High Blood Pressure During Pregnancy

Condition Basics

What is high blood pressure?

Blood pressure is a measure of the force of blood against the walls of your arteries. It's normal for blood pressure to go up and down throughout the day. But if it stays up, you have high blood pressure (hypertension). In general, high blood pressure ranges are above 130/80 or 140/90 mm Hg.^{footnote 1}

What is high blood pressure during pregnancy?

Usually, blood pressure falls during early pregnancy. Then it goes back to normal by the end of the pregnancy. But some people have high blood pressure (hypertension) while they are pregnant. They may have:

• Chronic hypertension. This is high blood pressure that started before pregnancy. It usually doesn't go away after the baby is born.
• Gestational hypertension. This is high blood pressure that starts in the second or third trimester. It usually goes away after the baby is born.

High blood pressure during pregnancy may keep the baby from getting enough nutrients and oxygen. This could limit the baby's growth. High blood pressure can also cause the placenta to pull away from the uterus too soon (placental abruption).

Sometimes high blood pressure during pregnancy is a first sign of preeclampsia. This condition can be dangerous for both you and your baby.

What are the symptoms?

High blood pressure usually doesn't cause symptoms. You will probably feel fine, even if your blood pressure is too high. You may not know you have high blood pressure. That's why it's important to go to all of your prenatal checkups and get your blood pressure checked.

How is it diagnosed?

High blood pressure is usually found during a routine prenatal visit. At each visit, your blood pressure is checked. You may also be checked for other signs of preeclampsia, such as protein in your urine and rapid weight gain. If you have high blood pressure, you'll have regular tests to check your baby's health.

How is high blood pressure during pregnancy treated?

If you have high blood pressure during pregnancy, you'll have frequent blood pressure checks and blood and urine tests. You may need blood pressure medicine. To reduce your risk of preeclampsia, your doctor or midwife may recommend taking low-dose aspirin. Your baby will also be checked more often toward the end of your pregnancy.

Symptoms

High blood pressure usually doesn't cause symptoms. You will probably feel fine, even if your blood pressure is too high. You may not know you have high blood pressure. That's why it's important to go to all of your prenatal checkups and get your blood pressure checked.

Tell your doctor or midwife right away if you have any signs of very high blood pressure or preeclampsia, such as:

• A severe headache.
• Blurry vision.
• Pain in your upper belly.
• Rapid weight gain—more than 1 kg (2 lb) in a week.

What Happens

High blood pressure during pregnancy can affect the amount of oxygen and nutrients your baby receives. This can affect how your baby grows. It can also cause other serious problems for both you and your baby. Sometimes it's a first sign of preeclampsia.

You and your baby will be watched very closely. You will have frequent tests to check you and your baby. And you will have to check your blood pressure often during and after pregnancy.

If your blood pressure rises suddenly or is very high during pregnancy, your doctor or midwife may prescribe medicines to control it.

If your blood pressure affects your or your baby's health, you may need to be watched in the hospital. You may get medicines. Or your doctor or midwife may need to deliver your baby early.

High blood pressure that starts during pregnancy usually goes away after the baby is born. But in some cases, it may last after delivery. After you've had it, you may have more risk of having high blood pressure, heart disease, stroke, kidney disease, and diabetes later in life. Work with your doctor or midwife to make heart-healthy lifestyle choices. These include eating healthy foods, being active, staying at a healthy weight, and not smoking. Get the checkups you need. Your doctor or midwife may also want you to check your blood pressure at home.

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When to Call a Doctor

Share this information with your partner or a friend. They can help you watch for warning signs.

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You have a seizure.
• You have trouble breathing.
• You have chest pain.

Call your doctor, midwife, or nurse advice line now or seek immediate medical care if:

• You have symptoms of preeclampsia, such as:
  • Sudden swelling of your face, hands, or feet.
  • New vision problems (such as dimness, blurring, or seeing spots).
  • A severe headache.
• Your blood pressure is very high, such as 160/110 or higher.
• Your blood pressure is higher than your doctor or midwife told you it should be, or it rises quickly.
• You have any vaginal bleeding.
• You have new nausea or vomiting.
• You think that you are in labour.
• You have pain in your belly or pelvis.
• You gain weight rapidly.

Examinations and Tests

High blood pressure is usually found during a routine prenatal visit. At each prenatal visit, your doctor or midwife will:

• Check your blood pressure. Sudden high blood pressure often is the first sign of a problem.
• Check your weight. Rapid weight gain can be a sign of preeclampsia.

If you have high blood pressure, you'll have regular tests to check your baby's health. These tests include:

• Fetal heart monitoring. This is done to check your baby's heart rate.
• Fetal ultrasound. This is done to check on your baby, the placenta, and the amniotic fluid.
• Doppler ultrasound. This checks how well the placenta is working.

If you're at high risk for preeclampsia, you may have other tests, including:

• A urine test for protein.
• Blood tests to check for problems such as kidney damage.

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Treatment Overview

If you have high blood pressure during pregnancy, you'll have frequent blood pressure checks, blood tests, and urine tests. These are done to watch for signs of preeclampsia.

You may need to take medicine if your blood pressure is too high.

• Medicines used during pregnancy include labetalol, methyldopa, and nifedipine.
• Some common blood pressure medicines aren't safe to use during pregnancy. If you already take blood pressure medicine, talk to your doctor or midwife about the safety of your medicine.

Your doctor or midwife may recommend that you take low-dose aspirin during the second and third trimesters. This may help to lower your risk for preeclampsia.

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Self-Care

Taking these steps can help you control your blood pressure and have a healthy pregnancy.

• Follow your doctor or midwife's advice.
  • Take and write down your blood pressure at home if your doctor or midwife says to.
  • If your doctor or midwife prescribed blood pressure medicine, take it exactly as directed.
• Monitor yourself for symptoms of preeclampsia.

  Call your doctor or midwife if you have symptoms such as a severe headache, vision changes, belly pain, or sudden swelling in your hands and face.

• If you smoke, quit or cut back as much as you can.

  This is one of the best things you can do to help your baby be healthy. If you need help to quit smoking, talk to your doctor or midwife.

• Be sure to go to all of your prenatal checkups.

  Your doctor or midwife can check your blood pressure. You may also want to check your blood pressure at home.

• Gain an amount of weight that's healthy for you.

  Your doctor or midwife can help you set a pregnancy weight goal.

• Be active.

  If your doctor or midwife says it's okay, get regular exercise during pregnancy. Things like walking or swimming several times a week can help lower blood pressure. And it's good for you and your baby.

• Try to keep your stress level low.

  This may be hard to do, especially if you continue to work, have young children, or have a hectic schedule. But try to find some time to relax. Smartphone apps for meditation or deep breathing can help.

• Talk to your doctor or midwife about your medicine.

  Some medicines, including certain blood pressure medicines, aren't safe during pregnancy. Be sure that your doctor or midwife has a complete list of all the medicines you take.

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