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High blood pressure and pregnancy: Healthy mom, healthy baby

High blood pressure and pregnancy isn't necessarily a dangerous combination. Here's what you need to know to take care of yourself — and your baby.

By Mayo Clinic staff

Having high blood pressure during pregnancy — whether you develop the condition before or after conception — requires special care. Here's what you need to know about high blood pressure and pregnancy.

Why is high blood pressure a problem during pregnancy?

High blood pressure during pregnancy poses various risks, including:

  • Decreased blood flow to the placenta. This reduces the baby's supply of oxygen and nutrients, potentially slowing the baby's growth and increasing the risk of a low birth weight.
  • Placental abruption. With this condition, the placenta prematurely separates from the uterus. Placental abruption can deprive the baby of oxygen and nutrients and cause heavy bleeding in the mother.
  • Premature delivery. Sometimes an early delivery is needed to prevent potentially life-threatening complications.
  • Future cardiovascular disease. Women who develop preeclampsia — a serious condition characterized by high blood pressure and protein in the urine after 20 weeks of pregnancy — may be at increased risk of cardiovascular disease later in life, despite the fact that their blood pressure returns to normal after delivery.

Are there different types of high blood pressure during pregnancy?

Sometimes high blood pressure is present before pregnancy. In other cases, high blood pressure develops during pregnancy.

  • Chronic hypertension. If high blood pressure develops before 20 weeks of pregnancy or lasts more than 12 weeks after delivery, it's known as chronic hypertension. Some women have undiagnosed chronic hypertension before they become pregnant.
  • Gestational hypertension. If high blood pressure develops after 20 weeks of pregnancy, it's known as gestational hypertension. Unlike with preeclampsia, affected women don't have protein in their urine. Gestational hypertension usually goes away after delivery.
  • Preeclampsia. Sometimes chronic hypertension or gestational hypertension leads to preeclampsia, a serious condition characterized by high blood pressure and protein in the urine after 20 weeks of pregnancy. Left untreated, preeclampsia can lead to serious — even fatal — complications for mother and baby.

What do I need to know about preeclampsia?

Warning signs of preeclampsia — which can develop gradually or strike suddenly, often in the last few weeks of pregnancy — may include:

  • Persistent headaches
  • Changes in vision, including blurred vision, light sensitivity and vision loss
  • Upper abdominal pain, usually on the right side
  • Sudden weight gain, typically more than 5 pounds (2.3 kilograms) a week

Swelling (edema), particularly in the face and hands, often accompanies preeclampsia as well. Swelling isn't considered a reliable sign of preeclampsia, however, because it also occurs in many normal pregnancies.

If you develop signs of preeclampsia, you and your baby will be closely monitored. Sometimes bed rest or hospitalization is recommended. The only cure for preeclampsia is delivery of the baby. If your health care provider is concerned about your health or your baby's health, early delivery may be needed — either through induction or a C-section.

Is it safe to take blood pressure medication during pregnancy?

Any medication you take during pregnancy can affect your baby. Although some medications used to lower blood pressure are considered safe during pregnancy, others — such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) and renin inhibitors — are generally avoided during pregnancy.

Treatment is important, however. The risk of heart attack, stroke and other problems associated with high blood pressure doesn't go away during pregnancy. And high blood pressure can be dangerous for your baby, too. If you need medication to control your blood pressure during pregnancy, your health care provider will prescribe the safest medication at the most appropriate dose. Take the medication exactly as prescribed. Don't stop taking the medication or adjust the dose on your own.

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References
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  2. High blood pressure during pregnancy. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp034.cfm. Accessed April 22, 2009.
  3. High blood pressure during pregnancy. March of Dimes. http://www.marchofdimes.com/professionals/14332_1222.asp. Accessed April 22, 2009.
  4. August P, et al. Clinical features, diagnosis, and long-term prognosis of preeclampsia. http://www.uptodate.com/home/index.html. Accessed April 23, 2009.
  5. The American Academy of Pediatrics Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108:776.
  6. High blood pressure during pregnancy may lead to postmenopausal heart disease. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=3045125. Accessed April 22, 2009.
  7. Cooper WO, et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. The New England Journal of Medicine. 2006;354:2443.
  8. Gauer R, et al. Does low-dose aspirin reduce preeclampsia and other maternal-fetal complications? The Journal of Family Practice. 2008;57:54.
  9. Your high blood pressure questions answered - Medication and getting pregnant. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=3028464. Accessed May 4, 2009.
  10. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. May 8, 2009.
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Aug. 1, 2009

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