What Is High Blood Pressure?
What Are the Effects of High Blood Pressure in Pregnancy?
Although
many pregnant women with high blood pressure have healthy
babies without serious problems, high blood pressure can be dangerous for both
the mother and the fetus. Women with pre-existing, or chronic, high blood
pressure are more likely to have certain complications during pregnancy than
those with normal blood pressure. However, some women develop high blood
pressure while they are pregnant (often called gestational hypertension).
The
effects of high blood pressure range from mild to severe. High blood pressure
can harm the mother's kidneys and other organs, and it can cause low birth
weight and early delivery. In the most serious cases, the mother develops
preeclampsia - or "toxemia of pregnancy"--which can threaten the
lives of both the mother and the fetus.
What Is Preeclampsia?
Preeclampsia is a condition that typically
starts after the 20th week of pregnancy and is related to increased blood
pressure and protein in the mother's urine (as a result of kidney problems).
Preeclampsia affects the placenta, and it can affect the mother's kidney, liver, and brain. When preeclampsia
causes seizures, the condition is
known as eclampsia--the second leading cause of maternal death in the U.S.
Preeclampsia is also a leading cause of fetal complications, which include low
birth weight, premature birth, and stillbirth.
There
is no proven way to prevent preeclampsia. Most women who develop signs of
preeclampsia, however, are closely monitored to lessen or avoid related
problems. The only way to "cure" preeclampsia is to deliver the baby.
How Common Are High Blood Pressure and Preeclampsia in Pregnancy?
High
blood pressure problems occur in 6 percent to 8 percent of all pregnancies in
the U.S., about 70 percent of which are first-time pregnancies. In 1998, more
than 146,320 cases of preeclampsia alone were diagnosed.
Although the proportion
of pregnancies with gestational hypertension and eclampsia has remained about the same in the
U.S. over the past decade, the rate of preeclampsia has increased by nearly
one-third. This increase is due in part to a rise in the numbers of older
mothers and of multiple births, where preeclampsia occurs more frequently. For
example, in 1998 birth rates among women ages 30 to 44 and the number of births
to women ages 45 and older were at the highest levels in 3 decades, according
to the National Center for Health Statistics. Furthermore, between 1980 and
1998, rates of twin births increased about 50 percent overall and 1,000 percent
among women ages 45 to 49; rates of triplet and other higher-order multiple
births jumped more than 400 percent overall, and 1,000 percent among women in
their 40s.
Who Is More Likely to Develop Preeclampsia?
·
Women with chronic hypertension (high blood pressure before becoming
pregnant).
·
Women who developed high blood pressure or preeclampsia during a
previous pregnancy, especially if these conditions occurred early in the
pregnancy.
·
Women who are obese prior to pregnancy.
·
Pregnant women under the age of 20 or over the age of 40.
·
Women who are pregnant with more than one baby.
·
Women with diabetes, kidney disease, rheumatoid arthritis, lupus, orscleroderma.
What Are the Symptoms of Preeclampsia and How Is It Detected?
Unfortunately,
there is no single test to predict or diagnose preeclampsia. Key signs are
increased blood pressure and protein in the urine (proteinuria). Other symptoms
that seem to occur with preeclampsia includepersistent headaches, blurred vision or sensitivity to light, and abdominal pain.
All of
these sensations can be caused by other disorders; they can also occur in
healthy pregnancies. Regular visits with your doctor help him or her to track
your blood pressure and level of protein in your urine, to order and analyze
blood tests that detect signs of preeclampsia, and to monitor fetal development
more closely.
How Can Women with High Blood Pressure Prevent Problems During
Pregnancy?
If you
are thinking about having a baby and you have high blood pressure, talk first
to your doctor or nurse. Taking steps to control your blood pressure before and
during pregnancy-and getting regular prenatal care-go a long way toward
ensuring your well-being and your baby's health.
Before
becoming pregnant:
·
Be sure your blood pressure is under control. Lifestyle changes
such as limiting your salt intake, participating in regular physical activity,
and losing weight if you are overweight can be helpful.
·
Discuss with your doctor how hypertension might affect you and
your baby during pregnancy, and what you can do to prevent or lessen problems.
·
If you take medicines for your blood pressure, ask your doctor
whether you should change the amount you take or stop taking them during
pregnancy. Experts currently recommend avoiding angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II (AII) receptor
antagonists during pregnancy;
other blood pressure medications may be OK for you to use. Do not, however,
stop or change your medicines unless your doctor tells you to do so.
While
you are pregnant:
·
Obtain regular prenatal medical care.
·
Avoid alcohol and tobacco.
·
Talk to your doctor about any over-the-counter medications you
are taking or are thinking about taking.
Does Hypertension or Preeclampsia During Pregnancy Cause Long-Term
Heart and Blood Vessel Problems?
The effects of high blood pressure during
pregnancy vary depending on the disorder and other factors. According to the
National High Blood Pressure Education Program (NHBPEP), preeclampsia does not
in general increase a woman's risk for developing chronic hypertension or other
heart-related problems. The NHBPEP also reports that in women with normal blood
pressure who develop preeclampsia after the 20th week of their first pregnancy,
short-term complications-including increased blood pressure-usually go away
within about 6 weeks after delivery.
Some
women, however, may be more likely to develop high blood pressure or otherheart
disease later in life. More
research is needed to determine the long-term health effects of hypertensive
disorders in pregnancy and to develop better methods for identifying,
diagnosing, and treating women at risk for these conditions.
Even
though high blood pressure and related disorders during pregnancy can be
serious, most women with high blood pressure and those who develop preeclampsia
have successful pregnancies. Obtaining early and regular prenatal care is the
most important thing you can do for you and your baby.
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