Pre-eclampsia, high blood pressure, hypertension can sound similar but they can cause serious pregnancy complications. Some women have high blood pressure during pregnancy. The good news is that high blood pressure is preventable and treatable. However, Preeclampsia is a serious condition that can occur during pregnancy. The condition causes your blood pressure to become very high and can be life-threatening.
In India, the incidence of preeclampsia is reported to be 8-10% among the pregnant women. According to a study, the prevalence of hypertensive disorders of pregnancy was 7.8% with preeclampsia in 5.4% of the study population in India*.
Both of these conditions can put the mother and her baby at risk for problems during the pregnancy. That is why it is important for you to understand the symptoms of Pre-eclampsia, its causes and what you need to do.
Pre-eclampsia and High Blood Pressure: How they can affect you during pregnancy?
What is high blood pressure?
Blood pressure is the pressure of the blood against the blood vessel walls each time the heart contracts (squeezes) to pump the blood through your body. High blood pressure also is called hypertension. During pregnancy, severe or uncontrolled hypertension can cause complications for you and your baby.
What is chronic hypertension?
Chronic hypertension is high blood pressure that was present before you became pregnant or that occurs in the first half (before 20 weeks) of your pregnancy. If you took blood pressure medication before you became pregnant—even if your blood pressure is normal—you have chronic hypertension.
What is gestational hypertension?
Gestational hypertension is high blood pressure that first occurs in the second half (after 20 weeks) of pregnancy. Although gestational hypertension usually goes away after childbirth, it may increase the risk of developing hypertension in the future.
What kinds of problems can hypertension cause during pregnancy?
High blood pressure during pregnancy can place extra stress on your heart and kidneys and can increase your risk of heart disease, kidney disease, and stroke. Other possible complications include the following:
- Fetal growth restriction—High blood pressure can decrease the flow of nutrients to the baby through the placenta. The baby may have growth problems as a result.
- Preeclampsia—This condition is more likely to occur in women with chronic high blood pressure than in women with normal blood pressure.
- Preterm delivery—If the placenta is not providing enough nutrients and oxygen to your baby, it may be decided that early delivery is better for your baby than allowing the pregnancy to continue.
- Placental abruption—This condition, in which the placenta prematurely detaches from the wall of the uterus, is a medical emergency that requires immediate treatment.
- Cesarean delivery—Women with hypertension are more likely to have a cesarean delivery than women with normal blood pressure. A cesarean delivery carries risks of infection, injury to internal organs, and bleeding.
How is chronic hypertension during pregnancy managed?
Your blood pressure will be monitored closely throughout pregnancy. You may need to monitor your blood pressure at home. Ultrasound exams may be done throughout pregnancy to track the growth of your baby. If growth problems are suspected, you may have additional tests that monitor the baby’s health. This testing usually begins in the third trimester of pregnancy.
If your hypertension is mild, your blood pressure may stay that way or even return to normal during pregnancy, and your medication may be stopped or your dosage decreased. If you have severe hypertension or have health problems related to your hypertension, you may need to start or continue taking blood pressure medication during pregnancy.
The most important thing to do is talk with your medical team about any blood pressure problems so you can get the right treatment and control your blood pressure. Getting treatment for high blood pressure is important before, during, and after pregnancy.
What is pre-eclampsia?
Pre-eclampsia is a serious blood pressure disorder that can affect all of the organs in a woman’s body. A woman has preeclampsia when she has high blood pressure and other signs that her organ systems are not working normally. One of these signs is proteinuria (an abnormal amount of protein in the urine). A woman with preeclampsia whose condition is worsening will develop other signs and symptoms known as “severe features.” These include a low number of platelets in the blood, abnormal kidney or liver function, pain over the upper abdomen, changes in vision, fluid in the lungs, or a severe headache. A very high blood pressure reading also is considered a severe feature.
When does preeclampsia occur?
It usually occurs after 20 weeks of pregnancy, typically in the third trimester. When it occurs before 32 weeks of pregnancy, it is called early-onset preeclampsia. It also can occur in the postpartum period.
What causes pre-eclampsia?
It is not clear why some women develop preeclampsia, but the risk of developing preeclampsia is increased in women who
- are pregnant for the first time
- have had preeclampsia in a previous pregnancy or have a family history of preeclampsia
- have a history of chronic hypertension, kidney disease, or both
- are 40 years or older
- are carrying more than one baby
- have certain medical conditions such as diabetes mellitus, thrombophilia, or lupus
- are obese
- had in vitro fertilization
What are the risks for my baby, if pre-eclampsia occurs?
If pre-eclampsia occurs during pregnancy, your baby may need to be delivered right away, even if he or she is not fully grown. Preterm babies have an increased risk of serious complications. Some preterm complications last a lifetime and require ongoing medical care.
What are the risks for the pregnant woman, if pre-eclampsia occurs?
Women who have had preeclampsia—especially those whose babies were born preterm—have an increased risk later in life of cardiovascular disease and kidney disease, including heart attack, stroke, and high blood pressure. Having preeclampsia once increases the risk of having it again in a future pregnancy. Preeclampsia also can lead to seizures, a condition called eclampsia and sometimes HELLP syndrome.
What are the signs and symptoms of preeclampsia?
Here are the warning signs of preeclampsia:
- Swelling of face or hands
- A headache that will not go away
- Seeing spots or changes in eyesight
- Pain in the upper abdomen or shoulder
- Nausea and vomiting (in the second half of pregnancy)
- Sudden weight gain
- Difficulty breathing
If you have any of these symptoms, especially if they develop in the second half of pregnancy, contact your doctor right away.
How is gestational hypertension or preeclampsia managed?
Management of gestational hypertension or preeclampsia with or without severe features will be done by your doctor with close monitoring of your health and fetal parameters.
How does preeclampsia affect future health?
Women who have had preeclampsia—especially those whose babies were born preterm—have an increased risk later in life of kidney disease, heart attack, stroke, and high blood pressure. Also, having preeclampsia once, increases the risk of having it again in a future pregnancy.
Taking care of yourself and having a healthy lifestyle can help reduce this risk. Try to:
- avoid smoking
- exercise regularly
- eat a healthy, balanced diet
- maintain a healthy weight.
References: Gestational Hypertension and Preeclampsia; Practice Bulletin 222; June 2020; https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/06/gestational-hypertension-and-preeclampsia * Preeclampsia | National Health Portal Of India; CREATED / VALIDATED BY : Dr. Aruna Rastogi; 2016 https://www.nhp.gov.in/disease/gynaecology-and-obstetrics/preeclampsia