High Bp: A Cause For Concern During Pregnancy

  Pregnancy and the birth of a new-born is one of the most fulfilling and wondrous journeys in the life of a woman. To ensure that this journey leads to an even more joyous time of new experiences and discoveries : awareness and preparedness for any medical complications is a must. Unknown to most people, hypertensive disorders are becoming one of the leading causes of worry for pregnant mothers. The disorders have been identified to significantly increase the risk of maternal and neonatal morbidity and mortality in new borns and their mothers. It is very important to understand that the complications and the way of management of these disorders during pregnancy differ from the generic ways such disorders are normally addressed and treated. This is because:  

• As pregnancy is limited to a smaller time span, mild or uncomplicated cases can be managed by close monitoring of the body BP levels. A sustained BP level of 140/90 or greater is categorized as hypertension.
• The drugs that are prescribed need to be certifiably safe for pregnant women

A woman may already have hypertensive disorders before she becomes pregnant or may develop the condition after she becomes pregnant. While medical supervision is an important element of hypertensive disorder management, it is also crucial that women are educated about recognizing and notifying about the dangerous occurrences such as headache, visual disturbances, and photophobia or Epigastric pain. A woman who is aware of her hypertensive disorders should plan her pregnancy once she has managed to normalize her high blood pressure. While it is a usual practice to monitor the blood pressure of a pregnant woman on her first visit, blood pressure levels need to be monitored on subsequent visits as the symptoms are not visible in the beginning of pregnancy. The health risks however are very much real and present. High blood pressure can cause a lot of complications for both the pregnant mothers and her baby. High BP can adversely impact the growth of the baby and may result in premature births. High BP also significantly increases the incidence of organ failures, caesarean births, strokes and death. Hemolysis, Elevated Liver enzymes, Low Platelets (HELLP) syndrome and Eclampsia, the presence of convulsions, are two most life threatening diseases categorized under hypertensive disorders associated with pregnancy. The primary aim of monitoring hypertension during pregnancy is:

• Monitor the health of both the pregnant mother and her unborn child
• Calculate the optimum time of delivery that is least traumatic for the mother and her child
• Take preventive and helpful actions to ensure complete recovery of both the mother and her child

While the primary goal is to ensure safe and timely delivery of the unborn child, depending on individual medical conditions, premature birth may be advised. If the hypertensive condition is not too advanced, health management can be done by just closely observing the mother and her child’s health condition. -          The writer is Dr. Suneeta Mittal, Director & HOD, Obstetrics & Gynaecology, Fortis Memorial Research Institute, Gurgaon.