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Jan.24.2020
 Postpartum Hypertension

Postpartum Hypertension

Postpartum hypertension is high blood pressure that remains higher than normal after childbirth. You may not realize that you have postpartum hypertension if your blood pressure is not being checked regularly. In most cases, postpartum hypertension will go away on its own, usually within a week of delivery. However, for some women, medical treatment is required to prevent serious complications, such as seizures or stroke.

What are the causes?

This condition may be caused by one or more of the following:
  • Hypertension that existed before pregnancy (chronic hypertension).
  • Hypertension that comes on as a result of pregnancy (gestational hypertension).
  • Hypertensive disorders during pregnancy (preeclampsia) or seizures in women who have high blood pressure during pregnancy (eclampsia).
  • A condition in which the liver, platelets, and red blood cells are damaged during pregnancy (HELLP syndrome).
  • A condition in which the thyroid produces too much hormones (hyperthyroidism).
  • Other rare problems of the nerves (neurological disorders) or blood disorders.
In some cases, the cause may not be known.

What increases the risk?

The following factors may make you more likely to develop this condition:
  • Chronic hypertension. In some cases, this may not have been diagnosed before pregnancy.
  • Obesity.
  • Type 2 diabetes.
  • Kidney disease.
  • History of preeclampsia or eclampsia.
  • Other medical conditions that change the level of hormones in the body (hormonal imbalance).

What are the signs or symptoms?

As with all types of hypertension, postpartum hypertension may not have any symptoms. Depending on how high your blood pressure is, you may experience:
  • Headaches. These may be mild, moderate, or severe. They may also be steady, constant, or sudden in onset (thunderclap headache).
  • Changes in your ability to see (visual changes).
  • Dizziness.
  • Shortness of breath.
  • Swelling of your hands, feet, lower legs, or face. In some cases, you may have swelling in more than one of these locations.
  • Heart palpitations or a racing heartbeat.
  • Difficulty breathing while lying down.
  • Decrease in the amount of urine that you pass.
Other rare signs and symptoms may include:
  • Sweating more than usual. This lasts longer than a few days after delivery.
  • Chest pain.
  • Sudden dizziness when you get up from sitting or lying down.
  • Seizures.
  • Nausea or vomiting.
  • Abdominal pain.

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 of postpartum hypertension.

How is this treated?

If blood pressure is high enough to require treatment, your options may include:
  • 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.
  • Stopping medicines that may be causing hypertension.
  • 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:

  • Take over-the-counter and prescription medicines only 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.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your symptoms get worse.
  • You have new symptoms, such as:
    • A headache that does not get better.
    • Dizziness.
    • Visual changes.

Get help right away if:

  • You suddenly develop swelling in your hands, ankles, or face.
  • You have sudden, rapid weight gain.
  • You develop difficulty breathing, chest pain, racing heartbeat, or heart palpitations.
  • You develop severe pain in your abdomen.
  • 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.
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

  • Postpartum hypertension is high blood pressure that remains higher than normal after childbirth.
  • In most cases, postpartum hypertension will go away on its own, usually within a week of delivery.
  • For some women, medical treatment is required to prevent serious complications, such as seizures or stroke.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.