High blood pressure after birth, known as postpartum hypertension, is a serious health concern for new mothers. It involves elevated blood pressure readings that can arise after childbirth. Recognizing and managing postpartum hypertension is important because, if left unaddressed, it can lead to health complications. This article explains what postpartum hypertension is, how to identify its signs, and approaches to managing it.
Understanding Postpartum High Blood Pressure
Postpartum high blood pressure can emerge within the first few days post-delivery, or up to six weeks, or even a year after birth. A blood pressure reading consistently at or above 140/90 mm Hg is considered high.
There are different forms of postpartum hypertension. It can be a continuation of gestational hypertension, which develops during pregnancy and persists after delivery. It can also be new-onset hypertension, meaning the mother had normal blood pressure throughout pregnancy and then develops high blood pressure after birth. Postpartum hypertension differs from pre-existing chronic hypertension, which is present before pregnancy. It is also distinct from postpartum preeclampsia, which involves both high blood pressure and elevated protein levels in the urine.
Recognizing the Signs and When to Act
New mothers should be aware of symptoms that may indicate high blood pressure after birth. These signs include a severe headache that does not improve with pain medication, vision changes like blurred vision or light sensitivity, and sudden weight gain. Other symptoms include swelling in the face, hands, or feet, pain in the upper abdomen, nausea, vomiting, shortness of breath, or decreased urination.
Some individuals experiencing postpartum hypertension may not have noticeable symptoms, making regular blood pressure monitoring after childbirth important. If any of these symptoms are present, seek medical attention promptly. For severe symptoms like a sudden and severe headache, vision changes, chest pain, or severe shortness of breath, immediate medical care is advised.
Managing and Treating Postpartum High Blood Pressure
Diagnosis involves blood pressure readings. Further diagnostic steps may include blood tests to assess liver and kidney function and platelet count, along with a urinalysis to check for protein in the urine. A 24-hour urine collection may also be requested to measure protein.
Treatment approaches vary based on the condition’s severity. For blood pressure readings below 160/110 mm Hg without severe symptoms, oral medications may be prescribed, often managed on an outpatient basis. Common medications include nifedipine (a calcium channel blocker) and labetalol (a beta-blocker), both considered safe for postpartum use. Methyldopa, an alpha-2-agonist, is another option. Medication duration varies, lasting several weeks to three months.
Lifestyle adjustments also play a role. Maintaining a healthy diet and engaging in regular physical activity can help reduce the risk of postpartum hypertension. Stress management techniques are beneficial for cardiovascular health. Consistent blood pressure monitoring and regular follow-up appointments are important to ensure the condition is well-controlled and to adjust medication. For breastfeeding mothers, many common antihypertensive medications, such as nifedipine and labetalol, are considered safe. However, certain medications like angiotensin-2 receptor blockers and some diuretics may be unsuitable during breastfeeding and should be discussed with a doctor.
Potential Health Implications
If postpartum high blood pressure is not properly managed, it can lead to several health implications. One serious complication is postpartum eclampsia, which involves seizures with high blood pressure and can cause permanent damage to organs such as the brain, eyes, liver, and kidneys. Another concern is pulmonary edema, a life-threatening condition where excess fluid accumulates in the lungs.
Uncontrolled high blood pressure can also increase the risk of a stroke, which occurs when blood supply to part of the brain is interrupted or reduced. Additionally, there is a risk of developing HELLP syndrome, characterized by hemolysis (destruction of red blood cells), elevated liver enzymes, and low platelet count, which can become life-threatening. In the long term, individuals who experience hypertensive disorders during pregnancy, including postpartum hypertension, may have an increased risk of developing chronic hypertension and other cardiovascular diseases later in life.