High Blood Pressure and Pregnancy

Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies.Sometimes high blood pressure is present before pregnancy. In other cases, high blood pressure develops during pregnancy. For example:
• Gestational hypertension. Women with gestational hypertension have high blood pressure that develops after 20 weeks of pregnancy.
• Chronic hypertension. Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy.
• Chronic hypertension with superimposed preeclampsia.This condition occurs in women with chronic high blood pressure before pregnancy who then develop worsening high blood pressure and protein in the urine or other health complications during pregnancy.
• Preeclampsia. Sometimes chronic hypertension or gestational hypertension leads to preeclampsia, a pregnancy complication characterized by high blood pressure and signs of damage to another organ system — usually after 20 weeks of pregnancy. Left untreated, preeclampsia can lead to serious — even fatal — complications for mother and baby. Previously, preeclampsia was only diagnosed if a pregnant woman had high blood pressure and protein in her urine. However, experts now know that it's possible to have preeclampsia, yet never have protein in the urine.
Preeclampsia sometimes develops without any symptoms. High blood pressure might develop slowly, but more commonly it has a sudden onset.
Monitoring your blood pressure is an important part of prenatal care because the first sign of preeclampsia is commonly a rise in blood pressure.
Various signs and symptoms are-

• Excess protein in your urine (proteinuria) or additional signs of kidney problems
• Severe headaches
• Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
• Upper abdominal pain, usually under your ribs on the right side
• Nausea or vomiting
• Decreased urine output
• Decreased levels of platelets in your blood (thrombocytopenia)
• Impaired liver function
• Shortness of breath, caused by fluid in your lungs
Sudden weight gain and swelling (edema) — particularly in your face and hands — often accompanies preeclampsia.

Preventive Measures-
Taking good care of yourself is the best way to take care of your baby. For example:
• Visit your health care provider regularly throughout your pregnancy.
• Your health care provider will prescribe the safest medication at the most appropriate dose.
• Follow your health care provider's recommendations for physical activity.
• Take less of salt
• Avoid smoking, alcohol and illicit drugs. Talk to your health care provider before taking any over-the-counter medications.

Thanks and Regards

Dr Richa Sharma
 Senior IVF consultant  DELHI NCR
Post Doctoral Fellow National Board(FNBE) 
Reproductive Medicine(New Delhi), Bangalore
Fellow Reproductive Medicine, Madras Medical Mission (Chennai)
MRCOG(London)