What Causes Hypertension in Pregnancy?

Hypertension (high blood pressure) usually doesn’t cause any symptoms. It is often dubbed “the silent killer” because many people don’t know they have high blood pressure until they develop a heart attack, kidney disease, or stroke.

Some pregnant women may have symptoms of hypertension, such as:

• Headache
• Dizziness
• Shortness of breath
• Blurred vision
• Feeling of pulsations in the neck or head
• Nausea

Not all women have symptoms of preeclampsia, but when symptoms occur, they may include:

• Persistent headache 
• Vision changes (blurred vision, seeing spots, or changes in eyesight)
• Pain in the upper stomach area
• Nausea or vomiting
• Swelling of the face or hands
• Sudden weight gain
• Difficulty breathing

Hypertension during pregnancy doesn’t just affect the mother. High blood pressure can have the following effects on the unborn baby: 

• Preterm delivery (premature birth that occurs before 37 weeks of pregnancy) 
• Low birth weight (baby weighs less than 5 pounds, 8 ounces at birth)
• Fetal growth restriction
  • High blood pressure in the mother can make it more difficult for the baby to get adequate oxygen and nutrients and it may grow more slowly
• Fetal death
• Neonatal death (death of the baby in the first 28 days of life)

Hypertension (high blood pressure) is diagnosed using a pressure cuff (sphygmomanometer) to get a blood pressure reading. A cuff is placed around the upper arm and manually or electronically inflated. When inflated, the cuff compresses the brachial artery, the major blood vessel of the upper arm, briefly stopping blood flow. The air in the cuff is then released slowly while the person performing the measurement listens with a stethoscope or monitors an electronic readout.

Blood pressure is checked at prenatal visits. 

Treatment for chronic hypertension during pregnancy depends on how high the blood pressure is. 

• In the first half of pregnancy, blood pressure normally drops and if the pressure is only mildly elevated, it may stay that way or return to normal during pregnancy
  • In this case, a doctor may recommend reducing or stopping blood pressure medication during pregnancy (never stop taking a prescribed medication without first talking to your doctor)
• Severe hypertension or health problems associated with it may require starting or continuing blood pressure medication during pregnancy

Treatment for gestational hypertension depends on how close a woman is to her due date. 

• When a woman is close to her due date and the baby is developed enough, delivering the baby as soon as possible may be advised
• If hypertension is mild and the baby is not yet fully developed, lifestyle changes may be suggested: 
  • Resting, lying on the left side to take the weight of the baby off the major blood vessels
  • Reducing salt intake
  • Drinking 8 glasses of water each day
  • Increasing prenatal checkups
• For severe hypertension, blood pressure medications may be prescribed until the woman is far enough along to safely deliver the baby

Treatment for mild preeclampsia may include: 

• Blood pressure measurement at home
• Monitoring fetal movement by doing a daily kick cunt
• Visiting the ob-gyn once or twice weekly
• Delivery may be considered at 37 weeks of pregnancy either by inducing labor with medications or via a cesarean birth (C-section)

Women who have severe preeclampsia may need to be treated in the hospital. 

• For women at least 34 weeks pregnant, delivery may be considered once the mother’s condition is stable
• Women less than 34 weeks pregnant and in stable condition may be able to wait to deliver the baby
  • Corticosteroids may be given to help the fetus’s lungs mature
  • Medications may be given to the mother to reduce blood pressure and help prevent seizures
  • Immediate delivery may be considered if the mother’s health or the fetus’s health worsens