High Blood Pressure in Pregnancy
Elevated blood pressure affects approximately 8% of all pregnancies. At each visit throughout your pregnancy your nurse will check and document your blood pressure. High blood pressure is defined as greater than 140/90 and usually happens nearer to the due date. The diagnosis used to be based on how much the blood pressure went up during pregnancy. However, now it is simple: hypertension is blood pressure greater than 140/90.
High blood pressure is associated with a long list of pregnancy complications. Testing monitors for changes in kidney and liver function as well as other blood abnormalities which can be harmful to the mother or baby, or both. ‘What to do’ in the event that your blood pressure is elevated is based on your test results. Your baby’s gestational age is a Very Important factor in that treatment plan…[read more]
Blood Pressure Monitoring & Treatment
Blood pressure without kidney, liver, or blood problems can be managed with medicine, especially before 34 weeks. Women who were taking blood pressure medication before pregnancy often need less medicine early in pregnancy and more medicine later. Your blood pressure and blood tests will be monitored to make sure you are on the correct dose of medicine AND to watch for changes in liver and kidney function. The monitoring will become more frequent as you gets closer to the due date. The proper treatment of high blood pressure should prevent strokes, heart, and kidney problems in the mother.
Effects On Baby
Over time, elevated blood pressure can damage the placenta. A damaged placenta may not be able to give the baby enough nutrients. Earlier in pregnancy, the result can be inadequate baby growth. We use ultrasounds to measure your baby’s growth every 4-6 weeks between 20 and 34 weeks. Blood pressure medicines can treat maternal blood pressure but they do not help the placenta.
After 34 weeks fetal testing focuses on the heartbeat pattern and the amniotic fluid level. We perform a non stress tests (NST) once or twice each week, to make sure the up-and-down changes in the baby’s heart beat prove good placental function. Additional ultrasounds will measure your amniotic fluid index (AFI), which also reflects how well the placenta is working. Delivery is usually indicated for those babies who do not “pass” the NST or AFI tests. If delivery is necessary, induction of labor is usually the next step.
Bed Rest & High Blood Pressure
There is no proven medical benefit to bed rest in treatment of elevated blood pressure in pregnancy. We do it all the time, but it has NOT been shown to make a difference in the mother or baby’s health. And there is plenty of proof that lying in bed for days or weeks is actually DANGEROUS. Prolonged bed rest in pregnancy makes muscles weak, bones thin, and can be emotionally and mentally hard on the mother. When it comes to bed rest, patients should discuss with their doctors the ‘what and why’ about their situation…[read more]
Preeclampsia & High Blood Pressure
Women with high blood pressure in pregnancy may also develop preeclampsia. Preeclampsia is a pregnancy-only combination of high blood pressure with kidney, liver, or blood problems. Preeclampsia can turn into eclampsia which is seizures during pregnancy. Toxemia and PIH (pregnancy induced hypertension) are old names for preeclampsia. The only cure for preeclampsia is delivery. MANY factors go into the decision about when to induce labor in a patient with preeclampsia…[read more]
Cure of High Blood Pressure in Pregnancy
Pregnancy related high blood pressure, with or without preeclampsia, is “cured” only with the delivery of your baby.