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Hypertension in Pregnancy (High Blood Pressure)

Some women will have preexisting high blood pressure before pregnancy. This will require monitoring and often medication adjustment prior to pregnancy. Others develop high blood pressure/ hypertension (HTN) during pregnancy. When this is associated with protein in the urine this is referred to as preeclampsia. The goal is to get to 38 weeks and then deliver the baby.

Preeclampsia is a dangerous condition that some women get when they are pregnant. It usually happens during the second half of pregnancy (after 20 weeks). It can also happen during labour or after the baby is born.

Women with preeclampsia have high blood pressure. They might also have too much protein in their urine, or problems with organs like the liver, kidneys, or eyes. Plus, the baby might not grow well and be small.

What are the symptoms of preeclampsia? — Most women with preeclampsia do not feel any different than usual. Preeclampsia usually does not cause symptoms unless it is severe. Signs and symptoms of severe preeclampsia include:

  •  A bad headache
  •  Changes in vision: blurry vision, flashes of light, spots
  •  Belly pain, especially in the upper belly

If you have any of these symptoms, tell your doctor or nurse. You might not have preeclampsia, because these symptoms can also occur in normal pregnancies. But it’s important that your doctor know about them.

How might preeclampsia affect my baby? — Preeclampsia can:

  • Slow the growth of the baby
  • Decrease the amount of amniotic fluid around the baby

Is there a test for preeclampsia? — Yes. To test for preeclampsia, your doctor or nurse will take your blood pressure and check your urine for protein during pregnancy. He or she might also do blood tests to make sure your organs are working as they should.

It is possible to have high blood pressure (above 140/90) during pregnancy without having high protein in the urine or other problems. That is not preeclampsia. Still, if you develop high blood pressure, your doctor will watch you closely. You could develop preeclampsia or other problems related to high blood pressure.

How is preeclampsia treated? — The only cure for preeclampsia is to deliver the baby. Your doctor or nurse will decide whether it is better for you to have your baby right away, or to wait. The goal is to get to 37 weeks, unless the preeclampsia is severe.

If your blood pressure is very high (more than 160/100), your doctor or nurse might give you medicine to lower blood pressure.

Women with severe preeclampsia can sometimes have seizures. Your doctor or nurse will probably give you medicine during labour to prevent this.

What can I do to prevent preeclampsia? — You can’t do anything to keep from getting preeclampsia. The most important thing you can do is to keep all the appointments you have with your doctor. That way, they can find out as soon as possible if your blood pressure goes up, or if you have too much protein in your urine or any other problems. Also, call someone on your healthcare team right away if you have symptoms of preeclampsia or the baby isn’t moving as much as usual. Your doctor or nurse can do things to keep you from having worse problems from preeclampsia.

If you are at high risk for preeclampsia, your doctor might tell you to take low-dose aspirin during your second and third trimesters of pregnancy (after 12 weeks). You might be at high risk if you have had preeclampsia before and your baby was born early, or if you have had preeclampsia in more than one pregnancy. Your doctor can tell you if you are at high risk.

Do not take aspirin or other medicines unless your doctor or nurse tells you it’s safe.


ALARM 2014

Uptodate Patient Information: Preeclampsia

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