Hypertension During Pregnancy

High blood pressure (hypertension) is when the force of blood pumping through the arteries is high enough to cause problems with your health. Arteries are blood vessels that carry blood from the heart throughout the body. Hypertension during pregnancy can cause problems for you and your baby. It can be mild or severe.

• Chronic hypertension. This happens when you had high blood pressure before you became pregnant, and it continues during the pregnancy. Hypertension that develops before you are 20 weeks pregnant and continues during the pregnancy is also called chronic hypertension. If you have chronic hypertension, it will not go away after you have your baby. You will need follow-up visits with your health care provider after you have your baby. Your health care provider may want you to keep taking medicine for your blood pressure.
• Gestational hypertension. This is hypertension that develops after the 20th week of pregnancy. Gestational hypertension usually goes away after you have your baby, but your health care provider will need to monitor your blood pressure to make sure that it is getting better.
• Postpartum hypertension. This is high blood pressure that was present before delivery and continues after delivery or that starts after delivery. This usually occurs within 48 hours after childbirth but may occur up to 6 weeks after giving birth.

When hypertension during pregnancy is severe, it is a medical emergency that requires treatment right away.

How does this affect me?

• Stroke.
• Heart attack.
• Injury to other organs, such as kidneys, lungs, or liver.
• Preeclampsia.
• A condition called hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome.
• Convulsions or seizures.
• Placental abruption.

How does this affect my baby?

• Be born early (prematurely).
• Not weigh as much as he or she should at birth (low birth weight).
• Not tolerate labor well, leading to an unplanned cesarean delivery.

This condition may also result in a baby's death before birth (stillbirth).

What are the risks?

• Having hypertension during a previous pregnancy or a family history of hypertension.
• Being overweight.
• Being age 35 or older.
• Being pregnant for the first time.
• Being pregnant with more than one baby.
• Becoming pregnant using fertilization methods, such as IVF (in vitro fertilization).
• Having other medical problems, such as diabetes, kidney disease, or lupus.

What can I do to lower my risk?

• Maintaining a healthy weight.
• Eating a healthy and balanced diet.
• Following your health care provider's instructions about treating any long-term conditions that you had before becoming pregnant.

It is very important to keep all of your prenatal care appointments. Your health care provider will check your blood pressure and make sure that your pregnancy is progressing as expected. If a problem is found, early treatment can prevent complications.

How is this treated?

• If you were taking medicine for high blood pressure before you became pregnant, talk with your health care provider. You may need to change medicine during pregnancy because some medicines, like ACE inhibitors, may not be considered safe for your baby.
• If you have gestational hypertension, your health care provider may order medicine to treat this during pregnancy.
• If you are at risk for preeclampsia, your health care provider may recommend that you take a low-dose aspirin during your pregnancy.
• If you have severe hypertension, you may need to be hospitalized so you and your baby can be monitored closely. You may also need to be given medicine to lower your blood pressure.
• In some cases, if your condition gets worse, you may need to deliver your baby early.

Follow these instructions at home:

Eating and drinking

• Drink enough fluid to keep your urine pale yellow.
• Avoid caffeine.

Lifestyle

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
• Do not use alcohol or drugs.
• Avoid stress as much as possible.
• Rest and get plenty of sleep.
• Regular exercise can help to reduce your blood pressure. Ask your health care provider what kinds of exercise are best for you.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all prenatal and follow-up visits. This is important.

Contact a health care provider if:

• You have symptoms that your health care provider told you may require more treatment or monitoring, such as:
  • Headaches.
  • Nausea or vomiting.
  • Abdominal pain.
  • Dizziness.
  • Light-headedness.

Get help right away if:

• You have symptoms of serious complications, such as:
  • Severe abdominal pain that does not get better with treatment.
  • A severe headache that does not get better, blurred vision, or double vision.
  • Vomiting that does not get better.
  • Sudden, rapid weight gain or swelling in your hands, ankles, or face.
  • Vaginal bleeding.
  • Blood in your urine.
  • Shortness of breath or chest pain.
  • Weakness on one side of your body or difficulty speaking.
• Your baby is not moving as much as usual.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Hypertension during pregnancy can cause problems for you and your baby.
• Treatment for hypertension during pregnancy varies depending on the type of hypertension you have and how serious it is.
• Keep all prenatal and follow-up visits. This is important.
• Get help right away if you have symptoms of serious complications related to high blood pressure.