Navigating Blood Pressure Management During Pregnancy

High blood pressure, also known as hypertension, is a condition that you should closely monitor, especially if you become pregnant or are planning to become pregnant.

Nearly 10% of pregnant women develop high blood pressure, which can cause complications if left untreated. Working closely with your doctor for evaluation and management is essential for you and the baby.

Read on to discover what you need to know if faced with hypertension during pregnancy.

Understanding High Blood Pressure in Pregnancy

Blood pressure is recorded using two numbers. The top number (systolic pressure) measures arterial pressure when your heart beats, and the bottom (diastolic pressure) measures arterial pressure between heartbeats.

In pregnancy, high blood pressure is defined as having a systolic pressure equal to or higher than 140 mm Hg or a diastolic pressure equal to or greater than 90 mm Hg.

There are several types of pregnancy-related hypertension:

Chronic Hypertension

This type occurs when you enter pregnancy already having HBP or develop it before 20 weeks gestation. Doctors typically adjust medications for safety during pregnancy if you have this type of hypertension.

Gestational Hypertension

Gestational Hypertension develops after you’ve been pregnant for 20 weeks and does not present excess protein in the urine or organ damage. However, it can progress to preeclampsia.

Preeclampsia

This serious condition presents signs of damage to organs such as the kidneys, liver, or brain. Swelling, sudden weight gain, headaches, vision issues, and pain under the ribs on the right side can occur.

Monitoring Your Blood Pressure

Checking your blood pressure frequently throughout pregnancy is imperative. Regular monitoring allows you to act quickly if the numbers start climbing too high.

If you have chronic hypertension and plan to become pregnant, let your doctor know so they can help you implement a plan to control it before conception. Tracking your blood pressure daily at home provides your doctor with helpful data.

Risk Factors to Know

Certain risk factors raise the chances of developing hypertension during pregnancy:

Having high blood pressure before conceiving
Being overweight or obese
Carrying more than one baby
Suffering from diabetes, autoimmune disorders, or kidney disease
Being older than 40 years of age
Having a family (or personal) history of preeclampsia

If you have any of these risk factors, your doctor will closely monitor you.

Dangers of High Blood Pressure in Pregnancy

If allowed to continue unmitigated, high blood pressure can result in:

Reduced blood flow to the placenta, which impacts oxygen/nutrients to the baby and can slow growth
Placental abruption, a condition in which the placenta separates early from the uterine wall
Preterm delivery
Future heart problems for the mother
Seizures or eclampsia
Damage to the brain, eyes, lungs, liver, and kidneys

In other words, it’s important to treat hypertension to make sure you stay healthy and avoid complications for you and your baby.

Treatment Considerations

If you enter pregnancy with already elevated pressure, the goal will be to keep your blood pressure stable. If you develop hypertension while pregnant, regulating those levels becomes the priority.

Medications

Your doctor will likely prescribe or adjust blood pressure medications that are known to be safe for pregnant individuals to keep your levels within strict parameters. Do not stop taking these without medical guidance. Commonly used drugs include labetalol, nifedipine, and methyldopa.

Magnesium sulfate injections may be administered in the hospital to prevent seizures for those with severely high blood pressure levels that could indicate preeclampsia.

Lifestyle Adjustments

Some lifestyle adjustments might also help keep your blood pressure under control, including:

Salt Intake: Limiting sodium is recommended to help regulate fluid retention and pressure.
Supplements: Calcium and omega fatty acids might assist with slight reductions.
Activity: Engage in moderate exercise daily if approved by your OB.
Weight: Losing any excess weight pre-pregnancy helps.
Stress: Manage anxiety with relaxation techniques such as meditation.

Aspirin

If you are at high risk for preeclampsia, your doctor may advise starting low-dose aspirin no later than the end of your first trimester.

Delivery Decisions

Depending on how your situation progresses, your OB provider will decide if early delivery is medically necessary. Steroid shots might be given before birth, depending on how soon the baby would be arriving, to strengthen lung development.

Breastfeeding is Still Encouraged

Nursing is considered safe for mothers with hypertension. Discuss your medications beforehand with your pediatrician and OB, but most women taking blood pressure drugs can safely breastfeed.

What You Can Do

While doctors treat and monitor hypertension, you play a pivotal role too by:

Seeing Your OB Regularly

Attending every prenatal visit allows close tracking of your progress. Monitoring your weight and blood pressure enables rapid response if readings spike. Immediately let your OB provider know of any symptoms that are concerning.

Voicing Your Concerns

Be honest with your OB about worries over medications, sticking to treatment plans, costs, future risks, or any aspect of management. They can only adjust their approach if they know exactly how you feel.

Educating Yourself

Read up on the latest research and ask your doctor to explain things in easy-to-understand language if needed. Enroll in local prenatal classes so you understand high blood pressure thoroughly. Avoid acting on random internet advice without first discussing it with your OB.

Tracking Readings

A home blood pressure monitor gives you objective numbers to share with your OB to provide the best care. Keep detailed records of your pressures to spot trends.

Communicating About Experiences

Keep your OB in the loop about how you feel about certain drugs, if home monitoring shows spikes or dips, when pressures rise, or when symptoms develop. Feedback is essential for effective treatment.

Remaining Proactive

Learn all you can about safely managing high blood pressure in pregnancy so you can advocate for the care you need while adhering properly to treatment protocols. You play a significant part in controlling this condition.

Imperial Center Family Medicine: Pregnancy Hypertension Care Experts

Imperial Center Family Medicine’s team of expert healthcare providers in Durham, NC has extensive experience caring for mothers with high blood pressure before, during, and after pregnancy.