Many women who have high blood pressure deliver healthy babies without serious problems even though high blood pressure can be dangerous for the mother and fetus. The problem, however, is with women who have pre-existing or chronic high blood pressure because they are more likely to have certain types of complications during their pregnancy more so than women who have normal blood pressure. There are women who develop high blood pressure when they are pregnant, this is called gestational hypertension.
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High blood pressure is dangerous to the mother because it can harm her kidneys and other organs and can also cause a low birth weight and early delivery. If the high blood pressure is severe, the mother may develop preeclampsia, also called “toxemia of pregnancy” and can threaten the life of the mother and fetus.
Preeclampsia is a condition that generally begins after the 20th week of pregnancy and is related to an increase in blood pressure and protein in the mother’s urine. The protein in the mother’s urine is the result of kidney problems associated with the high blood pressure. Preeclampsia has an affect on the placenta and can also affect the mother’s liver, kidney and brain. It is also the leading cause of fetal complications which include low birth weight, premature birth and stillbirth. When preeclampsia causes seizures in the mother it is known as “eclampsia” which is the second leading cause of maternal death in the United States.
There is no proven way to prevent preeclampsia and women who show signs of preeclampsia are closely monitored to lessen or avoid the problems associated with the condition. Delivering the baby is the way to “cure” preeclampsia.
The following are the women most likely to develop preeclampsia:
1. If a woman has high blood pressure or chronic hypertension before becoming pregnant.
2. If a woman developed preeclampsia or high blood pressure during a previous pregnancy. It is especially important if these conditions developed early in the pregnancy.
3. If a women is obese prior to pregnancy.
4. If a pregnant woman is under 20 years of age or over 40 years of age.
5. If a woman is pregnant with more than one baby.
6. If a woman is diagnosed with diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma.
Detecting preeclampsia is difficult since there is no single test that enables the physician to predict or diagnose the condition. There are the signs of increased blood pressure and the protein in the urine (proteinuria). Other signs that seem to be related to preeclampsia include abdominal pain, blurred vision, sensitivity to light, and persistent headaches. The problem is all these signs can also occur in a healthy pregnancy. They can also be caused by other disorders. This is an important reason why women should be seen by a physician during their pregnancy. The physician can monitor the pregnant woman’s blood pressure, the level of protein in her urine, have blood tests analyzed in order to detect signs of preeclampsia and monitor fetal development closely.
If you have high blood pressure and are thinking about becoming pregnant, talk to your doctor. Your physician can explain how your high blood pressure can affect you and your baby during the pregnancy and give you instructions on what you need to do before becoming pregnant. They may want you to have your blood pressure under control, change your diet to a more healthy diet for you and your baby, lose weight if you are overweight and add physical activity.
Discuss with your doctor the blood pressure medicines you are taking since there are some medicines like angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II (AII) receptor antagonists that physicians recommend avoiding during pregnancy. Other blood pressure medications may be OK to use, but do not stop or change your medicines unless told to do so by your physician.
An important thing to remember is that most pregnant women with high blood pressure and preeclampsia have successful pregnancies. By having early and regular prenatal care you are providing your physician with the information he or she needs to keep you and your baby safe and healthy during the pregnancy.
