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Blood Pressure and Pregnancy

Blood pressure is vital for the body's circulatory system—the heart, arteries, and veins—to function. It is created in part by the steady beating of the heart. Each time the heart contracts, or squeezes, it pumps blood into the arteries. The arteries carry the blood to the body's organs. The veins return it to the heart.

Blood pressure changes from person to person. It changes often during the day. It can increase if you are excited or if you exercise. Most often, it decreases when you are resting. These short-term changes in blood pressure are normal. It is only when a person's blood pressure stays high for some time that it may signal a problem.

In most pregnant women, readings less than 120/80 millimeters of mercury (mmHg) are normal. If you are pregnant and your systolic pressure is 140 millimeters of mercury (mmHg) or the diastolic pressure is 90 millimeters of mercury (mmHg) on two separate measurements at least four hours apart, it is too high. Your normal blood pressure can be an average of a number of readings taken at rest. 

Effects of blood pressure during pregnancy

In a healthy pregnancy, the fetus receives all of the nutrients and oxygen it needs for normal growth from the mother. This happens when the correct amount of the mother's blood flows through the placenta and the nutrients and oxygen pass through the umbilical cord to the baby.

High blood pressure can cause problems during pregnancy. For instance, when a woman has high blood pressure in pregnancy, it may cause less blood to flow to the placenta and the fetus receives less of the oxygen and nutrients it needs. This can cause the growth of the fetus to slow down.

When high blood pressure first occurs during the second half of pregnancy, it is known as gestational hypertension. This type of high blood pressure goes away soon after the baby is born. A woman with gestational hypertension may need to see the doctor more often to have blood pressure checked. When gestational hypertension occurs with other findings, it is called preeclampsia. Gestational hypertension may lead to preeclampsia.

Although gestational hypertension is the most common sign of preeclampsia, preeclampsia is a serious medical condition affecting all organs of the body. For example, preeclampsia causes stress on the kidneys, which results in increased amounts of protein in the woman's urine. Other signs of preeclampsia may include:
  • Headaches
  • Visual problems
  • Heartburn
  • Rapid weight gain
  • Swelling (edema) of the hands and face
 
The risk of developing preeclampsia is increased in women who:
  • Are pregnant for the first time
  • Have had preeclampsia in a previous pregnancy
  • Have a history of chronic hypertension
  • Are 35 years or older
  • Are carrying more than 1 fetus
  • Have certain medical conditions such as diabetes or kidney disease
  • Are obese
  • Have certain immune disorders, such as lupus, or blood diseases
A woman with preeclampsia may need to stay in the hospital so that she and her baby can be monitored. In some cases, her baby may need to be delivered early. When preeclampsia becomes severe, the woman's organs can be damaged, including the kidneys, liver, brain, heart, and eyes. In some cases, seizures will occur. This is called eclampsia.

Preeclampsia is a very serious illness for both the woman and baby. Severe preeclampsia may require early delivery, even if the baby is not fully grown. If a baby is born prematurely, it may have complications. In severe cases, the woman, baby, or both may die.

At each prenatal visit, a woman's weight, blood pressure, and a urine sample (to check for protein) are taken. This helps detect any changes that might have occurred. Once the doctor is aware that a woman's blood pressure is high, she may be checked more often.
 

When blood pressure increases slightly and the woman is not near the end of her pregnancy, bed rest at home or in the hospital may help reduce the pressure. If the blood pressure does not increase to dangerous levels, pregnancy may be allowed to continue until labor begins naturally.

If preeclampsia develops, the only real cure is to deliver the baby. The decision to deliver the baby depends on the risks to the woman and whether the risk to the baby is greater in the woman's uterus or in a special nursery. The labor may occur naturally or labor may be induced. Sometimes a cesarean birth is needed depending on the health of the woman and the baby.

Before deciding to deliver your baby early, your doctor may wait to see if your condition improves. During labor you may be given medication to help prevent seizures or decrease your blood pressure.

High blood pressure during pregnancy can place the woman and baby at risk for severe problems. If you have chronic hypertension or are at risk for developing preeclampsia, take steps to reduce the risks to your baby. You will need special care and may have to see your doctor more often. Working with your doctor to control your blood pressure level will help improve your chances of having a healthy baby.

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