High blood pressure by itself is not dangerous. Depending on when it occurs during pregnancy, you will be watched extra closely. Because very occasionally you may well develop symptoms and require prompt intervention. It can lead to serious complications in some situations, which is why we measure your blood pressure regularly, especially at the end of your pregnancy.
- The complications that can be related to high blood pressure are Pre-eclampsia and HELLP syndrome. Serious forms of these do pose a danger to yourself and your pregnancy. Fortunately, these forms are rare.
Blood pressure
The average blood pressure is 120/80 (upper/lower pressure). If you have naturally low blood pressure (for example, 90/60), a blood pressure of 120/80 may seem seem seemingly normal, when it is not. This is why it is good to know your blood pressure before you get pregnant. The midwife checks your blood pressure at every consultation to keep a close eye on whether it is going to rise.
Your blood pressure during pregnancy
Normally, during the first six months, your blood pressure is usually a little lower than before pregnancy. The last three months of the pregnancy your blood pressure is back to the same level as before the pregnancy and sometimes a little higher. If it turns out that your blood pressure does suddenly rise, the midwife may decide to measure your blood pressure a little more often or initiate urinalysis. If the blood pressure rises too much, an appointment is made at the hospital. Here your blood pressure will be measured every few minutes for a longer period of time, blood tests will be done and a heart film will be taken of the baby’s heartbeat.
Pregnancy hypertension
- First-time pregnant women are more likely to have high blood pressure.
- 1 in 20 women develop high blood pressure during pregnancy. This involves your blood pressure being continuously (at least twice at an interval of at least 6 hours) greater than or equal to 140/90.
- The higher the blood pressure, the more risk for mother and child.
- Fortunately, high blood pressure is easily treated with medication.
- Sometimes high blood pressure can degenerate into pre-eclampsia or HELLP.
- You cannot prevent or cure high blood pressure. Do try to avoid a lot of stress.
- With high blood pressure, you can just keep moving. That’s actually a good thing.
If you have high blood pressure, your midwife will keep an extra eye on you. Your blood pressure and urine will be checked more often (protein). Your midwife will also tell you what symptoms you may develop, how to keep an eye on them and when to contact her.
Effects on the baby
If your blood pressure gets too high, your blood vessels are constricted. This reduces the flow of your placenta. Your baby then receives less nutrients and oxygen through the placenta. If your blood pressure consistently exceeds 140/90, you will be monitored by your gynecologist. You will be given medication to lower your blood pressure. Sometimes your delivery is induced earlier.
Pre-eclampsia and eclampsia
Pre-eclampsia involves protein loss in the urine in addition to gestational hypertension. This can be detected by checking your urine for the presence of protein when your blood pressure is elevated. If protein is present in your urine, a blood test will often be done as well, as this can give a more reliable result. The severity and course of pre-eclampsia can vary greatly. Some women have few or no symptoms for a long time; others become seriously ill in a short period of time. Convulsions can occur with pre-eclampsia. Convulsions are attacks with twitching of arms and legs. This is called eclampsia. After eclampsia, a person often cannot remember anything. Medication stops the convulsions and prevents new ones. Very intensive monitoring is necessary.
HELLP syndrome
In addition to pre-eclampsia, HELLP syndrome also exists. Pre-eclampsia can progress into HELLP syndrome, but HELLP syndrome can also occur suddenly. HELLP syndrome stands for Hemolysis, Elevated Liver enzymes and Low Platelets. This means there is an increased breakdown of red blood cells and impaired liver function. In addition, there is a shortage of platelets, causing blood clotting to become dysregulated. Women with HELLP syndrome usually feel very sick. HELLP syndrome is an unpredictable syndrome in which a woman can feel fine one hour and very sick the next. The diagnosis of HELLP syndrome is made definitively based on blood tests.
Blood pressure is the pressure put on the arteries when blood is pumped around your body. When the heart squeezes, the pressure is highest. This is called the upper pressure. When the heart relaxes, blood pressure is lowest. This is called the negative pressure.
Pregnancy hypertension is high blood pressure resulting from pregnancy. It is when a woman who previously had normal blood pressure develops hypertension in the second half (i.e., after the 20th week) of pregnancy. In this case, the upper pressure exceeds 140 mmHg and the lower pressure exceeds 90 mmHg, or has increased by 20 mmHg.