Hypertension in Pregnancy

Your blood pressure is checked at each prenatal visit to detect any changes from your normal reading.

For approximately 7% of all pregnant women, high blood pressure or hypertension does become a problem. If your blood pressure is elevated, it can affect you and your baby's well-being. Some women enter pregnancy with higher than normal blood pressure readings. For others, high blood pressure is pregnancy induced (high blood pressure that develops after 20 weeks of pregnancy). If, at a prenatal visit, your blood pressure is higher than what is normal for you, your blood pressure will be re-checked and our doctors and nurses may order further testing.

The four categories of hypertension in pregnancy are:

  • Chronic hypertension - High blood pressure that occurs before pregnancy or before 20 weeks of pregnancy.
  • Gestational hypertension - High blood pressure that develops after 20 weeks of pregnancy.
  • Preeclampsia - High blood pressure that develops after 20 weeks of pregnancy accompanied by increased swelling and protein in the urine.
  • Chronic hypertension with preeclampsia (both) - High blood pressure that occurs before pregnancy and becomes worse during pregnancy.

Gestational hypertension is usually diagnosed in the third trimester of pregnancy and can occur after delivery. Pregnant women most at risk for this disorder include:

  • Those under age 20 or over age 35
  • Those pregnant for the first time
  • Those who have had hypertension in a previous pregnancy
  • Those whose mother had gestational hypertension
  • Those with kidney disease
  • Those with diabetes

Promptly contact your provider if any of the following symptoms occur:

  • A sudden weight gain (2 or more pounds in a few days)
  • Headache, blurred vision, or spots before the eyes
  • Pain in the upper abdomen ("epigastric pain")
  • Unusual swelling or puffiness in the face and/or hands. Treatment for hypertension may include:
    • Urine, blood pressure, and weight checks
    • Medication
    • Dietary changes
    • Restricted activity -- Restricted activity can refer to anything from periodic rest periods during the day, to complete bedrest. The purpose of restricted activity is two-fold:
      • Resting on your side (left side is best) decreases your blood pressure
      • A side lying position also improves the blood flow to the baby.

Talk with your midwife/doctor to formulate a treatment plan.

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