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Hypertension During Pregnancy

AMBULATORY CARE:

What you need to know about hypertension during pregnancy:

Hypertension is high blood pressure (BP). Your BP is the force of your blood moving against the walls of your arteries. Normal BP is 119/79 or lower. Elevated BP is 120/79 to 129/79. Stage 1 hypertension is 130/80 to 139/89. Stage 2 is 140/90 or higher. It is important to get screened and treated for an elevated BP or hypertension during pregnancy. This can prevent problems for you and your baby.

Types of hypertension during pregnancy:

  • Chronic hypertension means you have high BP before week 20 of your pregnancy. Hypertension may have been diagnosed before you became pregnant.
  • Gestational hypertension means you develop high BP between weeks 20 and 37 of your pregnancy. It may also develop after week 37 of your pregnancy.
  • Preeclampsia means you develop high BP after week 20 of your pregnancy. You may also have protein in your urine. Preeclampsia can cause mild to life-threatening health problems for you and your unborn baby. You are at risk for developing preeclampsia if you have chronic or gestational hypertension.
  • Severe hypertension is a condition that can also develop when you have preeclampsia. Your BP may be 160/100 or higher. This condition needs immediate treatment to prevent a stroke or heart problems for you, or problems for your baby.

Why it is important to treat hypertension during pregnancy:

Treatment of hypertension in pregnancy can help prevent the following:

  • Damage to organs such as your kidneys
  • Life-threatening bleeding or seizures
  • Preterm labor, miscarriage, or stillbirth
  • Placenta separation from the wall of your uterus
  • A baby that is born small for his or her gestational age
  • Diabetes during pregnancy
  • High blood pressure that continues after you deliver

Signs and symptoms:

You may have no signs or symptoms, or you may have any of the following:

  • Headache
  • Blurred vision
  • A fast heartbeat
  • Dizziness or weakness
  • Trouble breathing
  • Abdominal pain or uncontrolled vomiting
  • Ringing or buzzing in your ears

Call 911 or have someone else call for any of the following:

  • You have a seizure.
  • You have chest pain.
  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • and any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat
  • You faint or lose consciousness.

Seek care immediately if:

  • You have a severe headache or vision loss.
  • You have weakness in an arm or leg.
  • You have bleeding from your vagina.
  • You have fluid leaking from your vagina that does not stop.
  • You feel a gush of fluid from your vagina.
  • You have contractions that happen every 5 minutes or sooner, and last for more than 60 seconds.
  • You feel a change in your baby's movement, or you feel fewer than 6 to 10 movements in an hour.
  • You urinate less than usual or stop urinating.
  • You have severe abdominal pain with nausea and vomiting.
  • You have new or increased swelling in your face or hands.

Contact your healthcare provider if:

  • You have a fever.
  • You have new or increased swelling in your legs or feet.
  • You have nausea or are vomiting.
  • Your BP is higher than your healthcare provider said it should be.
  • You have questions or concerns about your condition or care.

Treatment:

Your healthcare provider will decide if you need medicine to lower your BP. If you already take medicine for high BP, your medicine may be changed. Instead, the dose of your BP medicine may be increased. You will need frequent ultrasounds. An ultrasound checks your baby's growth and makes sure your baby is healthy. Delivery usually stops preeclampsia. Healthcare providers may deliver your baby right away if he or she is full-term (37 weeks or more). You may need to deliver your baby early if you or the baby has life-threatening symptoms.

Manage hypertension during pregnancy:

  • Check your BP at home. Sit and rest for 5 minutes before you take your BP. Extend your arm and support it on a flat surface. Your arm should be at the same level as your heart. Follow the directions that came with your BP monitor. Take your BP at least 2 times each day. Choose the same times each day, such as morning and evening. Take at least 2 BP readings each time. Keep a record of your BP readings and bring it to your follow-up visits. Ask your healthcare provider what your BP should be.
    How to take a Blood Pressure
  • Do not smoke or drink alcohol during your pregnancy. Alcohol, nicotine, and other chemicals in cigarettes and cigars, can damage your blood vessels and increase your BP. They can also harm your baby. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Eat healthy foods. Healthy foods can help control your BP. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if you need to be on a special diet.
  • Exercise as directed. Exercise can help lower your BP. Ask your healthcare provider how much exercise you need and which exercise is right for you.

Follow up with your healthcare provider as directed:

Go to all prenatal appointments. Your healthcare provider may need to check your blood pressure every 1 to 2 weeks. You will need frequent ultrasounds. An ultrasound checks your baby's growth and makes sure your baby is healthy. Write down your questions so you remember to ask them during your visits.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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