Chronic hypertension in pregnancy can lead to preeclampsia and Severe forms lead to dangerous conditions, such as eclampsia (seizures during preeclampsia) and HELLP syndrome.
Chronic Hypertension in Pregnancy:
During the first 20 weeks of pregnancy.
Diagnosed prior to pregnancy.
Hypertension developing in the latter half of pregnancy is called gestational hypertension.
Complications of Hypertension in Pregnancy:
- kidney disease
- heart attack
- Fetal Growth Restriction
- Placental abruption
- Pre-term delivery
- Cesarean birth
- Neurological disabilities
Risk Factors for Preeclampsia:
- Extremes of reproductive age
- first pregnancy
- Family histoy
- New father increases the risk
- Multiple Gestations
- Greater than 10 years or less than two years from prior birth
- Chronic hypertension
- Diabetes I &II
- Kidney disorders
Symptoms of Preeclampsia:
- Excess weight gain and edema
- blurred or loss of vision
- Persistent headaches
- Protein in urine at visits
- Nausea& vomiting
- upper abdomen, epigastric pain
- Eclampsia is the onset of seizures in a woman with severe preeclampsia.
- Maternal morbidity is associated with eclampsia & severe preeclampsia.
Treatment of Preeclampsia:
- Delivery at 37 weeks
- Delivery with the onset of severe preeclampsia at any gestation
- Conservative management in absence of severe preeclampsia or fetal compromise.
15% of women with preeclampsia will develop HELLP syndrome.
HELLP stands for:
- Hemolysis – the breaking down of red blood cells
- Elevated Liver enzymes – indicates damage to the liver
- Low Platelet count – blood may be unable to clot properly, also called thrombocytopenia
Please monitor your blood pressure and fetal kick counts, attend routine and frequent antepartum visits and emergency room with any concern.
Blood pressure is the pressure of the blood against the blood vessel walls each time the heart contracts (squeezes) to pump the blood through your body (see FAQ123 Managing High Blood Pressure). High blood pressure also is called hypertension.Hypertension can lead to health problems. During pregnancy, severe or uncontrolled hypertension can cause complications for you and your fetus.
Chronic hypertension is high blood pressure that was present before you became pregnant or that occurs in the first half (before 20 weeks) of your pregnancy. The guidelines for blood pressure are the following:
- Normal: Less than 120/80 mm Hg
- Elevated: Systolic between 120–129 and diastolic less than 80 mm Hg
- Stage 1 hypertension: Systolic between 130–139 or diastolic between 80–89 mm Hg
- Stage 2 hypertension: Systolic at least 140 or diastolic at least 90 mm Hg
High blood pressure during pregnancy can place extra stress on your heart and kidneys and can increase your risk of heart disease, kidney disease, and stroke. Other possible complications include the following:
- Fetal growth restriction—High blood pressure can decrease the flow of nutrients to the baby through the placenta. The baby may have growth problems as a result.
- Preeclampsia—This condition is more likely to occur in women with chronic high blood pressure than in women with normal blood pressure.
- Preterm delivery—If the placenta is not providing enough nutrients and oxygen to your baby, it may be decided that early delivery is better for your baby than allowing the pregnancy to continue.
- Placental abruption—This condition, in which the placenta prematurely detaches from the wall of the uterus, is a medical emergency that requires immediate treatment.
- Cesarean delivery—Women with hypertension are more likely to have a cesarean delivery than women with normal blood pressure. A cesarean delivery carries risks of infection, injury to internal organs, and bleeding.
It is not clear why some women develop preeclampsia, but the risk of developing preeclampsia is increased in women who
- are pregnant for the first time
- have had preeclampsia in a previous pregnancy or have a family history of preeclampsia
- have a history of chronic hypertension, kidney disease, or both
- are 40 years or older
- are carrying more than one fetus
- have certain medical conditions such as diabetes mellitus, thrombophilia, or lupus
- are obese
- had in vitro fertilization
- Swelling of face or hands
- A headache that will not go away
- Seeing spots or changes in eyesight
- Pain in the upper abdomen or shoulder
- Nausea and vomiting (in the second half of pregnancy)
- Sudden weight gain
- Difficulty breathing