Hypertension in pregnancy is a major cause of
maternal, foetal and neonatal morbidity and mortality. In both developing and
developed countries, hypertension is the most common medical problem in
pregnancy complicating up to 30% of pregnancies.
maternal, foetal and neonatal morbidity and mortality. In both developing and
developed countries, hypertension is the most common medical problem in
pregnancy complicating up to 30% of pregnancies.
What is Hypertension?
Hypertension (high blood pressure) is the elevation of
the arterial blood pressure above the normal range expected in a human.
the arterial blood pressure above the normal range expected in a human.
OR
Hypertension is the amount of force exerted by the
blood against the walls of the arteries.
blood against the walls of the arteries.
Types of Hypertension
These are the common types of hypertension in
pregnancy
pregnancy
1.
Gestational Hypertension: (Pregnancy induced
hypertension) this is a type of hypertension caused as a result of the
pregnancy which develops after 20 weeks of pregnancy.
Gestational Hypertension: (Pregnancy induced
hypertension) this is a type of hypertension caused as a result of the
pregnancy which develops after 20 weeks of pregnancy.
2.
Pre-existing or Chronic
Hypertension: This is defined as a systolic blood pressure (BP) of
140 mmHg and diastolic BP of 90 mmHg or more either pre-pregnancy or at
booking.
Pre-existing or Chronic
Hypertension: This is defined as a systolic blood pressure (BP) of
140 mmHg and diastolic BP of 90 mmHg or more either pre-pregnancy or at
booking.
3.
Pre-eclampsia: Both chronic hypertension and
gestational hypertension can lead to the severe condition after 20 weeks of
pregnancy.
Pre-eclampsia: Both chronic hypertension and
gestational hypertension can lead to the severe condition after 20 weeks of
pregnancy.
Who is at Risk of Hypertension
in Pregnancy
in Pregnancy
1.
Pregnant women under the age of 20 or older than 40.
Pregnant women under the age of 20 or older than 40.
2.
Women with diabetes, kidney diseases.
Women with diabetes, kidney diseases.
3.
Women carrying multiple babies.
Women carrying multiple babies.
4.
First time mothers
First time mothers
5.
Women who are obese prior to pregnancy.
Women who are obese prior to pregnancy.
Effects of Hypertension in
Pregnancy
Pregnancy
Hypertension can prevent
the placenta from getting enough blood. If the placenta doesn’t get enough
blood, your baby gets less oxygen and food. This can result in low birth
weight. Most women still can deliver a healthy baby if hypertension is detected
early and treated with regular prenatal care. If your hypertension is severe,
it can lead to preeclmapsia which
can have much more serious affects on mother and baby.
the placenta from getting enough blood. If the placenta doesn’t get enough
blood, your baby gets less oxygen and food. This can result in low birth
weight. Most women still can deliver a healthy baby if hypertension is detected
early and treated with regular prenatal care. If your hypertension is severe,
it can lead to preeclmapsia which
can have much more serious affects on mother and baby.
Risk Factors of Hypertension in Mothers
Women
with hypertension in pregnancy have a higher risk of complications such as;
with hypertension in pregnancy have a higher risk of complications such as;
1. Abruptio placenta
2. Cerebrovascular accident
3. Disseminated intravascular
coagulation
coagulation
The foetus has an increased risk of
1. Intrauterine growth
restriction
restriction
2. Prematurity
3. Intrauterine death.
Causes of Hypertension in Pregnancy
According to the National
Health, Lungs and Blood Institute (NHLBI), there are several possible causes of
high blood pressure during pregnancy which leads to hypertension.
Health, Lungs and Blood Institute (NHLBI), there are several possible causes of
high blood pressure during pregnancy which leads to hypertension.
Unhealthy lifestyle choices
may lead to high blood pressure during pregnancy. Being overweight or obese or
failing to stay active are a major risk factors for high blood pressure.
may lead to high blood pressure during pregnancy. Being overweight or obese or
failing to stay active are a major risk factors for high blood pressure.
The NHLBI emphasized that
it is important to take preventive measures both before becoming pregnant and
during pregnancy to help lessen your risk of high blood pressure. One should
stay clear of smoking and drinking alcohol both which have been known to raise
blood pressure.
it is important to take preventive measures both before becoming pregnant and
during pregnancy to help lessen your risk of high blood pressure. One should
stay clear of smoking and drinking alcohol both which have been known to raise
blood pressure.
Management of Hypertension in Pregnancy
Management depends on the
woman’s blood pressure, gestational age and blood flow in the placenta.
Non-pharmacological management include dose supervision, limitation of
activities and some bed rest in the lateral position
woman’s blood pressure, gestational age and blood flow in the placenta.
Non-pharmacological management include dose supervision, limitation of
activities and some bed rest in the lateral position
All pregnant women should
receive antenatal education so that they are aware of the symptoms associated
with pre-eclampsia, its importance and the need to obtain medical advice.
receive antenatal education so that they are aware of the symptoms associated
with pre-eclampsia, its importance and the need to obtain medical advice.
Other recommended
management measures include;
management measures include;
1. Perform ultrasound
examination at 34 weeks to assess foetal growth and amniotic fluid volume.
examination at 34 weeks to assess foetal growth and amniotic fluid volume.
2. After birth, measure BP
daily for the first two days after birth or at least once between 3 and 5 days
daily for the first two days after birth or at least once between 3 and 5 days
3. Admit and monitor the
patient in hospital.
patient in hospital.
Prevention of Hypertension in Pregnancy
1. Be sure your blood pressure
is under control.
is under control.
2. Participating in regular
physical activities and losing weight if overweight can be helpful.
physical activities and losing weight if overweight can be helpful.
3. If you take medicine for
your blood pressure, ask your doctor whether you should change the amount you
take or stop taking then during pregnancy.
your blood pressure, ask your doctor whether you should change the amount you
take or stop taking then during pregnancy.
Treatment of Hypertension in Pregnancy
Treatment depends on how close you are to your due
date. If you are close to your due date, and the baby is developed enough. The health
care provider may want to deliver your baby as soon as possible.
date. If you are close to your due date, and the baby is developed enough. The health
care provider may want to deliver your baby as soon as possible.
In the case of mild hypertension and the baby has
not reached full development, the following is recommended;
not reached full development, the following is recommended;
- Rest, lying on your left side to take the
weight of the baby off your major blood vessels. - Increase prenatal
checkups. - Consume less salt.
- Drink lot of fluid
(water).
