High blood pressure, also known as hypertension, is a condition where the force of blood against the artery walls is consistently elevated. When this occurs during pregnancy, it can pose complications for both the birthing parent and the developing baby. Hypertension affects approximately 5% to 10% of pregnancies. Managing blood pressure during pregnancy requires careful medical guidance to ensure a healthy outcome.
Types of High Blood Pressure in Pregnancy
High blood pressure during pregnancy can manifest in several distinct forms. Chronic hypertension refers to high blood pressure present before pregnancy or diagnosed within the first 20 weeks of gestation. This condition can also persist after delivery.
Gestational hypertension develops after 20 weeks of pregnancy in individuals who previously had normal blood pressure. It is defined by blood pressure readings of 140/90 mmHg or higher on two separate occasions, at least four hours apart, without signs of organ damage. While gestational hypertension typically resolves after childbirth, it can elevate the future risk of developing high blood pressure.
Preeclampsia is characterized by new-onset high blood pressure after 20 weeks of pregnancy, often accompanied by signs of damage to other organ systems, such as the kidneys or liver. Protein in the urine is a common indicator. Preeclampsia can also develop in individuals with chronic hypertension.
Why Managing Blood Pressure Matters
Unmanaged high blood pressure during pregnancy can present risks for both the birthing parent and the baby. For the parent, complications can include an increased risk of severe preeclampsia, which can progress to eclampsia, a condition involving seizures. Other potential maternal risks include stroke, kidney damage, heart problems, and placental abruption. Placental abruption occurs when the placenta separates from the inner wall of the uterus before delivery, potentially leading to heavy bleeding.
For the baby, poorly controlled maternal blood pressure can result in less oxygen and fewer nutrients reaching the fetus due to reduced blood flow to the placenta. This can lead to complications such as preterm birth, which occurs before 37 weeks of pregnancy, and low birth weight. Fetal growth restriction, where the baby grows more slowly than expected, is another concern associated with maternal hypertension. These outcomes highlight the importance of proactive management to ensure the well-being of both the parent and the infant.
High Blood Pressure Medications During Pregnancy
Certain blood pressure medications are generally considered safe for use during pregnancy, while others are avoided due to potential risks to the developing baby. Commonly recommended medications include labetalol, nifedipine, and methyldopa. These medications have established safety profiles and effectively lower blood pressure without negatively impacting blood flow to the placenta.
Conversely, some medications are typically contraindicated during pregnancy. Angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril, and Angiotensin Receptor Blockers (ARBs), like valsartan, are generally avoided. These medications carry a boxed warning from the FDA against their use in pregnancy due to the potential for severe fetal abnormalities and complications.
If a person is taking an ACE inhibitor or ARB and discovers they are pregnant, they should contact their healthcare provider immediately. The provider can then determine the safest and most effective medication plan, considering the individual’s specific health condition, the type of hypertension, and the stage of pregnancy. The decision to use or change medication always involves a careful evaluation of the benefits for the parent against any potential risks to the baby.
Lifestyle Approaches to Blood Pressure Management
Beyond medication, several lifestyle adjustments can support blood pressure management during pregnancy, always under medical guidance. Adopting a healthy, balanced diet is beneficial, emphasizing fruits, vegetables, and whole grains. Reducing sodium intake is also a common recommendation.
Regular physical activity, tailored to pregnancy, can contribute to overall health and blood pressure control. Safe forms of exercise, such as walking or swimming, are often advised. Stress reduction techniques, including meditation or prenatal yoga, may also help manage blood pressure.
Avoiding harmful substances is another important aspect of management. This includes abstaining from smoking, alcohol, and illicit drugs, as these can negatively impact both maternal and fetal health. While these lifestyle changes are supportive, they should always be discussed with a healthcare provider to ensure they are appropriate for the individual’s specific pregnancy.
Medical Monitoring and Ongoing Care
Consistent medical follow-up is important throughout pregnancy for individuals with high blood pressure. This includes more frequent prenatal visits to closely monitor blood pressure levels. Healthcare providers may also instruct patients on how to monitor their blood pressure at home and what readings warrant immediate medical attention.
Regular laboratory tests are a component of care. Urine tests are often performed to check for protein, which helps screen for preeclampsia, and blood tests assess kidney and liver function. Fetal monitoring is also increased, involving ultrasounds to check the baby’s growth and amniotic fluid levels.
Monitoring continues after birth, as blood pressure can fluctuate significantly in the postpartum period. This ongoing care helps to manage any lingering hypertension and mitigate potential risks for the birthing parent. Adherence to the healthcare team’s recommendations is important for a healthy outcome.