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Pregnancy and high blood pressure

What you need to know if you are expecting



High blood pressure problems occur in 6-8 percent of all pregnancies in the United States, according to the National Heart, Lung, and Blood Institute. Seventy percent of those pregnancies are of women who are pregnant for the first time.

Although high blood pressure, or hypertension, can cause heart disease, stroke, heart failure and kidney disease, it is possible to have a healthy baby with this condition. 

Dr. Elizabeth Lavery with Novant Health UVA Health System Prince William OB-GYN, helped explain the different types of high blood pressure women may experience during pregnancy.

Chronic high blood pressure

The most common form of hypertension Dr. Lavery sees in her office is in chronic hypertension, where women have high blood pressure before becoming pregnant.

“We’re seeing a rise nationally in women who have hypertension before becoming pregnant,” Lavery said. “Because obesity is becoming more common and women are having babies at an older age, they are more at risk of having hypertension.”

The risk factors for chronic hypertension include family history, obesity and older age. The effects of high blood pressure can range from mild to severe. Hypertension can harm the mother’s kidneys and other organs as well as cause low birth weight and early delivery for the baby.

Lavery suggested taking a low dose aspirin to help keep a woman’s blood pressure under control.

Preeclampsia

Another form of hypertension in pregnancy is preeclampsia. Preeclampsia is a condition that usually starts after the 20th week of pregnancy and involves increased blood pressure and protein in the mother’s urine. Preeclampsia can risk lives of both the mother and the baby.

“Preeclampsia is typically for women who don’t have trouble with high blood pressure before they are pregnant,” Lavery said. “But women who already have chronic hypertension can be at risk as well.”

Lavery described risk factors including a first pregnancy, being a teenager or over the age of 35, having a history of preeclampsia in earlier pregnancies and having hypertension to begin with. She added that diabetes and kidney disease can increase your risk as well.

With preeclampsia, the blood pressure can increase quickly, so women can be at a risk for stroke, fluid in the lungs, a ruptured placenta and still birth.

The treatment for preeclampsia is to deliver the baby. If the woman is greater than 37 weeks pregnant, it’s recommended to induce labor or have a cesarean section. Lavery said if it’s earlier than 37 weeks, you have to balance the risk to the mom versus the risk to the baby of being born too early.

“High blood pressure is a big reason why prenatal care exists,” Lavery said. “It’s important to regularly check a woman’s blood pressure and adapt care if necessary.”

 




Published: 2/13/2015