Postpartum Hypertension

Postpartum hypertension is blood pressure that is higher than normal after childbirth. It usually starts within 1 to 2 days after delivery, but it can happen at any time for up to 12 weeks after delivery. For some women, medical treatment is required to prevent serious complications, such as seizures or stroke.

What are the causes?

• Hypertension that existed before pregnancy (chronic hypertension).
• Hypertension that happens as a result of pregnancy (gestational hypertension).
• Hypertensive disorders during pregnancy or seizures in women who have high blood pressure during pregnancy. These conditions are called preeclampsia and eclampsia.
• A condition in which the liver, platelets, and red blood cells are damaged during pregnancy (HELLP syndrome).
• Obesity.
• Diabetes.

What are the signs or symptoms?

• Headaches. These may be mild, moderate, or severe. They may also be steady, constant, or sudden (thunderclap headache).
• Vision changes, such as blurry vision, flashing lights, or seeing spots.
• Nausea and vomiting.
• Pain in the upper right side of your abdomen.
• Shortness of breath or trouble breathing.
• Swelling in your face or hands.
• A decrease in the amount of urine that you pass.

You may not have any signs or symptoms.

How is this diagnosed?

This condition may be diagnosed based on the results of a physical exam, blood pressure measurements, and blood and urine tests.

You may also have other tests, such as a CT scan or an MRI, to check for other problems.

How is this treated?

• Medicines to reduce blood pressure (antihypertensives). Tell your health care provider if you are breastfeeding or if you plan to breastfeed. There are many antihypertensive medicines that are safe to take while breastfeeding.
• Treating medical conditions that are causing hypertension.
• Treating the complications of hypertension, such as seizures, stroke, or kidney problems.

Your health care provider will also continue to monitor your blood pressure closely until it is within a safe range for you.

Follow these instructions at home:

Learn your goal blood pressure

Two numbers make up your blood pressure. The first number is called systolic pressure. The second is called diastolic pressure. An example of a blood pressure reading is "120 over 80" (or 120/80). Ask your health care provider what your goal blood pressure is.

Know how to take your blood pressure

To check your blood pressure, follow the instructions in the manual that came with your blood pressure monitor. This includes any instructions on what to do before taking your blood pressure.

Record your blood pressure readings

Follow your health care provider's instructions on how to record your blood pressure readings. Your health care provider may ask you to:

• Get one reading in the morning (a.m.) before you take any medicines.
• Get one reading in the evening (p.m.) before supper.
• Take at least 2 readings with each blood pressure check. This makes sure the results are correct. Wait 1–2 minutes between measurements.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• 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.
• Check your blood pressure as often as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Keep all follow-up visits. Your health care provider will continue to monitor your blood pressure closely until it is in a safe range for you.

Contact a health care provider if:

• You have new symptoms, such as:
  • A headache that does not get better.
  • Dizziness.
  • Vision changes.
  • Nausea and vomiting.

Get help right away if:

• You have trouble breathing.
• You have chest pain.
• You faint.
• You have any symptoms of a stroke. "BE FAST" is an easy way to remember the main warning signs of a stroke:
  • B - Balance. Signs are dizziness, sudden trouble walking, or loss of balance.
  • E - Eyes. Signs are trouble seeing or a sudden change in vision.
  • F - Face. Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.
  • A - Arms. Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.
  • S - Speech. Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.
  • T - Time. Time to call emergency services. Write down what time symptoms started.
• You have other signs of a stroke, such as:
  • A sudden, severe headache with no known cause.
  • Nausea or vomiting.
  • Seizure.

• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.

Summary

• Postpartum hypertension is blood pressure that is higher than normal after childbirth.
• For some women, medical treatment is required to prevent serious complications, such as seizures or stroke.
• Follow your health care provider's instructions on how to record your blood pressure readings.
• Keep all follow-up visits. Your health care provider will continue to monitor your blood pressure closely until it is within a safe range for you.