High blood pressure (hypertension) during gestation can be dangerous for both mother and baby. Gestational hypertension may even progress to preeclampsia or HELLP syndrome (hemolysis, elevated liver enzymes, low platelets).
At your prenatal appointments, your physician will monitor your blood pressure; additionally, you may be instructed to monitor it at home.
What is Gestational Hypertension?
Gestational hypertension is high blood pressure that arises during the second trimester (the last half of pregnancy) and resolves itself after your baby is born, occurring in approximately 5-8% of pregnancies. Sometimes this progresses into more serious conditions such as preeclampsia or HELLP syndrome (hematologic abnormalities, elevated liver enzymes and low platelets – cells which help your blood to clot).
Gestational hypertension symptoms often do not include protein in urine or other symptoms common to preeclampsia, making it hard to distinguish. Therefore, it’s essential that we see our healthcare provider frequently to check your blood pressure.
Your healthcare provider will monitor both systolic and diastolic blood pressure at each prenatal visit to ensure it remains within the safe range. Women who have had chronic high blood pressure or had hypertension during a previous pregnancy are encouraged to start monitoring their blood pressure prior to becoming pregnant.
Gestational hypertension or preeclampsia increases your risk for cardiovascular disease later in life, so it’s crucial that you follow the advice of healthcare providers regarding healthy diet, exercise and weight maintenance. At UPMC Magee-Womens Heart Program we have extensive expertise and training in caring for women with heart and vascular conditions including gestational hypertension.
What are the Symptoms of Gestational Hypertension?
Gestational hypertension refers to elevated blood pressure that occurs during gestation and resolves after delivery, differing from chronic hypertension which was already present before gestation and preeclampsia which is characterized by proteinuria, severe hypertension and the HELLP syndrome [hemolysis, elevated liver enzymes and low platelets] symptoms. Both gestational hypertension and preeclampsia are forms of induced hypertensive disorders caused by pregnancy-related hormones.
Gestational hypertension usually only manifests itself with increased blood pressure, though some women experience mild symptoms such as swollen ankles or feet, headaches, blurred vision or an increased feeling of fullness in the belly.
If your condition worsens, it could have serious repercussions for both of you: preterm birth and low birth weight may occur as well as increased risks of high blood pressure and heart disease after gestation.
Staying at a healthy weight before becoming pregnant can help avoid this problem, which means eating well and engaging in regular physical activity if necessary. Furthermore, seeing your doctor regularly and undergoing prenatal tests such as urine analysis and blood pressure checks is also recommended to monitor fetus movements during gestation and may recommend nonstress tests or biophysical profiles that combine ultrasound images and nonstress testing; they may even give corticosteroids medications in order to develop your baby’s lungs before it’s born.
What are the Risks of Gestational Hypertension?
Hypertension that begins in the second trimester can result in low birth weight and premature delivery in 6-8% of pregnancies, or lead to preeclampsia which damages liver, kidneys, lungs and brain function.
Gestational hypertension typically presents no noticeable symptoms, yet requires close monitoring. Diagnosis occurs when two separate occasions, four hours apart after 20 weeks gestation when gestation was initially normotensive, show systolic blood pressure of 140 mmHg or higher on two different occasions after gestation in women who were once normotensive; gestational hypertension usually resolves before preeclampsia develops in most women.
However, if this condition persists it may increase your risk of miscarriage or placental abruption during pregnancy and lead to chronic hypertension post-birth.
At each prenatal appointment, your health care provider will monitor your blood pressure. They may also check the fetal heart rate and perform ultrasound tests such as nonstress testing or biophysical profiles that include Doppler flow studies.
High blood pressure and diabetes mellitus increases one’s risk for gestational hypertension. If you had hypertension before pregnancy or had any autoimmune disorders such as lupus, you also increase this risk further.
What is the Treatment for Gestational Hypertension?
Gestational hypertension usually does not present with additional symptoms and resolves shortly after childbirth. However, if gestational hypertension becomes severe (blood pressure greater than 140/90 mmHg twice or more on different occasions) or is accompanied by proteinuria or other symptoms associated with preeclampsia then treatment may be required.
Untreated gestational hypertension can result in low birthweight or preterm birth and increase your risk for high blood pressure later on. Furthermore, gestational hypertension can adversely impact the health of both mother and fetus by decreasing blood flow to vital organs like liver, kidneys, and brain as well as decreasing oxygen-rich nutrient-rich blood flow to your fetus.
Medication is often prescribed to women suffering gestational hypertension; it’s especially essential if their risk factors include being under age 20 or over age 35, having chronic hypertension or diabetes, having had high blood pressure during a previous pregnancy, or an autoimmune disease like Lupus.
Monitoring fetal movement and counting the times you feel your baby move each day are two effective treatments to detect gestational hypertension. Doing this allows doctors to spot any changes in movement that could indicate gestational hypertension is present or severe. You will also undergo prenatal appointments where blood and urine tests will be conducted regularly in order to check for signs of high blood pressure.
