- Get your blood pressure before planning pregnancy
- Switch to medicines that will not harm the baby
- Maintain a healthy weight, exercise regularly and optimise your diet
High blood pressure (Hypertension) is a common treatable condition affecting up to 15% of all pregnancies. Pregnancy induced hypertension needs close monitoring and if not properly treated, it can have negative effects for both the mother and the baby. Blood pressure problems in pregnancy are of different types. One is gestational hypertension: when blood pressure rises around or after 20 weeks of pregnancy. This may or may not be complicated with preeclampsia. The another one is chronic hypertension: which usually occurs when a woman suffers from high blood pressure even before getting pregnant.
Preeclampsia is a condition when hypertension sets in after 20 weeks and is associated with a lack of protein in the urine, swollen legs, headaches, etc. This is a worrying manifestation of hypertension as multiple organs of the body are affected like kidneys, liver, brain. It also hampers blood circulation in the body. In such severe conditions, a few women can also develop seizures, which can be fatal during pregnancy.
Chronic hypertension with superadded preeclampsia is a condition when a woman is already suffering from long-lasting hypertension and develops preeclampsia during her pregnancy. On the occasion of World Health Day 2019, which falls on April 7, let's take a look at how high blood pressure affects pregnancy.
World Health Day: Why is high blood pressure a problem in pregnancy?
Hypertension can have serious repercussions in pregnancy, especially when not managed properly. Enlisted below are a few risk factors:
1. Decreased blood flow to the placenta: This causes the baby to get less oxygen and nutrients and leads to intrauterine growth retardation, low birth weight or premature birth.
2. Prematurity: It can lead to breathing problems, increased risk of infection and failure to thrive for the baby.
3. Placental abruption: High blood pressure during pregnancy can separate placenta from uterus, leading to heavy bleeding. It can be life-threatening for the mother and the baby.
4. Intrauterine growth restriction: Hypertension affects the growth of the baby.
5. Planned pemature delivery: Sometimes an early delivery has to be planned to prevent potentially life-threatening complications.
6. Post-partum haemorrhage: Women who have blood pressure problems during pregnancy tend to bleed a lot heavier at the time of the delivery.
7. Ecclapsia: Ecclapsia is the risk of developing fits when blood pressure shoots out of control. This is a medical emergency and can have life-threatening consequences for the mother and the baby.
How to know you have a blood pressure problem in pregnancy?
Monitoring your blood pressure during pregnancy is the key. After 20 weeks of pregnancy, blood pressure that exceeds 140/90 mmHg taken on two or more consecutive occasions at least 4 hours apart, is considered to be diagnostic.
If preeclampsia sets in, there are other additional risk factors. These include protein in the urine (proteinuria), severe frequent headaches, changes in vision, right-sided upper abdominal pain, nausea or vomiting, sudden weight gain and swelling (edema) of legs, face and hands.
Tips for pregnancy if you have high blood pressure
1. Create a proper plan for pregnancy before you decide to start a family. Get your blood pressure and your medicines reviewed. Reduce dosage of blood pressure medicines to the least, just enough to manage blood pressure.
2. Switch to medicines that will not harm the baby.
3. Maintain a healthy weight, exercise regularly and optimise your diet.
4. Try meditation and yoga as methods of blood pressure control.
5. During pregnancy, attend all antenatal visits regularly.
6. Invest in a good blood pressure monitoring machine so that you can keep a watch on your pressure even at home.
7. Flag up any signs or symptoms from above as soon as they occur.
8. Get your medicines reviewed intermittently for any adjustments that may be needed.
9. Do not self-medicate.
10. Track your weight to avoid excess gain during pregnancy.
11. After delivery, continue monitoring blood pressure for at least 6 months. Symptoms may occur even after that, so be alert and careful.
Is it advisable to take blood pressure medication when one is expecting?
Some blood pressure medications such as calcium channel blockers are considered safe during pregnancy. Whereas, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers and renin inhibitors are not very safe and are generally to be avoided. Medication is vital to avoid complications of hypertension like a heart attack or stroke etc. Usually, the safest medication is the most appropriate dose which is prescribed. It is important to take the medicine exactly as prescribed and not adjust or miss your dose.
What about labour and delivery?
In conditions where hypertension has been difficult to control, there are signs of IUGR early delivery which may be recommended. Usually, labour can be safely induced and normal vaginal delivery is possible. Sometimes, when there are complications of hypertension, a cesarean section may be recommended.
Is breastfeeding allowed?
Breastfeeding is actually encouraged. Your medicines may have to be adjusted for the breastfeeding. Sometimes, in the special conditions, the BP medication may be changed for the nursing mothers.
The above-mentioned tips or suggestions are highly recommended for the expecting mothers for a healthier pregnancy and a happier motherhood.
( Dr. Rajalaxmi Walavalkar is Senior Gynaecologist and IVF specialist at Cocoon Fertility)
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