Having high blood pressure (hypertension) at any time can lead to problems but especially so during pregnancy. It could have dangerous outcomes for you and your baby, particularly the risk of pre-eclampsia, if adequate care is not taken to control it effectively. With proper antenatal care, however, the risks can be greatly reduced.

If you consistently have a systolic blood pressure of 140 or more and a diastolic blood pressure of 90 or more, you will be said to be suffering from hypertension.

Types of Hypertension in Pregnancy

During pregnancy, hypertension can be of 4 types

• Chronic hypertension (essential hypertension).
• Transient hypertension, gestational hypertension, or pregnancy-induced hypertension.
• Pre-eclampsia and eclampsia.
• Superimposed pre-eclampsia.

Chronic Hypertension (Essential Hypertension)

Chronic or essential hypertension is high blood pressure which is present before conception, before 20 weeks of pregnancy and which continues throughout pregnancy and for more than 6 weeks after delivery. Chronic hypertension, at any time, can be dangerous if not controlled properly because of the risks associated with it such as heart attacks and stroke. During pregnancy, it can affect the developing baby, causing growth retardation. If you are planning a pregnancy, it would be ideal if your blood pressure could be brought to a normal level before conception. All through your pregnancy, your blood pressure will need to be monitored carefully so that you do not develop any complications which may harm you or the baby.

Gestational Hypertension

Sometimes, you develop high blood pressure for the first time during your pregnancy, without any previous history of hypertension. This transient hypertension or gestational hypertension usually occurs after mid-pregnancy or in the first 24 hours after birth of your baby, without other signs of pre-eclampsia, but it soon returns to normal following delivery. This type of hypertension needs to be monitored very carefully because it may lead to more serious complications of pregnancy such as pre-eclampsia and eclampsia. It may not always be possible to differentiate it from pre-eclampsia and is then treated as pre-eclampsia. Its importance lies in the fact that it often develops into essential hypertension later in life.

Pre-eclampsia and Eclampsia

Pre-eclampsia is a serious complication of pregnancy where high blood pressure is present along with swelling of the body (edema), especially of the hands and face, and protein in the urine. Pre-eclampsia occurs typically in the first pregnancy, after the 20th week of pregnancy, most frequently in the third trimester, towards the end of pregnancy. This condition may be further complicated by convulsions, occurring without any other cause, when it is known as eclampsia. Both these conditions are potentially harmful for you and your baby, especially because of the risk of preterm delivery.

Superimposed Pre-eclampsia

When pre-eclampsia develops in a woman already suffering from chronic hypertension, it is known as superimposed pre-eclampsia.

With hypertension during pregnancy it is often difficult to determine whether it is essential hypertension, superimposed pre-eclampsia or pre-eclampsia because the blood pressure normally decreases in the second trimester and this decrease may mask the presence of chronic hypertension.

Symptoms of Pre-eclampsia

In most women, hypertension does not produce any symptoms.
The symptoms of pre-eclampsia may be

• Severe persistent headaches.
• Problems with vision, such as blurring or photophobia (sensitivity to light).
• Sudden weight gain over one or two days
• Swelling (edema), especially of the face and hands, present on getting out of bed in the morning.
• Abdominal pain.
• Chest pain.
• Vomiting.