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Pregnancy causes natural changes in the body. And for child-bearing people who don’t know what to expect when expecting, it can be difficult to determine what is a normal change and what needs closer medical attention.
Hypertension is fairly common during pregnancy—1 in every 12 to 17 pregnancies to be exact, according to the Centers for Disease Control and Prevention. Defined as having a systolic blood pressure reading (the top number) of 140 or higher and a diastolic blood pressure reading (the bottom number) of 90 or higher, hypertension, if left untreated, can be harmful to parent and baby.
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“During pregnancy, there’s a lot more blood flow involved. So, if you have long-standing hypertension, it can lead to impaired functioning of the heart, cardiac problems like congestive heart failure or peripartum cardiomyopathy, which is a specific heart condition during pregnancy where the heart is not able to keep up with the increased volume of blood volume,” Aneesha Varrey, MD, maternal fetal medicine specialist and high risk obstetrician at Perinatal Associates at GBMC Health Partners, said. “In terms of the baby, the placental blood flow can be compromised in a woman with hypertension, which can lead to impaired growth of baby and therefore lead to a preterm birth.”
Women might already have high blood pressure before becoming pregnant or develop it during pregnancy. Either way, the interventions are the same. Dr. Varrey recommends lifestyle changes such as 30 minutes of aerobic exercise daily and lowering salt intake. There are also medications safe for pregnancy that help to stabilize blood pressure.
“One medication we give for women with high blood pressure prior to pregnancy or women who are at increased risk of preeclampsia is baby aspirin, which we start at 12 weeks,” Dr. Varrey said. “It reduces the risk of hypertension developing into preeclampsia by 40%.”
If high blood pressure suddenly develops after 20 weeks, that is referred to as preeclampsia or gestational hypertension. It is an important distinction because preeclampsia is a more serious condition associated with high blood pressure as well as increased protein in the urine and impact on other organs. Pregnant women who have hypertension are at higher risk for preeclampsia, but it is not a certainty.
“In the first two trimesters, blood pressure naturally drops during pregnancy for everyone, so hypertensive women may not require as many medications during the first two trimesters,” Dr. Varrey said. “During the third trimester, blood pressure starts to go up again, and that’s when we usually have to go up on the medications to make sure they don’t develop preeclampsia.”
Pregnant women diagnosed with hypertension should expect to visit with their obstetrician more regularly to check in and be monitored, but the frequency depends on how high their blood pressure is. Dr. Varrey also said that while she and her team do not typically recommend early induction for a traditional pregnancy, this would be different.
“For chronic hypertension, if they’re on medications, we usually recommend an induction by 39 weeks,” Dr. Varrey said. “After that, the risk of stillbirth and abruption increase. At 39 weeks, the baby is fully developed, and we have very good data that shows induction at 39 weeks does not increase risk of cesarean section or any other harmful outcomes.”
Knowing what to expect is step one, and then, advocate for what you need. The best thing pregnant women can do to protect their health and their baby’s health is monitor symptoms, advocate for tests and interventions, and get a second opinion if they feel needs are getting dismissed. Pregnancy can be a new challenge, but now you know what to expect.
The post What Does It Mean to Have Hypertension During Pregnancy appeared first on AFRO American Newspapers.
