Causes of sudden high blood pressure during pregnancy

• Overview
• Symptoms and Causes
• Management and Treatment
• Prevention
• Outlook / Prognosis

Overview

What is high blood pressure (hypertension)?

Blood pressure is the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels) that carry the blood throughout the body. High blood pressure, also called hypertension, means that the pressure in the arteries is above the normal range.

How is high blood pressure (hypertension) during pregnancy different from high blood pressure at other times?

High blood pressure during pregnancy can impact the body in different ways than it normally would. Mothers with high blood pressure during pregnancy are at a higher risk of complications before, during and after the birth. Not only is the mother’s health in danger, but the baby can be impacted by high blood pressure during pregnancy.

High blood pressure during pregnancy can affect the development of the placenta, causing the nutrient and oxygen supply to the baby to be limited. This can lead to an early delivery, low birth weight, placental separation (abruption) and other complications for the baby.

What are the different forms of high blood pressure (hypertension) during pregnancy?

High blood pressure (hypertension) complicates about 10 percent of all pregnancies. There are several different types of high blood pressure during pregnancy. These types vary in severity and impact on the body. The forms of high blood pressure during pregnancy include:

• Chronic hypertension: High blood pressure which is present prior to pregnancy.
• Chronic hypertension with superimposed preeclampsia: Preeclampsia, which develops in someone who has chronic hypertension (high blood pressure before pregnancy).
• Gestational hypertension: High blood pressure is noted in the latter part of pregnancy, but no other signs or symptoms of preeclampsia are present. Some women will later develop preeclampsia, while others probably have high blood pressure (chronic hypertension) before the pregnancy.
• Preeclampsia: A condition only found in the latter half of pregnancy and results in hypertension, protein in the urine, and generalized swelling in the mother. It can impact other organs in the body and also cause seizures (eclampsia).

Who is at higher risk of developing high blood pressure (hypertension) during pregnancy?

A woman is more likely to develop high blood pressure (hypertension) during pregnancy if she:

• Is under age 20 or over age 40
• Has a history of chronic hypertension (high blood pressure before becoming pregnant)
• Has had gestational hypertension or preeclampsia during past pregnancies
• Has a family history of gestational hypertension
• Has diabetes or gestational diabetes
• Is overweight
• Has an immune system disorder, such as lupus
• Has kidney disease
• Is expecting multiple babies
• Had in vitro fertilization
• Is African American

Symptoms and Causes

What is the danger of high blood pressure (hypertension) during pregnancy?

High blood pressure (hypertension) during pregnancy can prevent the placenta (the food supply for the baby in the womb) from receiving enough blood. The lowered amount of blood to the placenta can lead to a low birth weight. Other complications can occur from high blood pressure during pregnancy. These conditions do not happen to all women with high blood pressure. They can include:

• Seizures in the mother
• Stroke
• Temporary kidney failure
• Liver problems
• Blood clotting problems
• Placental abruption: The placenta pulls away from the wall of the uterus, causing distress to the baby and the bleeding in the mother
• Premature (early) delivery of the baby
• A cesarean delivery

Management and Treatment

How is high blood pressure (hypertension) during pregnancy treated?

High blood pressure (hypertension) during pregnancy can be treated in a variety of ways depending on the severity, cause and time of onset. Mothers with all forms of hypertension will need to be monitored closely. This could include more prenatal visits, ultrasounds, and other tests to ensure the baby’s well-being (monitoring of fetal heart rate or activity).

What steps can I take to have a safe delivery with high blood pressure (hypertension) during pregnancy?

Steps that patients with high blood pressure (hypertension) during pregnancy can take to help the chances of having a safe and healthy delivery include:

• Taking any blood pressure medication as prescribed
• Going to all of your prenatal visits
• Having an early delivery if it is needed
• Maintaining a healthy diet (low-sodium foods are recommended)
• Following your healthcare providers instructions regarding activity and exercise

Prevention

Can high blood pressure (hypertension) during pregnancy be prevented?

Since the cause of high blood pressure (hypertension) during pregnancy is not known, it is not a condition that can usually be prevented. In some women at high risk for developing high blood pressure, healthcare providers often recommend daily baby aspirin for prevention. High blood pressure during pregnancy can sometimes be managed and controlled with the help of a healthcare provider. However, this may often require delivery of the baby. Your blood pressure will be checked regularly during prenatal appointments. If you have any concerns about your blood pressure, speak with your healthcare provider.

Outlook / Prognosis

Will I still have high blood pressure (hypertension) after the baby is delivered?

High blood pressure (hypertension) during pregnancy typically goes away after the baby is delivered but increases the risk of high blood pressure and heart disease in the future. Women who had chronic hypertension before pregnancy will usually still have the condition after delivery. Sometimes, blood pressure can remain high after delivery, requiring treatment with medication. Your healthcare provider will work with you after your pregnancy to manage your blood pressure.

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