Hypertension affects about 2-10 % of pregnant women around the globe. In pregnancy, it can occur due to various causes and needs to be managed in an entirely different way so as to keep the mother safe without affecting the baby. Dr. Purva Sahakari, an Obstetrician, Gynecologist and Infertility Specialist, gives us some interesting insights on the same.
Hypertension in pregnancy could be of any of these four patterns:
- When a pregnant lady develops high BP prior to pregnancy or prior to 20 weeks (5 months) of gestation of pregnancy.
- When a pregnant lady develops high BP after 20 weeks (5 months) of gestation of pregnancy and is associated with the presence of protein in urine examination.
- When a pregnant lady develops hypertension after 20 weeks (5 months) of gestation of pregnancy and is not associated with the presence of protein in urine examination.
- A combination of 1 and 2.
Hypertension in pregnancy is detected usually during a pregnancy checkup when the recorded blood pressure seems to be elevated above 140 / 90 mm Hg on at least two occasions which are at least 6 hours apart. The presence of protein in the urine (on a urine test) helps us to know the type of hypertension.
Who are at high risk?
1.First pregnancy.
2. If the lady is 40 yrs and above.
3.If the lady has had a history of high BP in prior pregnancies.
4. Women with Diabetes, Obesity, already have high BP prior to pregnancy, autoimmune disorders, history of smoking, any kidney disorders.
5.Twin or multiple pregnancies.
Recognizing the onset of high BP in pregnant women.
Swelling of legs, swelling of hands & face.
Headache, giddiness, blurring of vision, abdominal pain, sudden nausea & vomiting etc.
Hypertension in a pregnant woman can have an effect on the mother as well as the fetus.
Complications to the mother include sustained high BP requiring admission to the hospital and sometimes emergency delivery, the lady may get convulsions, affections of liver and clotting mechanisms, brain haemorrhage & stroke.
Fetus (baby in the womb) of a woman with hypertension can have growth retardation, premature delivery, complications of prematurity, low birth weight, and even death of the fetus.
Level of essential care:
Such women have frequent visits to her obstetrician and may need to undergo a few extra blood investigations and special ultrasound examinations.
Regular checking of blood pressure and maintaining a chart would add to better monitoring.
Adequate sleep, rest, light walks, meditation etc can be taken.
Medications to maintain BP are started when essential, in a few women to ensure proper control of blood pressure.
Normal delivery or cesarean?
This depends on multiple factors. The doctor decides depending on the presenting condition and each case is individualized. Cases with specific indications or complications are delivered by caesarean section.
Does the BP settle after delivery?
In many cases, Yes. However, some might need to continue their medications even after delivery. It needs to be addressed on a case to case basis. Some might be prone to develop high BP later in life. So, it is advisable to have a healthy lifestyle with good weight control and a good healthy diet to avoid the chance of developing hypertension (high BP).
With regular checkups, maintaining good mental health, support and tender loving care from the family and the healthcare persons, such women with high BP in pregnancy can definitely have a safe pregnancy and delivery.
For your queries, contact drpurva1410@gmail.com
