High blood pressure is a serious concern during pregnancy, especially for women who have chronic hypertension. Chronic hypertension refers to high blood pressure which is already present before pregnancy. It also includes high blood pressure which develops before 20 weeks of pregnancy, or lasts for longer than 12 weeks after giving birth.
The onset of high blood pressure during pregnancy may be a sign of preeclampsia. Although high blood pressure and preeclampsia can be related, they are different. If you were diagnosed with hypertension before becoming pregnant, you may be wondering how this will affect your pregnancy, or even if you should become pregnant at all.
Can I have a healthy pregnancy with High Blood Pressure?
It is ideal to see your doctor before you become pregnant. This gives your healthcare provider an opportunity to see if your high blood-pressure is under control and review your medications. Certain medications are not safe during pregnancy and can harm your baby.
During pregnancy, chronic hypertension can worsen, especially if you develop preeclampsia in addition to chronic hypertension. If this happens, you may develop complications such as congestive heart failure, vision changes, stroke, seizures, and kidney or liver problems.
Am I predisposed to develop preeclampsia?
Preeclampsia is high blood pressure that occurs exclusively in pregnancy. Therefore, even if your chronic high blood pressure is under control before you are pregnant, you may later develop preeclampsia, as well. If you have chronic hypertension, you are more likely to develop preeclampsia, but it does not necessarily mean you will. Also, should you develop preeclampsia, your doctor may recommend inducing labor before your due date to prevent further pregnancy complications. If the preeclampsia is severe, your doctor may recommend a cesarean birth.
Will my pregnancy be classified as high-risk?
One indicator of a high-risk pregnancy includes certain chronic medical problems, such as high blood pressure. Therefore, since you already have hypertension and have become pregnant, your pregnancy is automatically classified as high risk.
High-risk pregnancies typically need expert advice and the care of a healthcare specialist. You will most likely see a perinatologist—- an obstetrician who specializes in the care of high-risk pregnancies. Perinatologists give expert care to women who have pre-existing medical conditions, as well as women who develop complications during pregnancy.
In addition, you may be referred to a perinatal care center, before delivery, to lessen the likelihood your baby may become ill. Usually, these centers work together with obstetricians and a newborn intensive care unit to provide the best care for you and your baby.
How may high blood pressure during pregnancy affect my baby?
It is possible to have chronic hypertension and go on to have a healthy baby. However, chronic hypertension has the possibility of a number of adverse effects on your developing baby.
These possible concerns include:
- Impairment of the baby’s growth
- Higher risk of breathing problems before or during labor
- Higher risk of placental abruption (placenta separating from the uterus before labor)
- Possible side effects from the medications you are taking
How can I manage my high blood pressure during pregnancy?
Although there is no cure for chronic hypertension, there are ways to successfully manage your condition when pregnant. Taking care of yourself is the best way to take care of your developing baby.
Below are some examples:
- Eat a healthy diet, and especially limit your sodium intake
- Take your blood pressure medications the way you are supposed to
- Keep all your prenatal appointments
- Stay physically active, although your healthcare provider may prescribe bed rest if you develop preeclampsia
- Do not smoke, drink alcohol, or take illicit drugs
- Monitor your weight gain—do not gain too much
Compiled from the following resources:
Harms, R. W., Johnson, R. V., & Murray, M. M. (2004). Mayo Clinic Guide to a Healthy Pregnancy. New York: HarperCollins Publishers.
Mayo Clinic Staff. (2014, July 3). Preeclampsia. Retrieved from http://www.mayoclinic.org/diseases-conditions/preeclampsia/basics/definition/con-20031644
The American College of Obstetricians and Gynecologists. (2010). Your Pregnancy and Childbirth: Month to Month, Fifth Edition. Washington, DC: American College of Obstetricians and Gynecologists.