By Idesha S. Reese
Hypertensive disorders affecting pregnant women
Hypertension or high blood pressure is defined as a repeatedly elevated blood pressure exceeding 140 over 90 mmHg – a systolic pressure over 140 or a diastolic pressure above 90. It affects six percent to 8 percent of all pregnancies. Hypertensive disorders during pregnancy are divided into four categories: 1) chronic hypertension, 2) preeclampsia/eclampsia, 3) preeclampsia superimposed on chronic hypertension and 4) gestational hypertension.
Preeclampsia – a condition involving blood pressure elevation after 20 weeks of gestation with proteinuria (excretion of protein in urine) or thrombocytopenia (platelet count <100,000), impaired liver function, development of renal deficiency, pulmonary edema (fluid accumulation in lungs) or new onset cerebral or visual disturbances
Anyone with chronic hypertension should take steps to get their condition under control before becoming pregnant and discus with their doctor if their condition has had an adverse effect on their overall health. Being overweight can also contribute to hypertension, so being at a healthy weight before pregnancy is a good idea. Management of any existing medical condition is recommended prior to pregnancy to help ensure the best possible outcome for mother and baby.
With any hypertensive disorder, blood pressure of the expectant mother will be monitored and if deemed necessary ultrasound exams will be performed throughout the pregnancy to track the growth of the baby. Pregnancy and delivery complications from hypertension are directly related to the severity and duration of elevated blood pressure. That is why it is important to get the elevation in blood pressure, along with any other symptoms, under control.
Preeclampsia – also known as toxemia, is a condition usually beginning after the 20th week of pregnancy for which hypertension is a key factor
Eclampsia – symptoms of preeclampsia with new occurrence of seizures
Small for gestational age – also referred to as low birth weight, is fetal weight that is below the 10th percentile for gestational age of the infant
Placental abruption – when the placental separates from the walls of the uterus prior to delivery. This condition can deprive the baby of necessary oxygen and nutrients and cause heavy bleeding in the mother
Cesarean section – sometimes when a hypertensive disorder develops during pregnancy it may not be safe for the mother, the baby or both to undergo the stress of laboring and contractions; a cesarean section will then be performed to safely deliver the infant
Maternal death – increased likelihood of maternal death is associated with the symptoms and effects of preeclampsia
In most cases, many of the symptoms of preeclampsia start to go away after delivery. Elevated blood pressure caused by preeclampsia or gestational hypertension should start to return to normal levels once the baby and placenta have been delivered. Patients will continued to be monitored and treated postpartum for all related symptoms and should follow the doctor’s plan of care.