Women at Risk of Developing Hypertension in Pregnancy

• First pregnancy.
• Hypertension or pre-eclampsia in previous pregnancies.
• Family history, with mother or sisters suffering from hypertension during pregnancy.
• Multiple pregnancies, such as twins.
• Women over 35.
• Women suffering from hypertension or kidney disease prior to pregnancy.

Dangers of High Blood Pressure during Pregnancy

Having high blood pressure during pregnancy can be dangerous for you and your baby.

• High blood pressure leads to less blood supply to the placenta, resulting in reduction of oxygen supply and nutrients to the baby. This may cause growth retardation and low birth weight of the baby.
• Uncontrolled hypertension may lead to preterm delivery. The preterm delivery may be spontaneous or it may become necessary to induce delivery or go for a Cesarean section as the only means of controlling the high blood pressure and complications such as pre-eclampsia and eclampsia.
• Hypertensive disorders in pregnancy can become life-threatening for mother and baby.
• Increased risk of stillbirths.
• Complications and reduced chances of survival of a preterm baby, especially if delivered long before the due date.
• Abruptio placentae is a complication which may develop as a result of hypertension. The placenta separates from the uterus before delivery and can cause severe bleeding in the mother as well as depriving the baby of oxygen and nutrients.
• Increased risk of gestational diabetes mellitus.

Importance of Prenatal Care

• Routine prenatal care is essential because most women do not have any symptoms of hypertension. Routine blood pressure monitoring and testing urine for proteins can detect many such cases and help in better management.
• A woman with known hypertension can reduce chances of complications during pregnancy by consulting her doctor prior to conception and following his advice regarding diet, exercise and medications so that her blood pressure can be brought under control.
• During pregnancy, regular prenatal checkups of known hypertensive women will help to detect and treat any problems that may occur at the earliest. These women may need more frequent checkups than others, with blood pressure, weight and urine for proteins being checked during each visit.
• Regular monitoring of the fetal heart rate and repeated ultrasonography will help to assess the well-being of the baby.

Treatment of Hypertension in Pregnancy

Treatment starts as soon as hypertension is detected.
If you already have hypertension prior to pregnancy and would like to conceive, treatment starts from then on. Your doctor will advise you about weight reduction, if necessary. Rest, proper diet (including a salt-restricted diet) and adequate exercise are important. You may continue with the antihypertensive drugs you are on or the doctor may prefer to change your medications to those most suitable for use during pregnancy.
During your prenatal visits, if your blood pressure is found to be slightly increased and your delivery date is not too near, you may be advised bed rest, either at home or in the hospital.
If the blood pressure becomes too high or symptoms of pre-eclampsia develop, the doctor may have no other choice but to deliver the baby, even if it is preterm, because that is the only definitive treatment for pre-eclampsia.
If no serious complications develop, your doctor may let you carry your pregnancy to term or may prefer to deliver the baby 2 to 3 weeks before your due date to avoid complications which are most likely to develop as you near term.