How to Manage High Blood Pressure During Pregnancy

Hypertension during pregnancy is concerning and requires careful management and close monitoring to ensure the health and safety of the mother and the unborn child. Understanding the physiological changes in the blood pressure that occur during pregnancy is essential for the appropriate management of pregnancy-related hypertension.  

Understanding high blood pressure during pregnancy

High blood pressure refers to a blood pressure of 140/90 mmHg or higher. If left untreated, it can lead to serious complications such as preeclampsia, posing a risk to maternal and foetal health. Generally, hypertension does not show any noticeable symptoms. Based on the occurrence, it is categorised into four types, which include:

• Chronic hypertension: This type of hypertension either develops before pregnancy or within the first 20 weeks. Since hypertension often has no symptoms, it can be difficult to determine when it is exactly started.
• Chronic hypertension with superimposed preeclampsia: This is when high blood pressure that existed before pregnancy worsens.  
• Gestational hypertension: This condition is high blood pressure in pregnant women after 20 weeks, which can eventually lead to preeclampsia.
• Preeclampsia: This condition refers to hypertension that emerges after 20 weeks of pregnancy combined with damage to other organs or body systems, such as the kidney, liver, blood or the brain.

Risk factors

The risk factors for high blood pressure during pregnancy include:

• Age: Individuals younger than 20 and older than 40 are at a higher risk.
• Obesity: Individuals having higher body mass index are at higher risk.
• Multiple pregnancies: Carrying twins or triplets can elevate the risk.
• Family history: A family history of hypertension is likely to increase the risk.
• Pre-existing conditions: Diabetes, kidney disease or auto-immune disorders can also increase the risk.

Management of hypertension during pregnancy

Management of hypertension during pregnancy should aim to prevent complications of the cardiovascular and cerebrovascular system in the mother without affecting foetal health. Women with existing hypertension should undergo pre-pregnancy evaluation and close monitoring during and after pregnancy to prevent complications such as end-organ damage.

Hypertension treatment during pregnancy aims to balance maternal health and foetal safety. Research shows that antihypertensive therapy can significantly lower high blood pressure.  

Here are some common methods used to monitor blood pressure and overall health during pregnancy:

• Regular prenatal visits: Routine doctor visits are essential, and adhering to the frequency of checkups is important as the pregnancy moves to the next stage. The blood pressure is taken at every visit to check for any elevation of BP or the development of preeclampsia.
• Home blood pressure monitoring: Devices: Prenatal blood pressure can be monitored using home blood pressure monitoring to keep track of prenatal appointments. However, one should record their blood pressure daily or as per the instructions provided by a health care practitioner.
• Record keeping: Monitoring previous readings is also important when there is a change in the pattern when one is monitoring one’s own blood pressure.
• Urine tests: A urine examination is done to determine the presence of protein, basically to confirm preeclamptic condition.
• Blood tests: These include kidney and liver function tests to determine their function since both kidney and liver can be affected by hypertension.
• Ultrasound: An ultrasound test will be advised to examine the foetal growth.  
• Non-stress test (NST): This test determines a baby’s heart rate to ensure the baby is healthy.  
• Biophysical profile (BPP): This combines an ultrasound with an NST to comprehensively assess the baby’s health.
• Dietary adjustments: Monitor and adjust the diet to reduce salt intake and ensure proper nutrition.
• Physical activity: Safe physical activities and meditation techniques can help to manage blood pressure.

Conclusion

Regular monitoring and early detection of high blood pressure during pregnancy are essential for preventing complications. By following medical advice and keeping track of health indicators, pregnant individuals can help ensure a safer pregnancy for themselves and their babies.