Gestational Hypertension

What is gestational hypertension?

Blood pressure is the force that moves blood through our circulatory system. High blood pressure is when this force against artery walls is too high.

High blood pressure during pregnancy is defined as 140 mm Hg or higher systolic, diastolic 90 mm Hg or higher.

Gestational hypertension is high blood pressure a woman develops during her second half of her pregnancy (after 20 weeks). This is quite common and seen in 3 in 50 pregnancies. This type of hypertension usually goes away after your baby is born.  

Gestational hypertension is different from chronic hypertension (women having high blood pressure before her pregnancy) and preeclampsia (high blood pressure and high levels of protein in the urine during pregnancy).

Causes

The causes of gestational hypertension is not well established. Some of the possible causes are listed below

·         First pregnancy

·         Hypertension in previous pregnancy

·         Family history of hypertension

·         Gestational diabetes

·         Overweight

·         Kidney disease

·         Is expecting multiple babies

·         If conception is through In vitro Fertilization

·         Maternal age less than 20 or more than 40 years

·         Mother having any autoimmune disorder

Symptoms

Symptoms of gestational hypertension varies from person to person. Some women may not have any symptoms. Some of the common symptoms include headache, edema, sudden weight gain, vision problems, nausea, urinating small amounts and mild abdominal pain.

Diagnosis

During each of your prenatal checkups, your blood pressure will be monitored. If your doctor notices 2 or 3 blood pressure readings to be persistently high, he may advise you to undergo treatment. He will also monitor other features of hypertension like swelling in feet and if there is a sudden weight gain.

Blood tests to check the liver and kidney function and levels of platelets will also be tested. The presence of protein (albumin) in the urine will be examined to rule out preeclampsia.

Ultrasound will be done to monitor fetal growth and Doppler Scan to measure the efficiency of blood flow to the placenta will be tested.

Treatment

The aim of treatment is to prevent complications to you and your baby. You will be treated with mild corticosteroids. Your doctor will advise you to monitor your baby’s kicks and movements to ensure the wellbeing of your baby. 

Complications of gestational hypertension

High blood pressure can affect your blood vessels. This may decrease blood flow in your liver, kidneys, brain, uterus, and placenta. When gestational hypertension turns into preeclampsia and eclampsia, some complications can occur.

Placental abruption. This is when the placenta pulls away from the uterus too early. This is a medical emergency that requires immediate treatment.

Poor fetal growth: Due to high blood pressure, there can be a decrease in the flow of nutrients to the baby through the placenta. This may lead to growth restriction and result in low birth weight babies.

Preterm delivery: Due to lack of oxygen supply to the fetus and also to prevent further complications of high blood pressure, sometimes an early delivery is planned.

Management of Gestational Hypertension:

·         Reduce the intake of salt

·         Increase your physical activity

·         Drink at least 8 glasses of water a day

·         Avoid smoking and alcohol

·         Reduce caffeine intake

·         Avoid junk foods

Gestational hypertension is common and it can be managed well with the right medication and lifestyle changes.