Prevention of Developing Gestational Hypertension

Introduction:

High blood pressure of greater than 140/90 millimeters of mercury (mmHg) is known as hypertension. In the United States, hypertension is commonly seen in pregnant women (about one in 12 to 17 pregnancies). Hypertension that develops during pregnancy is known as gestational hypertension. During the prenatal check-up, the healthcare providers usually check the pregnant woman's blood pressure and urine protein levels and perform scans and blood tests to assess for gestational hypertension. Treatment for gestational hypertension depends on how close the pregnant woman is to her due date. At present, there is no sure way to prevent gestational hypertension. However, women planning for pregnancy or those who have conceived can try to control the factors contributing to hypertension development.

What Are the Different Types of Hypertension Seen in Pregnant Women?

High blood pressure can occur in different ways during pregnancy. The types of hypertension scenarios during pregnancy include:

1. Chronic Hypertension - Women with hypertension before conception have high blood pressure greater than 140/90 millimeters of mercury (mmHg) during pregnancy and continue to have hypertension after delivery. Thus, if a person has hypertension before pregnancy, they require treatment for the condition before, during, and after the pregnancy.

2. Gestational Hypertension - Women develop hypertension during pregnancy, which is usually detected after 20 weeks of pregnancy, and the high blood pressure resolves itself after delivery.

3. Preeclampsia - A serious condition that pregnant women with chronic or gestational hypertension may develop, usually after 20 weeks of pregnancy. If left untreated, this can result in serious complications for the mother and baby.

4. A Sudden Spike in Blood Pressure - The blood pressure may increase suddenly, exceeding 160/110 millimeters of mercury (mmHg) during pregnancy or delivery. This is a medical emergency that requires immediate medical management.

What Is Gestational Hypertension?

Gestational hypertension is also called pregnancy-induced hypertension, in which pregnant women have increased (high) blood pressure during pregnancy. About six to eight percent of pregnant women are affected by this condition. Gestational hypertension can lead to preeclampsia or toxemia, a serious condition in which pregnant women have high blood pressure along with protein in urine and swollen legs, hands, and feet. Preeclampsia can result in seizures or eclampsia, which can even be fatal.

Who Is at Risk of Gestational Hypertension?

The following individuals may have an increased risk of developing hypertension during pregnancy:

1. Women with a family history of pregnancy-induced hypertension (sisters or mothers had the condition).

2. Women, pregnant for the first time (first-time moms).

3. Obese women.

4. Women with an unhealthy lifestyle, without proper diet, rest, or exercise.

5. Women who are carrying multiple babies (such as twins or triplets).

6. Pregnant women younger than 20 years of age or older than 40 years of age.

7. Women who have a medical history of kidney problems before pregnancy.

8. Women with a medical history of high blood pressure (hypertension) before pregnancy.

How to Manage Blood Pressure During Pregnancy?

Healthcare providers usually measure pregnant women's blood pressure during prenatal visits as a part of regular care. Their blood pressure is usually closely monitored throughout the pregnancy. In case of high blood pressure, pregnant women receive special attention and care to decrease the chance of complications related to blood pressure. Every pregnant woman should:

• Check their blood pressure at home regularly if pregnant women are at an increased risk of developing gestational hypertension or have developed hypertension.

• Track the baby's movements and kicks every day, and contact their healthcare provider if they notice a decrease in their baby's movements.

• Consult their healthcare provider regarding the types of exercises suitable for them and the level of physical activity that is right for them to maintain normal blood pressure.

• Should take the medications prescribed by their healthcare provider if found to have gestational hypertension. The doctors usually prescribe medications that are safe for their baby, such as oral calcium channel blockers, or may administer intravenous injections (vasodilators or beta-blockers).

• Should take Aspirin if prescribed. Pregnant women who are at increased risk of preeclampsia may be prescribed Aspirin in the second trimester by their healthcare provider.

• Visit their healthcare provider regularly to monitor their blood pressure and their fetal development.

• Undergo testing as recommended by their healthcare providers, such as blood tests, urine tests, and scans to help detect preeclampsia.

If a pregnant woman develops gestational hypertension, their healthcare provider may recommend delivery before their due date (in case of concerns regarding the baby's or the mother's health due to the high blood pressure or its complications). In such scenarios, the pregnant woman might be asked to stay in the hospital to receive medications to help the fetal lung development before scheduling the delivery.

What Are the Ways to Prevent Gestational Hypertension?

At present, there are no sure ways to prevent the development of gestational hypertension. Pregnant women and those trying to get pregnant can try to control the factors that could contribute to gestational hypertension. One must follow their healthcare provider's instructions about diet and exercise. A few ways to prevent developing hypertension during pregnancy include:

• Women trying to conceive must maintain a healthy weight, as obesity is a risk factor for gestational diabetes. Getting in shape and losing weight before pregnancy lowers the risk of developing gestational hypertension.

• Pregnant women and women trying to conceive must lead a healthy lifestyle and practice healthy living habits.

• Pregnant women must limit their salt intake and use only as much salt as needed for taste.

• Pregnant women must stay hydrated and drink at least eight glasses of water every day.

• Pregnant women must follow a healthy, well-balanced diet with increased protein in their food. They must limit their intake of junk or fried foods. Eating a healthy meal and snack, with plenty of fruits and vegetables, helps their baby's healthy development as well.

• Pregnant women must ensure that they get sufficient sleep and rest.

• Regular stretching and exercise help maintain a healthy pregnancy (must avoid strenuous exercise regimens).

• Pregnant women must keep their feet elevated several times during the day.

• Pregnant women and those trying to conceive must avoid drinking alcohol and other unhealthy habits.

• Pregnant women must limit or avoid the intake of beverages containing caffeine.

• Consuming the medicines and nutritional supplements the healthcare provider prescribes regularly ensures a healthy pregnancy.

Conclusion:

Some pregnant women may develop or have high blood pressure during pregnancy. High blood pressure can put the mother and the baby at risk of health complications. Increased blood pressure also causes problems during delivery and after the baby's birth. Fortunately, high blood pressure can be prevented and treated. With good blood pressure control, the pregnant mother and baby can stay healthy. It is essential for expecting mothers to talk with their healthcare provider about their risk of developing gestational hypertension and the measures that can help prevent it.