Topic Overview
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This topic is about high blood pressure that some women get during pregnancy. For information about preeclampsia, a more serious kind of high blood pressure, see the topic Preeclampsia.
What is high blood pressure?
Blood pressure is a measure of how hard your blood pushes against the walls of your arteries. If the force is too hard, you have high blood pressure (also called hypertension).
Blood pressure is shown as two numbers. The top number (systolic) is the pressure when the heart pumps blood. The bottom number (diastolic) is the pressure when the heart relaxes and fills with blood.
Blood pressure is high if the top number is more than 140 or if the bottom number is more than 90.
Blood pressure during pregnancy
Normally, a woman's blood pressure drops during her second trimester. Then it returns to normal by the end of the pregnancy.
But in some women, blood pressure goes up very high in the second or third trimester. This is sometimes called gestational hypertension, and it can lead to preeclampsia. You will need to have your blood pressure checked often and you may need treatment. Usually, the problem goes away after the baby is born.
Some women have chronic high blood pressure before they get pregnant. High blood pressure that started before pregnancy usually doesn't go away after the baby is born.
A small rise in blood pressure may not be a problem. But your doctor will watch your pressure to make sure it doesn't get too high. The doctor also will check you for preeclampsia.
Very high blood pressure keeps your baby from getting enough blood and oxygen. This could limit your baby's growth or cause the placenta to pull away too soon from the uterus. High blood pressure also could lead to stillbirth.
What causes high blood pressure during pregnancy?
Experts don't know the exact cause of high blood pressure during pregnancy.
What are the symptoms?
High blood pressure usually doesn't cause symptoms. But very high blood pressure sometimes causes headaches and shortness of breath or changes in vision.
If you have high blood pressure, tell your doctor right away if you get a headache or belly pain. These are early signs of preeclampsia.
How is high blood pressure diagnosed?
High blood pressure is usually found during a prenatal visit.
This is one reason why it's so important to go to all of your prenatal visits. You need to have your blood pressure checked often. During these visits, your blood pressure is measured. A sudden increase in blood pressure often is the first sign of a problem.
How is it treated?
Your doctor may have you take medicine if he or she thinks your blood pressure is too high.
Does high blood pressure during pregnancy lead to long-term high blood pressure?
If you have high blood pressure during pregnancy but had normal blood pressure before pregnancy, your pressure is likely to go back to normal after you have the baby.
Frequently Asked Questions
Learning about high blood pressure during pregnancy: | |
Being diagnosed: | |
Getting treatment: | |
Symptoms
If you get high blood pressure during pregnancy, you will probably not have any symptoms. It usually requires a blood pressure check to detect high blood pressure.
Blood pressure is shown as two numbers. The top number (systolic) is the pressure when the heart pumps blood. The bottom number (diastolic) is the pressure when the heart relaxes and fills with blood.
Blood pressure is too high if the top number is more than 140, or if the bottom number is more than 90 (usually described as "140 over 90" or 140/90). Blood pressure measured at 140/90 or higher is classified as high and 160/110 or higher is classified as severe.
Chronic high blood pressure
Some women have high blood pressure during pregnancy because they had chronic high blood pressure before getting pregnant.
Women with chronic high blood pressure who become pregnant normally have a drop in blood pressure during the first two trimesters. But during the late second or in the third trimester, blood pressure returns to higher-than-normal levels. After delivery, their blood pressure remains high.
If you aren't certain that you had normal blood pressure before pregnancy, it is possible that you had chronic high blood pressure before you got pregnant. If so, your blood pressure may remain high after your pregnancy.
High blood pressure that develops before the 20th week of pregnancy is usually a sign of either chronic high blood pressure or short-term, mild high blood pressure. In rare cases, it is an early sign of preeclampsia.
Exams and Tests
High blood pressure is typically found during regular
prenatal checkups.
Routine prenatal tests
Certain tests are given at
each prenatal visit to check for high blood pressure. These
include:
- Blood pressure readings. Blood pressure is always monitored closely during pregnancy.
- Urine tests to check for too much protein in the
urine. This is a sign of kidney damage caused by preeclampsia.
- Weight
measurement. Rapid weight gain can be a sign of preeclampsia.
Tests for women considered high-risk for preeclampsia
Other tests may also be used to monitor for signs of
preeclampsia, including:
- Blood tests to check for problems such as HELLP syndrome and kidney damage.
- Creatinine clearance test, which
requires both a blood sample and a 24-hour urine collection, to check kidney
function.
- 24-hour urine collection test to look for protein in the
urine.
Tests for the baby
If you get high blood
pressure while you're pregnant, the baby's health also will be closely
monitored. The more severe your condition, the more often you'll need testing,
ranging from once a week to daily.
Tests commonly used include:
- Electronic fetal heart monitoring (including nonstress tests), which records the baby's
heart rate.
- Fetal ultrasound, which uses reflected sound waves to
produce a computerized picture of the baby, placenta, and uterus to check:
- The baby's well-being and
growth.
