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High Blood Pressure in Pregnancy

High blood pressure — also called hypertension — can lead to serious problems when you’re pregnant. But people with high blood pressure in pregnancy can have healthy pregnancies and babies with treatment and help from a doctor or nurse.

There are a few kinds of hypertension in pregnancy:

Chronic hypertension:
Chronic hypertension is high blood pressure that started before your pregnancy, or during the first 20 weeks of your pregnancy. You also have chronic hypertension when you’re diagnosed with high blood pressure for the first time during your pregnancy, and it doesn’t go away after you give birth.

Gestational Hypertension (also called Pregnancy Induced Hypertension or PIH):
Gestational hypertension is high blood pressure that starts after 20 weeks of pregnancy. Gestational hypertension usually goes away after you give birth, but it makes you more likely to have chronic hypertension in the future.

Preeclampsia is a serious blood pressure disorder that can happen in pregnancy. Preeclampsia in pregnancy can damage organs in your body and can cause health risks for your baby. Preeclampsia tends to happen in the last trimester, but can happen earlier. It can also happen after pregnancy (called postpartum preeclampsia). If you have preeclampsia, you may need to give birth early. Preeclampsia can lead to something called HELLP syndrome, which affects your organs and blood and can be life threatening. Preeclampsia can also lead to eclampsia, which causes seizures.

Signs of preeclampsia include:

  • Swelling in your face or hands

  • Severe headaches that don’t go away

  • Vision changes

  • Trouble breathing

  • Gaining a lot of weight very fast

  • Belly or shoulder pain

  • Nausea or vomiting in the second half of your pregnancy

What problems can high blood pressure in pregnancy cause?

Hypertension in pregnancy can cause serious health problems for both the pregnant person and the fetus. But working closely with your doctor or nurse during pregnancy can help you stay safe and healthy.

Complications for the pregnant person may include heart, kidney, and liver problems, stroke, blood clotting problems, and seizures. High blood pressure can also lead to an emergency medical issue called placental abruption, when the placenta comes off the wall of your uterus too early. People with high blood pressure  in pregnancy are more likely to have a cesarean section and give birth early.

High blood pressure in pregnancy can also cause problems for your baby. High blood pressure can decrease blood flow to the placenta, the part that brings oxygen and food to your fetus. This can lead to things like low birth weight (less than 5 pounds 8 ounces), or giving birth too early (before 37 weeks of pregnancy).

How is high blood pressure in pregnancy treated?

High blood pressure is common, and can be managed during your pregnancy. With treatment and careful monitoring, most people will have a healthy pregnancy and baby.

If you have high blood pressure, diabetes, or other health problems and are planning to get pregnant, talk with your nurse or doctor about any medicines you should start or stop taking, along with other ways to stay healthy during your pregnancy (like eating well and staying active).

During your pregnancy, get regular prenatal care and make sure you go to all of your check ups. Talk with your nurse or doctor before you start or stop taking any medicine, including over-the-counter medicine like aspirin.

If you’re 12 weeks pregnant or more and you’re at high risk for preeclampsia, your doctor may prescribe a low dose of aspirin to help prevent preeclampsia. You’ll continue to take a daily dose of aspirin until you give birth.

If you’re pregnant and have high blood pressure, you’ll need to see your doctor or nurse more often. They’ll track your blood pressure, check your urine (pee) and blood, and measure your fetus’s growth and movement. You may need to measure your blood pressure at home with a blood pressure monitor, and track other things like your weight and how much your fetus moves.

Your doctor might give you blood pressure medicine if your hypertension is serious or starts causing health problems. And you may get ultrasounds or other tests to make sure your fetus is growing normally. Some people have to give birth at 37 weeks or earlier if staying pregnant is dangerous to you or your fetus.

People who are diagnosed with high blood pressure in pregnancy are more likely to develop blood pressure problems in the future. Talk with your nurse or doctor about ways to keep track of your blood pressure and your overall health after your pregnancy.