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Let's Talk Babies!

Pregnancy is usually a very joyous time as a woman witnesses the creation of life, and watches the changes her body is going through, and witnesses on the ultrasound monitor all the changes the baby is going through as well. Unfortunately, for some women the joy can be tainted by fear and worry as they struggle with a pregnancy complication like pregnancy-induced high blood pressure and preeclampsia.

Normally a pregnant woman’s blood pressure will drop during the second trimester and then return to normal levels again during the third trimester. However, some women experience something much different. In about 10% of pregnancies the woman’s blood pressure begins to go up during the second trimester, instead of lowering, and will continue to go up throughout the remainder of the pregnancy. This is known as pregnancy-induced high blood pressure.

During either your pre-pregnancy check up (if you have one), or during your first prenatal check up your doctor or midwife will take your blood pressure. They will determine first if there are any pre-existing high blood pressure issues that need to be addressed, and secondly to develop a baseline reading to which they can compare all follow up readings. At each prenatal check up your doctor or midwife will take your blood pressure, which will allow them to determine if there have been any changes since the last check up and if your blood pressure appears to be on the rise. A couple of other routine tests that are done during your prenatal check ups to monitor for high blood pressure and preeclampsia are urine tests to monitor for protein in the urine (a sign of preeclampsia), and weight measurements since rapid weight gain can also be a sign of preeclampsia.

Both preeclampsia and high blood pressure can occur gradually or suddenly and can range in severity from mild to severe, so it is important to keep up with your prenatal check ups and tell your doctor or midwife if you notice any changes or have any concerns.

The treatment for high blood pressure will depend on the severity and how far along you are in your pregnancy. Mild high blood pressure will be monitored closely by your doctor or midwife, no medication is usually required for mild high blood pressure but your doctor may recommend a change in diet and mild aerobic exercise to help control your blood pressure. If there are any sudden changes to your blood pressure or you have a more severe case your doctor may recommend the use of high blood pressure medication in addition to the closer monitoring of your pregnancy. Each case will be different depending on the severity of your high blood pressure, how far along you are in your pregnancy, and any other complications that may impact your particular care. Be sure to discuss everything in detail with your doctor or midwife to ensure you have a proper understanding of how you will be treated, and what is expected of you. Careful monitoring is essential since high blood pressure can be a sign of a more severe complication, preeclampsia.

Preeclampsia is the new onset of high blood pressure along with higher than normal levels of protein in your urine. In its most severe form preeclampsia can be life threatening so your doctor will monitor you very closely and may recommend either full bedrest at home or hospitalization. Preeclampsia occurs in about 5% of pregnancies, and appears to happen most often with first pregnancies.

Little is known about what causes high blood pressure and preeclampsia in pregnancy. There are a few factors that can put you at an increased risk of developing high blood pressure and preeclampsia.

  • Existing high blood pressure problem. Your chances are 1 in 4 chance that you will developing preeclampsia during pregnancy.
  • Chronic kidney disease
  • Vascular disease
  • Diabetes
  • High blood pressure in a prior pregnancy, especially if it occurred prior to 34 weeks.
  • Preeclampsia in a prior pregnancy
  • A family history of preeclampsia, especially if either parent was born from a pregnancy affected by preeclampsia.
  • Obesity
  • Multiple pregnancy
  • Either first pregnancy ever, or first pregnancy with this partner.
  • If you are younger than 21 or older than 35
  • Fetal hydrops, which is caused by Rh sensitization or an infection in the uterus.

Everyone hopes that their pregnancy will go by without a hitch and they will be lucky enough not to suffer from any of the pregnancy complications they read about in all those pregnancy books. Unfortunately, that is not always the case. It is very important to have quality prenatal care during your pregnancy, and to bring up any changes you have noticed or concerns you have with your doctor or midwife.

(Source: WebMD, Healthwise)

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