High Blood Pressure in Pregnancy

What is high blood pressure in pregnancy?

From: MedlinePlus, National Library of Medicine

Blood pressure is the force of your blood pushing against the walls of your arteries. Your arteries are blood vessels that carry blood from your heart to other parts of your body. High blood pressure, or hypertension, is blood pressure that is higher than normal. Having high blood pressure can put you at risk for other health problems, such as heart disease, heart attack, and stroke.

During pregnancy, high blood pressure can cause problems for you and your baby. To keep you and your baby healthy, it's important to get treatment for high blood pressure before, during, and after pregnancy.

What are the types of high blood pressure in pregnancy?

From: MedlinePlus, National Library of Medicine

There are different types of high blood pressure in pregnancy:

• Gestational hypertension is high blood pressure that you develop while you are pregnant. It starts after you are 20 weeks pregnant. You usually don't have any other symptoms. In many cases, it does not harm you or your baby, and it goes away within 12 weeks after childbirth. But it does raise your risk of high blood pressure in the future. If it becomes severe, it can lead to a preterm birth or your baby having a low birth weight. Some women with gestational hypertension do go on to develop preeclampsia, a more serious type of high blood pressure in pregnancy.
• Chronic hypertension is high blood pressure that starts before the 20th week of pregnancy or before you became pregnant. Some people may have had it long before becoming pregnant but didn't know it until they got their blood pressure checked at their prenatal visit. Sometimes chronic hypertension can also lead to preeclampsia.
• Preeclampsia is a sudden increase in blood pressure after the 20th week of pregnancy. It usually happens in the last trimester. Preeclampsia also often includes signs of damage to some of your organs, such as your liver or kidneys. The signs may include protein in the urine (pee) and very high blood pressure. Preeclampsia can be serious or even life-threatening for both you and your baby. If preeclampsia becomes severe enough to affect your brain function and causes seizures or a coma, it is called eclampsia. In rare cases, preeclampsia symptoms may not start until after delivery. This is called postpartum preeclampsia. If this type of preeclampsia becomes more severe and causes a seizure, it is known as postpartum eclampsia. When a person with preeclampsia or eclampsia has damage to the liver and blood cells, it's called HELLP syndrome. It is rare, but very serious.

Who is more likely to develop high blood pressure in pregnancy?

From: MedlinePlus, National Library of Medicine

You are more likely to develop high blood pressure in pregnancy if you:

• Had chronic high blood pressure or chronic kidney disease before pregnancy
• Had high blood pressure or preeclampsia in a previous pregnancy
• Have obesity
• Are under age 20 or over age 40
• Are pregnant with more than one baby
• Have a family history of high blood pressure in pregnancy
• Have certain health conditions, such as diabetes or lupus

What are the symptoms of high blood pressure in pregnancy?

From: MedlinePlus, National Library of Medicine

High blood pressure usually has no symptoms. People usually find out they have high blood pressure when their health care provider measures their blood pressure.

Preeclampsia can cause other symptoms, including:

• Too much protein in your urine (called proteinuria).
• Swelling (edema) in your face and hands. Your feet may also swell, but many women have swollen feet during pregnancy. So swollen feet by themselves may not be a sign of a problem.
• A headache that does not go away.
• Vision problems, including blurred vision or seeing spots.
• Pain in your upper right abdomen (belly).
• Trouble breathing.

Eclampsia can also cause seizures, nausea and/or vomiting, and low urine output.

If you go on to develop HELLP syndrome, you may also have bleeding or bruising easily, extreme fatigue, and liver failure.

What problems can high blood pressure in pregnancy cause?

From: MedlinePlus, National Library of Medicine

High blood pressure in pregnancy can lead to complications such as:

• Placental abruption, where the placenta (the organ that brings oxygen and nutrients to the baby) separates from the uterus (the place where a baby grows during pregnancy)
• Poor fetal growth, caused by a lack of nutrients and oxygen
• Preterm birth
• Your baby having a low birth weight
• Damage to your kidneys, liver, brain, and other organ and blood systems
• A higher risk of heart disease for you

How is high blood pressure in pregnancy diagnosed?

From: MedlinePlus, National Library of Medicine

Your provider will check your blood pressure and urine at each prenatal visit. If your blood pressure reading is high (140/90 or higher), especially after the 20th week of pregnancy, your provider will likely want to order some tests. These may include blood tests and other lab tests, such as a test to look for extra protein in your urine.

What are the treatments for high blood pressure in pregnancy?

From: MedlinePlus, National Library of Medicine

If you have high blood pressure, you and your baby will be closely monitored to lower the chance of complications. You may need to:

If you have eclampsia, HELLP syndrome, or a severe case of preeclampsia, you will most likely need to go to the hospital. Treatment often includes medicines. Your provider may also recommend delivering the baby early. They will make the decision based on:

The goal is to lower the risks to you while giving your baby as much time as possible to mature before delivery.

The symptoms of preeclampsia can last after delivery, but they usually go away within 6 weeks.

• Check your blood pressure at home.
• Keep track of how many times you feel the baby kicking each day.
• Adjust your physical activity. Talk to your provider about what level of physical activity is right for you.
• Take medicine to control your blood pressure. Talk to your provider about which medicines are safe for your baby.
• Take aspirin in the second trimester, if you are at risk of preeclampsia and your provider recommends aspirin.
• Visit your provider more often to monitor your condition and your baby's growth rate and heart rate.
• How severe the condition is
• The possible risks to you and your baby
• How far along the pregnancy is

Which doctor should you see?

The suggested department for discussing High Blood Pressure in Pregnancy is Obstetrics and Gynaecology, with a obstetrician-gynaecologist as the relevant type of clinician. Urgent in-person medical assessment; emergency department if severe or deteriorating.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• How do age, pregnancy status and reproductive goals affect the assessment?
• Which changes in bleeding, pain or general health need prompt review?
• What are the benefits and risks of the available options in this situation?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.