Gestational (pregnant) hypertension What we need to know

18.06.2024

Gestational hypertension is a condition where blood pressure readings are equal to or greater than 140/90 mmHg and the condition begins in the second half of pregnancy - usually from 20 weeks. An increase in blood pressure harms the health of both the mother and the fetus.

Table of Contents

Arterial hypertension associated with pregnancy is a condition that begins from the 20th week of pregnancy and ends shortly after the birth of the child. It develops in 6-8% of pregnant women.

High blood pressure may not cause noticeable symptoms, so it is important to check blood pressure regularly during pregnancy.

What is high blood pressure (hypertension)?

Blood pressure is the force with which the circulating blood stream exerts pressure on a blood vessel. During the development of hypertension, the pressure on blood vessels increases.

Does the effect of elevated blood pressure differ on pregnant women and non-pregnant women?

The effect of high blood pressure on the pregnancy process is somewhat different. During pregnancy, the body is already in a stressful situation, because the intensity of the heart's work is increased even under physiological conditions to ensure blood supply to the body of the mother and the fetus.

High blood pressure disrupts the processes of placental development and normal functioning, which increases the risk of complications for both mother and fetus during pregnancy and childbirth.

Variants of gestational hypertension in pregnant women

There are different forms of blood pressure increase in pregnant women. Manifestation depends on the duration of arterial hypertension and the established symptom complex.

The most common types of hypertension in pregnancy are:

Chronic hypertension - Presence of high blood pressure before pregnancy, or in the early (up to 20 weeks) stage of pregnancy. This form of hypertension continues even after childbirth. Pregnant women with chronic hypertension often develop preeclampsia.
Gestational hypertension – High blood pressure, developed in the second half of pregnancy. Some patients with gestational hypertension also develop preeclampsia.
Preeclampsia - It is a condition that develops only in the second half of pregnancy (from 27 weeks). To confirm the diagnostics, it is necessary to have high blood pressure numbers along with proteinuria (the presence of protein in the urine). The condition affects a pregnant woman's kidneys, liver, lungs and brain, as well as the placenta. In preeclampsia, the risk of heart failure increases.

Who is at risk of developing high blood pressure and preeclampsia during pregnancy?

Pregnant women under the age of 20 and over the age of 40
with gestational hypertension or preeclampsia developed in previous pregnancies
Pregnant women with a family history of gestational hypertension
Pregnant women with diabetes and gestational diabetes
Pregnant women with autoimmune pathologies, such as lupus erythematosus
Pregnant women with chronic kidney disease
During pregnancy with 2 or more fetuses

Are gestational hypertension and preeclampsia the same thing?

The answer to the question is: No! Gestational hypertension is a condition that appears in the second half of pregnancy, but does not cause kidney damage and proteinuria. This condition may develop into preeclampsia, which is why more frequent monitoring of blood pressure is necessary.

Preeclampsia is a form of hypertension in pregnant women, which also develops in the second half of pregnancy and is characterized by multiorgan complications, which also affects the normal development of the fetus and may cause premature birth.

Symptoms

What causes high blood pressure during pregnancy?

There is no single specific cause, but the coexistence of several risk factors increases the risk of its development.

High blood pressure (hypertension) is often called the "silent killer" because most people have no symptoms at all and therefore have no idea about their blood pressure. However, some of the cases still show a certain symptom complex:

swelling
headache
Sudden weight gain
Deterioration of vision
Nausea and/or vomiting
Decreased urination
stomach-ache

What are the dangers of gestational hypertension during pregnancy?

Hearts
stroke
Temporary renal failure
Liver damage
Increased blood clotting

In case of arterial hypertension in pregnant women, the need for caesarean section is frequent.

What effect does gestational hypertension have on the fetus?

High blood pressure prevents the delivery of sufficient food and oxygen through the placenta to the fetus, which in turn causes various pathologies of the fetus:

Low birth weight (less than 2500 grams)
Premature newborn (up to 37 weeks of gestation)
The need for artificially induced labor (up to 39 weeks)

Warning signs developed in gestational hypertension

A sudden, severe headache
Blurred or double vision
swelling
Urinary retention

All these cases require an urgent visit to the doctor and often immediate medical intervention.

What should be normal blood pressure in pregnant women?

Two indicators of blood pressure are measured: systolic - the force of blood flow, which is created by the contraction of the left ventricle of the heart, and diastolic - the force of blood flow, which acts on blood vessels in the period between heart contractions. The unit is a millimeter of silver water column.

In the first trimester of pregnancy, it is necessary to evaluate the blood pressure level in order to determine if it is a normal level or if we are dealing with chronic hypertension. Blood pressure higher than 140/90 mmHg requires medical treatment. 160/110mmHg and more may cause heart failure, stroke and often require inpatient care.

Diagnosis and studies of gestational hypertension

During pregnancy monitoring, changes in blood pressure of any nature require attention and response. When detecting any pathology, certain diagnostic tests are necessary:

General blood test
General analysis of urine
Determination of protein in urine
Functional tests of the liver
Functional samples of the kidney
electrolytes
Coagulogram

Treatment and management

The treatment plan for gestational hypertension depends on your general health, the length of your pregnancy, and other factors.

Regular blood pressure monitoring and regular examinations during pregnancy monitoring allow for the management of gestational hypertension and the prevention of preeclampsia.

What means can we control gestational hypertension?

Antihypertensive treatment
Self-control of pressure
Prenatal care
If necessary, artificial childbirth
Adhering to the correct diet and limiting salt in the diet
Moderate physical activity

Is bed rest necessary during gestational hypertension?

Bed rest is often one of the methods of treatment of gestational hypertension.

Prevention

Is it possible to prevent gestational hypertension?

Because the exact cause of gestational hypertension is often unknown, it is difficult to prevent the disease. However, there are a number of recommendations that help us maintain physiological blood pressure

Maintaining a healthy weight
Proper nutrition
Moderate physical activity
Abstinence from alcohol and tobacco consumption
enough rest

forecast

Will high blood pressure continue after childbirth?

In typical cases, blood pressure readings return to normal after delivery. However, the detection of gestational hypertension increases the risks of developing arterial hypertension and heart diseases in the future. In severe forms of preeclampsia and gestational hypertension, treatment with hypotensive agents continues even after delivery.

Chronic hypertension before pregnancy usually continues after delivery.