Hypertension in pregnancy

Hypertension or high blood pressure is a condition where blood flowing in the blood vessels of the body, flows at a greater than normal pressure. Hypertension if present during pregnancy poses a grave threat to the health of both the baby and mother. If the blood pressure recorded in a pregnant lady 6 hours apart comes to greater than 140/90 mm.Hg. she is said to be having a high blood pressure or gestational hypertension. About 60% of women may develop high blood pressure only during pregnancy, which will settle after delivery. In case of women having hypertension from before, it can be aggravated when they are pregnant. Some women tend to develop high blood pressure with every pregnancy, whereas for some it may be during a pregnancy but in subsequent times, it may remain normal. Complications related to high blood pressure can also be more, when it is present during pregnancy. Pre-existing high blood pressure can be aggravated during pregnancy because greater volume of blood flows inside the body and at a slightly higher pressure during this state. This can lead to sudden heart or kidney failure. Some women develop sudden swelling of feet, a very high blood pressure and convulsions, when pregnant, a condition called eclampsia. This is a medical emergency. The blood pressure is brought down immediately, and the fetus is evacuated, otherwise the mother can die. Hypertension during pregnancy, can lead to death of the baby in the mother’s womb necessitating induction of labor or operative removal of the dead baby depending on the stage of pregnancy. This is cumbersome as well as painful for the woman. A woman who has hypertension from before has to continue her antihypertensive medication when pregnant. Some of these drugs have potential to cause damage to the unborn baby, particularly when taken during the first 3 months, when the baby’s body is being formed. Sedative drugs like diazepam are sometimes used as adjunct therapy to control high blood pressure. But during pregnancy it can harm the fetus. Associated diabetes can aggravate these problems. Women who smoke or take alcohol are more prone to develop high blood pressure, and its related complications during pregnancy. Very young mothers, i.e. in teens, or those who conceive after 40 years are said to be more susceptible to develop high blood pressure during pregnancy. Similarly obese women are also at high risk for hypertension, when pregnant. Twin pregnancy ( i.e. when twins are present in the uterus) poses a threat for the woman to have high blood pressure. When a woman conceives, it is important for her to have her blood pressure checked at regular intervals. Thus high blood pressure can be detected and treated at the earliest before any complications develop. Checking the blood sugar regularly for diabetes is also useful, because both can co-exist and one can aggravate the other, thus augmenting the risk of damage to the mother and baby. Testing the urine for passage of proteins, is also an important antenatal test done and is more useful for women suffering from hypertension. This helps in detecting any damage to the kidneys at the earliest and also in diagnosing eclampsia of pregnancy. If somebody is overweight, she should take to exercising to reduce the body weight and prevent high blood pressure. Brisk walking is by far the most suitable exercise for a pregnant woman. This should be combined with a low or fat free diet, which would help in preventing or reducing obesity. Smoking and alcohol should be totally avoided. Apart from causing hypertension, these toxic substances have various other harmful effects during pregnancy. If possible, a previously known hypertensive patient should avoid medicines to lower the blood pressure during the first 3 months. This is advised to avoid the potential damaging effect of drugs on the unborn baby. If at all necessary, she should consult the doctor first regarding the medicines to be taken. Thus overall management of a pregnant lady with hypertension becomes slightly different from a non pregnant person. For the sake of her own and the unborn baby’s well being, a lady should be careful about her blood pressure. –rachna212002@yahoo.co.uk