Pregnancy-induced hypertension, also known as gestational hypertension, affects approximately 6 to 8 per cent of all pregnant women.
Hypertensive disorders in pregnancy may cause maternal and foetal death, and remain a leading cause of maternal mortality.
There are three types of hypertension in pregnancy: chronic hypertension, in which women may have had hypertension prior to pregnancy, during pregnancy, and after delivery.
Hypertension is present in about 22 per cent of women of child-bearing age. These are the ones at risk of hypertension in pregnancy as well. Gestational hypertension develops after week 20 of pregnancy.
Preeclampsia is a complication of both chronic and gestational hypertension and can lead to severe complications for both the mother and the baby. It presents as hypertension in pregnancy, with the presence of protein in urine.
Risk factors for hypertension in pregnancy include:
- First time mothers
- Women whose sisters and mothers have had hypertension in pregnancy
- Twin pregnancies.
- Pregnant women in extremes of age, for instance less than 18 and over 35.
- Women with high blood pressure or kidney disease prior to pregnancy.
- A new partner, maternal obesity, diabetes, and inter-pregnancy intervals of less than two years or longer than 10 years.
Diagnosis of hypertension in pregnancy is made during routine antenatal check-ups whenever a mother’s blood pressure is taken.
A BP reading of above 140 systolic over 90 diastolic (140/90) must be repeated for confirmation.
Two readings at different intervals above 140/90 confirm hypertension and must be closely monitored and treatment initiated.
Preeclampsia (hypertension in pregnancy with protein in urine), will usually present with visual disturbances, new-onset headache that is frontal, throbbing, or similar to a migraine headache, and sudden new-onset upper abdominal pains.
It may present with rapidly increasing leg swelling or rapid weight gain. A few women may present with convulsions (seizures). This is usually an ominous sign of eclampsia (preeclampsia with seizures).
A routine antenatal check must, therefore, include the following:BP check, urine for proteins, an abdominal examination, and a weight check.
Treatment of gestational hypertension
Treatment of hypertension in pregnancy depends on gestational age (how far along the pregnancy is) as well as the severity of the hypertension or complications arising due to hypertension.
Mild hypertension without any complications may be managed by closer monitoring through more frequent antenatal visits, increased rest especially lying on one’s left side, avoiding salt, and drinking six to eight glasses of water every day.
Severe high blood pressure may require medication until when the baby can be delivered safely.
If one is close to their due date and the hypertension is severe or they are developing complications such as seizures, the mother may need to be delivered urgently.
Gestational hypertension reduces placental blood flow, leading to low birth weight.
Early diagnosis through honouring antenatal visits as prescribed by health care workers can result in proper treatment and prevent complications.
- Prevention of hypertension in pregnancy includes using minimal salt, and only as required.
- Taking plenty of fluids (at least eight glasses a day).
- Getting adequate rest.
- Exercising regularly.
- Avoiding alcohol and stimulants such as coffee, especially if you are trying to get pregnant.
- Raising your feet often, and once pregnant, ensuring proper follow up by the doctor
The writer is a medical doctor and a public health specialist. Do you have any health-related questions? Write to [email protected]