately.

Summary

In summary, hypertensive disorders of pregnancy are a group of diseases characterized by blood pressures greater than 140/90 in late pregnancy. These disorders include preeclampsia, eclampsia and HELLP syndrome, and are characterized by high blood pressure but also -- depending on severity and type -- pathologic swelling, kidney disease, liver dysfunction, clotting disorders, bleeding in the brain, and other very serious problems. Hypertensive disorders in pregnancy can lead to very severe illness, even death, if not managed appropriately. Multiple medications can be used to manage the high blood pressure, and magnesium can prevent seizures in eclamptic patients. Delivery, however, is the definitive treatment for very severe cases of hypertensive disorders in late pregnancy. You can decrease your risk of getting hypertension in pregnancy or its consequences by getting good prenatal care and taking blood pressure medications if your doctor prescribes them.

Dr. Michelle Finkel is an attending in the Emergency Department of the Massachusetts General Hospital. Dr. Finkel has published articles in emergency medicine journals and contributed to textbooks on a diverse group of topics. Subjects include high blood pressure in pregnancy, headaches, physician professionalism, substance abuse, and abdominal pain.

Copyright © Michelle Finkel. Permission to republish granted to Pregnancy.org, LLC.