When Anticipation for a New Baby is High, Make Sure Your Blood Pressure Isn’t, Too!

There are so many things to consider when a baby is on the way.  Many of them – like choosing a name and decorating the nursery – are fun and exciting but there are a few things to look out for, as well, and for the sake of both the mother and the baby, hypertension is one of them.

When Dr. Laura K. Price of Thompson Health’s Canandaigua Medical Group did her OB/GYN residency between 2012 and 2016, the condition was found in 8 percent of pregnancies, but now it’s found in 15 percent.

Symptoms of hypertension – also known as high blood pressure – can include headaches, swelling, visual changes, and upper abdominal pain. All of these symptoms can occur for other reasons, however, and some women who have hypertension in pregnancy have no symptoms at all. That’s why hypertension is one of the things OB/GYN providers are always mindful of.

According to Dr. Price, there are four types of hypertension that can be found in pregnancy:

• Chronic hypertension, which is when the woman – who may or may not be aware – has had elevated blood pressure prior to pregnancy. This can be due to a number of factors including genetics, obesity, age, and cigarette smoking.
• Hypertension that develops after 20 weeks’ gestation. This is known as gestational hypertension.
• Preeclampsia, which is elevated blood pressure with symptoms and/or lab abnormalities. This can occur at any point during the 40-week period.
• Chronic hypertension with superimposed preeclampsia, which is when a woman with chronic hypertension develops symptoms and/or lab abnormalities during the pregnancy.

Because high blood pressure involves the constricting of blood vessels, it can cause growth restrictions in the baby and less blood flow to the baby’s developing brain, as well as risks to the mother including seizures and/or strokes.

Steps women can do to prevent hypertension in pregnancy include:

• Being at a healthy weight
• Avoiding illicit drug use
• Not smoking
• Attending prenatal visits

Also, if patients have a history of any of the four types of hypertension in pregnancy, they take two baby aspirin (162mg) from 12 weeks’ gestation until the end of the pregnancy, because this is shown to decrease the risk of preeclampsia.

With this approach and additional management that can include anti-hypertensive medications and increased monitoring, the goal is to prevent the condition from worsening so the mother and baby can safely get closer and closer to the due date.

Occasionally, managing hypertension during pregnancy involves taking the woman out of work. If the blood pressure remains high, there’s also a possibility that the woman will be hospitalized, with a pre-term delivery more likely.

When hypertension is pregnancy-related as opposed to chronic, it typically goes away within four to six weeks after delivery. This leads doctors to believe hypertension has something to do with the hormones secreted by the placenta, but there is still more research underway.

“If we knew the exact cause, we’d be able to prevent it entirely,” Dr. Price noted.

And something to keep in mind is that when a woman experiences gestational hypertension or preeclampsia during a pregnancy, it means she has a 30 percent higher chance of developing chronic hypertension later in life.