High-risk pregnancies require specialized expert care: Hypertension (high blood pressure) and preeclampsia

August 10, 2020
Several conditions can endanger a pregnancy. Yet, medical experts can identify most risks in time and properly treat them. Moms and babies receive the best care possible with specialized expert care at Bumrungrad’s Women’s Center, so that the mother enjoys a safe pregnancy and her child is born healthy and without any complications.
Two conditions discussed in this blog that may touch your life, or that of someone you know, are hypertension and preeclampsia. Hypertension or high blood pressure in pregnancy is defined as blood pressure equal to or greater than 140/90. The top and bottom values mark the cut-off points. And their elevations can be a serious concern during pregnancy.
Preeclampsia, likewise, includes high blood pressure. In addition, protein leaks into the urine and signs of swelling in the feet can be seen. The swelling can progress up the legs and affect the hands as well if the condition increases in severity.

When are hypertension and preeclampsia in pregnancy usually diagnosed?

High-risk hypertension and preeclampsia during pregnancy are defined as new onset of hypertension after 20 weeks of gestation. The diagnosis requires that the patient has elevated blood pressure not associated with white-coat syndrome.
Preeclampsia is usually detected in the third trimester of pregnancy, with a rising blood pressure during the weeks 30 to 32 of the pregnancy. However, it can occur after 20 weeks already and, in rare cases, just after delivery. In 85 percent of cases, preeclampsia is diagnosed after the 34th week of gestation. 10 percent of cases are diagnosed before delivery and 5 percent 48 hours after giving birth.


What is the cause of preeclampsia?

Medical professionals are not exactly sure of the under cause of preeclampsia. It’s believed to be due to multiple factors. The placenta, which sustains the fetus during pregnancy, is thought to play a key role. In early development the blood vessels don’t function effectively. They may be narrower and respond differently to hormones, thereby limiting the blood flow through the vessels and the placenta. Hormones also affect mom’s circulating blood flow. 
Regardless, consistent monitoring of blood pressure at every visit during and after pregnancy is important. This is to ensure that conditions such as hypertension and preeclampsia are detected early, so monitoring and management are provided promptly by Bumrungrad’s multidisciplinary team.

What do these risk factors mean when considering pregnancy?

For every woman considering pregnancy in the future, visiting your Obstetrician/Gynecologist at the Women’s Center is advised. The expert physicians there can provide an assessment and recommendations to increase likelihood of having a healthy pregnancy for those who may be at risk.
Women with the following conditions may belong to the group with increased risks for high blood pressure and preeclampsia:
  • Immune system disorder history, such as lupus
  • Kidney disease history
  • Diabetes
  • Hypertension during past pregnancies
  • Carrying twins or triplets
  • First pregnancy younger than 20 or older than 40 years

Why monitoring high blood pressure in pregnancy is important

High blood pressure during pregnancy is not uncommon. In the United States, high blood pressure happens during 1 in every 12 to 17 pregnancies among women aged 20 to 44 years. The good news is that the condition is treatable and controllable.

Once diagnosed, high blood pressure is the common sign or clue to gestational hypertension and preeclampsia that requires increased monitoring and care during pregnancy by an expert specialist to increase positive health outcomes for mom and baby.

With good blood pressure management based on healthy lifestyle and medical recommendations provided by an expert specialist, the expecting mother and her baby are more likely to stay healthy. Nevertheless, close monitoring and knowledge about warning signs are imperative as these conditions can sometimes lead to severe health complications for both mom and baby. 

How are hypertension and preeclampsia treated?

Currently, there is no “one size fits all” way to treat high blood pressure and preeclampsia. An expert specialist will go over specific recommendations based on each person as she presents. However, some guidance is standard for everyone: stay hydrated, reduce stress, follow a balanced diet and exercise (but with limitations, unless bedrest is implemented).
Medication may be prescribed in some cases. Regular follow-up is crucial to ensure the health of mom and baby are progressing appropriately. And if abnormalities do develop, they are caught early.

Watch out for these potential complications associated during pregnancy

Complications can occur with any high-risk condition. It is important to have open conversations with your Bumrungrad specialist regarding your personal level of risk and, more importantly, how to partner with your specialist to mitigate your level of risk to the lowest amount possible.
Continue to watch for fetal movements every day. Notify your specialist if you have:
  • An extreme or unusual headache
  • Dizziness or visional changes
  • Unusually strong pain just below the lower ribs in the middle to right side
Potential complications include:
  • Seizures
  • Poor fetal growth or low birth weight
  • Placenta separation
  • Preterm birth occurring before 37 weeks
Should any of these signs or symptoms occur, contact the Emergency Department at 1378 for emergency pick-up transport to the hospital. The Emergency Department provides experts who will stabilize and refer you.

A high-risk pregnancy requires specialist care and observation

The risks of hypertension and preeclampsia during pregnancy should not be underestimated. These pose high-risk pregnancies that require an experienced specialist team to closely observe both mom and baby during pregnancy, delivery and after giving birth.
Bumrungrad’s expert specialists and departments are well prepared and experienced with high-risk pregnancies. If an expecting mom develops hypertension or preeclampsia during pregnancy, Bumrungrad specialists are prepared to care for the well-being of both mom and baby.
By Dr Amporn Thaisomboon, received her Diploma from the Thai Board of Obstetrics and Gynecology a Sub-board Diploma in Maternal Fetal Medicine. Dr Amporn is presently seeing patients at Bumrungrad International Hospital

Women’s Center:
+66 2011 2361
Location: Bumrungrad International Hospital (BIH) Building, 2nd floor
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