Chronic hypertension during pregnancy and the dangers that lurk

If you had high blood pressure (hypertension) before you became pregnant or you were diagnosed with hypertension before you reached 20 weeks pregnant, then you have a chronic hypertensive condition. At least 5 percent of women experience chronic hypertension while pregnant.

Blood pressure measurement shows how forcefully the blood is pushing against the artery walls. The measurement has two numbers: the upper number (systolic) is the pressure when the heart pumps blood, and the lower number (diastolic) is when the heart relaxes and fills with blood. To find out more, let's look at the explanation below.

What is the measure of chronic hypertension blood pressure in pregnancy?

High blood pressure during pregnancy is defined when the pressure reaches 140/90 or higher, even if only one of the numbers is higher. Chronic hypertension during pregnancy occurs when the pressure reaches 160/110 or higher. Because your blood pressure may be different, your doctor may use readings at different times and use average readings.

Chronic hypertension isn't the only condition that involves high blood pressure during pregnancy. If you develop high blood pressure after 20 weeks of pregnancy, you will be diagnosed with gestational hypertension. If your blood pressure doesn't return to normal within 12 weeks of giving birth, you may have chronic hypertension all the time.

If you have chronic hypertension while pregnant, after 20 weeks of pregnancy, have protein in your urine, liver or kidney disorders, headaches, or vision changes, you may have preeclampsia.

What affects the occurrence of chronic hypertension during pregnancy?

Having chronic hypertension indirectly increases your risk of developing preeclampsia. Preeclampsia that develops when you already have chronic hypertension is called "superimposed preeclampsia." About 1 in 4 women with chronic hypertension and as many as half of women with severe chronic hypertension develop preeclampsia during pregnancy.

High blood pressure during pregnancy can also cause less blood to flow through the placenta, providing less oxygen and less nutrition for your growing baby. Chronic hypertension increases the risk for a number of pregnancy complications, including fetal failure to thrive in utero, preterm birth, placental abruption, and stillbirth.

If your chronic hypertension is mild, your risk of developing this complication during pregnancy is not much higher if you have normal blood pressure. As long as you don't have other medical problems, hypertension won't get worse and you won't get preeclampsia.

However, the more severe your hypertension is, the higher your risk of developing chronic hypertension, and your risk of developing preeclampsia even higher. Your risk is also higher if you've had hypertension for a long time and it has damaged your cardiovascular system, kidneys, or other organs, or if your hypertension is the result of diabetes, kidney disease, or lupus.

What are the signs that I should look out for?

Once your baby starts moving regularly, the doctor may ask you to count fetal kicks to track your baby's movements (this is a good way to monitor your baby's health when you're not at the doctor.) Tell the doctor right away if you think your baby is less active. than usual.

Your doctor can also check and track your blood pressure at home. He will tell you how often you should do this and will see the results during the examination at the clinic. The doctor will also direct you when to call the doctor or go to the hospital if your pressure is above a certain level.

Call your doctor immediately if you experience:

• Headaches, especially severe or persistent headaches
• Your chest or heart is pounding
• Dizzy
• Swelling of the face or around the eyes, slight swelling of the hands, excessive or sudden swelling of the feet or ankles (swelling of the feet and ankles is usually normal during pregnancy), or swelling of your calves
• Weight gain more than 2.5 kg in a week
• Changes to vision, including double vision, blurred vision, seeing spots or flashing lights, sensitivity to light, or temporary loss of vision
• Pain or tenderness in the upper abdomen
• Nausea or vomiting (other than morning sickness early in pregnancy)

What will happen after giving birth?

When you develop chronic hypertension while pregnant, you are at risk for cardiovascular complications as your body systems adapt to all the changes in your body after you give birth. So after giving birth, you will be closely monitored for at least 48 hours.

Because preeclampsia can occur after childbirth, tell your doctor right away if you experience symptoms of this condition, even after you have been discharged home. You will start taking your blood pressure medication again or take the dosage as needed. Tell your doctor if you plan to breastfeed, as doing so will affect the choice of blood pressure medication for you.

In addition to taking your medications as prescribed and consulting your doctor regularly, you need to take care of yourself to reduce your risk of long-term complications of hypertension, such as heart or kidney disease and stroke. Try to maintain a healthy lifestyle, pay special attention to diet and weight, avoid tobacco, and limit the alcohol you drink.

When your puerperium is over and your doctor allows you to start exercising, ask your doctor what type of exercise routine is best for your personal situation and stick to it.

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