- The condition of the placenta and the possibility of
placenta abruptio.
- The amount of amniotic
fluid surrounding the baby.
- Doppler ultrasound to check how well the placenta is
working.
Treatment Overview
If you have high blood pressure during your pregnancy, your treatment may
include close monitoring by your doctor and taking blood pressure medicine.
Your doctor may have you take medicine if he or she thinks
your blood pressure is too high. Some women with ongoing high blood
pressure stay on blood pressure medicine but take a lower dose
during pregnancy if their blood pressure improves.
Blood pressure medicines
Medicines used to control chronic high blood pressure during pregnancy include:
Some high blood pressure medicines are dangerous during pregnancy.1 If you take high blood pressure medicines, talk to your
doctor about the safety of your medicine before you become pregnant or as soon
as you learn you are pregnant. Make sure that your doctor has a complete list
of all medicines that you are taking.
Other blood pressure medicines that may be used include:
- Hydralazine, an
intravenous medicine for quickly lowering severely
high blood pressure during pregnancy.
- Labetalol, an
intravenous medicine for quickly lowering severely high blood pressure in the
hospital, and also an oral medicine for controlling high blood pressure during
pregnancy.
Lowering blood pressure too
much or too fast can reduce blood flow to the placenta, causing problems for
the baby. So medicine is reserved for preventing severely high blood pressure
levels that may be life-threatening to you or the baby.
Home Treatment
If you have high blood pressure during pregnancy, take
steps to help control your blood pressure:
- Go to all of your prenatal checkups. It is
important to monitor your blood pressure, because a dangerous increase in blood
pressure can occur without symptoms. You may also want to keep track of your
blood pressure readings at home.
- If you smoke, quit smoking. This
helps decrease your blood pressure and improve your baby's growth and
health.
- Don't gain too much weight during your
pregnancy. Talk to your doctor about how much is healthy for you to
gain.
- Get regular mild exercise during pregnancy. Walking or
swimming several times weekly can be healthy for you and your developing baby.
- Reduce stress. Find time to relax, especially if you continue to
work, are parenting small children at home, or have a hectic
schedule.
Other Places To Get Help
Organizations
| American Congress of Obstetricians and Gynecologists
(ACOG) |
| 409 12th Street SW |
| P.O. Box 70620 |
| Washington, DC 20024-9998 |
| Phone: | 1-800-673-8444 |
| Phone: | (202) 638-5577 |
| Email: | resources@acog.org |
| Web Address: | www.acog.org |
| |
American Congress of Obstetricians and Gynecologists
(ACOG) is a nonprofit organization of professionals who provide health care for
women, including teens. The ACOG Resource Center publishes manuals and patient
education materials. The Web publications section of the site has patient
education pamphlets on many women's health topics, including reproductive
health, breast-feeding, violence, and quitting smoking. |
|
| American Pregnancy Association |
| 1425 Greenway Drive |
| Suite 440 |
| Irving, TX 75038 |
| Phone: | 1-800-672-2296 |
| Fax: | (972) 550-0800 |
| Email: | questions@americanpregnancy.org |
| Web Address: | www.americanpregnancy.org |
| |
| The American Pregnancy Association is a national health
organization committed to promoting reproductive and pregnancy wellness through
education, research, advocacy, and community awareness. You can call a
toll-free helpline or use the Web site to request patient education materials.
|
|
| National Heart, Lung, and Blood Institute
(NHLBI) |
| P.O. Box 30105 |
| Bethesda, MD 20824-0105 |
| Phone: | (301) 592-8573 |
| Fax: | (240) 629-3246 |
| TDD: | (240) 629-3255 |
| Email: | nhlbiinfo@nhlbi.nih.gov |
| Web Address: | www.nhlbi.nih.gov |
| |
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
and treating: - Diseases affecting the heart and circulation, such as heart
attacks, high cholesterol, high blood pressure, peripheral artery disease, and
heart problems present at birth (congenital heart diseases).
- Diseases that affect the lungs, such as asthma, chronic
obstructive pulmonary disease (COPD), emphysema, sleep apnea, and
pneumonia.
- Diseases that affect the blood, such as anemia,
hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.
|
|
References
Citations
- Cooper WO, et al. (2006). Major congenital malformations after first-trimester exposure to ACE inhibitors. New England Journal of Medicine, 354(23): 2443–2451.
Other Works Consulted
- American College of Obstetricians and Gynecologists (2012). Chronic hypertension in pregnancy. ACOG Practice Bulletin No. 125. Obstetrics and Gynecology, 119(2): 396–407.
- American College of Obstetricians and Gynecologists
(2002, reaffirmed 2010). Diagnosis and management of preeclampsia and eclampsia. ACOG Practice
Bulletin No. 33. Obstetrics and Gynecology, 99(1):
159–167.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | William Gilbert, MD - Maternal and Fetal Medicine |
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| Last Revised | November 5, 2012 |
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