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Hypertension in pregnancy: what you need to know about this potentially serious complication for mother and baby

Blood pressure is the pressure exerted by the blood against the wall of the arteries, something essential for the blood to circulate through the blood vessels, providing oxygen and nutrients to all the organs of the body so that they can function.

When there is a continuous increase in the blood pressure figures in the arteries, we are faced with a case of arterial hypertension, which if manifested during pregnancy could constitute a risk to the health of the mother and the baby.

Many pregnant women with hypertension usually present this disease before pregnancy, although there are also cases of gestational hypertension, where the circulatory system suffers alterations due to the pregnancy itself. Today we analyze what are the types of hypertension during pregnancy and what solutions exist .

Types of hypertension during pregnancy

There are four main types of hypertension during pregnancy, the common denominator of which is an increase in blood pressure equal to or greater than 140/90 mmHg:

  • Preeclampsia. This potentially serious disorder for both mother and fetus is characterized by a rise in blood pressure caused by pregnancy and the presence of protein in the urine .

It affects 15% of pregnant women, but if detected early it can be controlled and its risks reduced. It usually develops after 20 weeks of pregnancy and disappears after delivery. In the most severe cases it leads to eclampsia, when hypertension is accompanied by seizures and / or coma.

  • Gestational hypertension , also known as pregnancy-induced hypertension or transient hypertension. This type of hypertension develops after 20 weeks of pregnancy and disappears after delivery.

Although women with gestational hypertension do not have protein in their urine , some of them develop pre-eclampsia later in pregnancy. The chances of having preeclampsia are 50% if gestational hypertension develops before 30 weeks. If it develops after 36 weeks of gestation, the hypertension is generally moderate.

  • Chronic hypertension This is called high blood pressure diagnosed before pregnancy or before 20 weeks of pregnancy. As the name suggests, this type of hypertension does not go away after delivery.

Most of the time it corresponds to essential arterial hypertension in 90% of the cases that is of unknown cause and only 10% of the cases is secondary to another disease such as diabetes, kidney and heart diseases and autoimmune diseases, among others.

  • Chronic hypertension with preeclampsia , a subtype of the previous section. About 25% of women with chronic hypertension also develop preeclampsia. It occurs more frequently in multiparous women and is characterized by severe arterial hypertension and increased uric acid in the blood.

This hypertensive picture is dangerous since it can present seizures, kidney damage and liver damage, as well as thrombocytopenia (decrease in platelets).

Medication and treatment to control hypertension in pregnancy

The only person indicated to say if the woman can medicate (or continue to medicate) and which are the most appropriate drugs in case of hypertension, is the specialist who controls her pregnancy .

In general, the guidelines to follow depend on the degree of hypertension suffered by the woman, and the following may be recommended:

  • If a woman has slightly high blood pressure , takes medication and is trying to get pregnant or finds that she is already pregnant, the doctor usually stops the drug treatment she is following, as there could be a risk that the drugs increase morbidity and mortality of the fetus.

  • In case your blood pressure is moderately high , you should generally continue taking antihypertensive drugs. However, some of the drugs that are safe for the woman may not be safe for the baby, so it will be the specialist who determines the most appropriate medication during pregnancy. Every month, an analysis is necessary to know the kidney function, and the growth of the fetus is monitored with ultrasound scans.

  • Pregnant women with severe high blood pressure need special care and rigorous monitoring, and hospitalization may even be necessary during the second half of pregnancy. Pregnancy can greatly worsen hypertension, leading to swelling of the brain, brain hemorrhage, kidney failure, heart failure, and even death in the mother. There are also serious risks to the fetus such as premature detachment of the placenta from the uterine wall or a reduction in the blood supply to the placenta which affects fetal growth.
In any case, as we say, it will be the specialist who indicates the appropriate treatment for each particular case, weighing risks and benefits.

In addition, it is necessary to have good gestational control to prevent the risks of hypertension during pregnancy, and to follow healthy habits even before achieving pregnancy, so as not to suffer the disease when it is not suffered chronically.

Photos | iStock

Via | Medline Plus, Nacer Sano, WHO, Mayo Clinic

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