Intermountain Healthcare

Managing High Blood Pressure During Pregnancy to Keep Mom and Baby Safe

 

Salt Lake City, UT -- (ReleaseWire) -- 11/23/2021 --High blood pressure is very common. According to the Centers for Disease Control and Prevention about half of Americans have high blood pressure. And many of them may not know it. That's why it's known as the silent killer.

If a woman is pregnant and has high blood pressure, it is important to know you they have it and take steps to manage it.

"High blood pressure or hypertension is when your blood pressure, the force of your blood pushing against the walls of your blood vessels, is consistently too high," said Dr. Tania Bodnar, an OB/Gyn with Intermountain Healthcare in Utah. She said that people with high blood pressure have systolic blood pressure greater than 140 mm Hg or a diastolic blood pressure greater than 90 mm Hg.

When asked if individuals get high blood pressure for the first time during pregnancy or if it is something women have prior to pregnancy, Dr. Bodnar said it can happen both ways. "Some women have chronic high blood pressure which is high blood pressure prior to pregnancy. Some women develop high blood pressure during pregnancy."

Dr. Bodnar said some have chronic high blood pressure and are already being treated for it by a primary care provider and others don't know they have it. "That's why it's important to go to your prenatal visits and have your blood pressure checked," she said. Some women can acquire high blood pressure during pregnancy, especially towards the end of pregnancy. "It is important to know if your blood pressure is high and if it's getting worse, because this could become dangerous for the pregnancy and ultimately the baby."

Technically, a woman is considered to have chronic hypertension if the high blood pressure is diagnosed before 20 weeks of pregnancy. Alternatively, if it is diagnosed after 20 weeks of pregnancy we call this gestational hypertension. According to the CDC, in the United States, high blood pressure happens in 1 in every 12 to 17 pregnancies among women ages 20 to 44.

The risk factors for high blood pressure include:

- First pregnancy
- Young age at first pregnancy
- Advanced maternal age
- Obesity
- Decreased physical activity
- Smoking or drinking alcohol
- Diabetes
- Autoimmune disease
- Engaging in assistive reproductive technology such as IVF
- Carrying multiples (like twins or triplets)

"Many people have no symptoms at all," said Dr. Bodnar. Worsening hypertension can cause headaches, blurry vision, floaters in the eyes. In severe cases people may experience shortness of breath or chest pain, or abdominal right upper quadrant or epigastric pain.

"Identifying whether your symptoms are due to pregnancy, hypertension, or COVID-19 can be confusing. Talk to your provider about any concerns."

It important to manage high blood pressure during pregnancy because complications can be very serious and include:

- Preeclampsia, when high blood pressure can lead to organ damage in the mother and ultimately cause problems with the baby
- Eclampsia, when the mother can have seizures
- A stroke due to very high blood pressure.
- Decreased blood flow to the placenta can lead to baby receiving less oxygen and fewer nutrients, causing low birth weight
- Sometimes a recommendation is made for a preterm delivery

"It's often during the third trimester when symptoms can get worse and high blood pressure can become preeclampsia, but it can happen before this as well," said Dr. Bodnar.

She adds that some high blood pressure medications are safe during pregnancy and some are not, so women need to check with their primary care provider, OB, or midwife. "It's good to talk about it with them before you're thinking getting pregnant."

"If you already had hypertension, before you got pregnant, you provider may need to adjust your medication to something different. If you are taking a medication for your high blood pressure that is not considered safe in pregnancy and this wasn't changed for you prior to getting pregnant, you may need some closer follow ups and ultrasounds to make sure there was no danger caused to the baby," said Dr. Bodnar.

Diet and exercise are important for overall health and are somewhat helpful in controlling regular hypertension, but not as helpful at controlling it during pregnancy. Dr. Bodnar recommends staying active and eating a well-balanced diet during pregnancy.

"If you have high blood pressure when you're pregnant, blood tests may be done to make sure it's not progressing. Depending on your diagnosis, additional monitoring may be recommended, including checking on the baby as through non-stress tests, fluid checks or growth scans," said Dr. Bodnar.

Ultimately, the treatment for gestational hypertension is delivery. "In some cases, you may need to deliver your baby early to keep you and your baby safe. Sometimes gestational hypertension doesn't resolve after delivery and can lead to chronic hypertension, but this does not happen often," said Dr. Bodnar.

About Intermountain Healthcare
Intermountain Healthcare is a nonprofit system of 25 hospitals, 225 clinics, a Medical Group with 2,700 employed physicians and advanced practice clinicians, a health insurance company called SelectHealth, and other health services in Utah, Idaho, and Nevada. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and in efficient healthcare delivery. For more information about Intermountain, visit intermountainhealthcare.org. For helpful advice for expectant moms and new parents, see Intermountain Moms online or follow us on www.facebook.com/intermountainmoms, www.instagram.com/intermountainmoms, or https://twitter.com/IntermtnMoms.