What Is Considered High Blood Pressure When Pregnant?

Pregnancy is a beautiful time filled with anticipation and joy. But did you know that managing blood pressure during pregnancy is crucial for the health of both mother and baby? Many women wonder what is considered high blood pressure during pregnancy, and understanding its causes, symptoms, and treatment options is an important part of avoiding complications. Here's how to ensure a healthy pregnancy for you and your developing little one.

Pregnancy high blood pressure: the basics.

• Hypertension in pregnancy is a blood pressure reading of 140/90 mmHg or higher, with potential complications if not well managed.

• Common causes of pregnancy high blood pressure include chronic hypertension, excessive weight gain, and certain lifestyle choices. This can cause gestational hypertension, preeclampsia, and HELLP syndrome.

• Preconception counseling and preventive measures such as routine prenatal checkups and eating a healthy diet are important for reducing the risk of high blood pressure during pregnancy.

Understanding High Blood Pressure in Pregnancy 

Blood pressure is defined as the force exerted by blood against the walls of blood vessels. A "normal" blood pressure is considered when the readings are 120/80 or lower. Anything above that number would likely require care from a medical professional.

Hypertension during pregnancy can lead to serious complications for both mother and baby, such as:

• heart disease

• seizures

• coma

• premature birth

• death

Having a healthy blood pressure during pregnancy is crucial as it influences blood flow and overall health.

What Is Hypertension In Pregnancy?

Hypertension in pregnancy is defined as a blood pressure reading of 140/90 or higher on two separate readings. Gestational hypertension, which affects up to 8% of pregnancies, is characterized by:

• a systolic blood pressure higher than 140 mmHg

• a diastolic blood pressure higher than 90 mmHg

• occurs after 20 weeks of gestation

• occurs without any associated organ damage

Usually blood pressure issues resolve after childbirth, but gestational hypertension can contribute to high blood pressure from becoming a chronic problem for some women.

There are different types of hypertension that can occur during pregnancy, such as gestational hypertension, preeclampsia, and HELLP syndrome. Preeclampsia is characterized by elevated blood pressure and can have devastating consequences if left untreated, possibly leading to life-threatening conditions such as eclampsia and HELLP syndrome. Keeping track of a pregnant woman’s blood pressure and urine during prenatal visits is fundamental in identifying the emergence of chronic or gestational hypertension, potentially causing more severe conditions like preeclampsia and eclampsia.

What Are Some Causes and Risk Factors?

Hypertension during pregnancy may be caused by factors such as chronic hypertension with preeclampsia, being overweight, lack of physical activity, and lifestyle factors such as smoking and drinking alcohol. Risk factors associated with hypertension in pregnancy include age, family history, race, and pre-existing medical conditions such as diabetes, kidney disease, or experiencing blood pressure issues with a previous pregnancy.

Although the exact causes of preeclampsia and HELLP syndrome are not known, researchers think that they may be related to alterations in the placenta and the mother’s immune system.

Common Causes of High Blood Pressure Hypertension

Common causes of high blood pressure during pregnancy include:

• Chronic hypertension

• Preeclampsia

• Excessive weight gain

• Swelling (especially in the face, hands, and feet)

• Vision changes/blurred vision

• Lack of physical activity

• Smoking and drinking

A higher risk of developing high blood pressure during pregnancy is associated with:

• Age (under 20 or over 35)

• Being a first time mother

• Chronic hypertension

• Overweight or obese

• Family history of preeclampsia or high blood pressure

• Multiple gestation

• Diabetes

• Kidney disease

• Autoimmune disorders

What are some warning signs of pregnancy-induced hypertension? 

Symptoms of high blood pressure during pregnancy can vary. Some women experience no symptoms, while other women may have several warning signs of preeclampsia or HELLP syndrome. Signs of high blood pressure (called hypertension) in pregnancy may include:

• Sudden weight gain

• Sudden swelling

• Severe headache

• Changes in vision

• Abdominal pain

• Nausea and vomiting

• Protein in the urine

It is important for pregnant women to attend all of their prenatal checkups, so that they can be closely monitored for changes in blood pressure. If you experience a blood pressure greater than the standard range, your doctor might recommend further testing or observation.

Gestational Hypertension:

Gestational hypertension usually doesn't have noticeable symptoms. The main symptom of gestational hypertension is elevated blood pressure during pregnancy, which can be identified during your regular prenatal care visits.

Preeclampsia and HELLP Syndrome:

Preeclampsia and HELLP syndrome can have severe symptoms, such as sudden weight gain and swelling in the face and hands. Preeclampsia can also lead to complications such as eclampsia, which is characterized by seizures.

HELLP syndrome is a severe complication of preeclampsia and can affect the liver, red blood cells, and platelets, causing nausea, abdominal pain, and jaundice.

Diagnosis and Monitoring

A diagnosis of high blood pressure throughout pregnancy is based on multiple blood pressure readings and a patient's medical history, with prenatal care and monitoring being crucial for managing hypertension. Regular blood pressure checks, monitoring at home, and ultrasound exams can help detect any changes in the mother’s health that could influence her baby’s health. The KeaBabies Blood Pressure Cuff can help with monitoring blood pressure at home.

Diagnostic Criteria

A pregnant woman’s blood pressure readings are monitored closely by medical personnel. If the readings are higher than 140 systolic or 90 diastolic on two separate occasions, she is then diagnosed with hypertension. Preeclampsia can be diagnosed even without the presence of protein in the urine.

Gestational hypertension is diagnosed when blood pressure measurements are recorded on two or more occasions, at least four hours apart.

Prenatal care is important for pregnant women with high blood pressure. It’s recommended to have regular blood pressure checks at each prenatal visit, monitor blood pressure at home, and undergo routine ultrasound examinations.

It is also important to contact your healthcare provider if your blood pressure is high, as it may be a sign of a more serious condition like severe hypertension, preeclampsia, or HELLP syndrome, requiring early detection and treatment to prevent low birth weight, premature birth, and other complications to the mom and baby.

Treating High Blood Pressure/Hypertension During Pregnancy

Treatment and management of high blood pressure during pregnancy can include medications, lifestyle changes, and extra planning for labor and delivery. Blood pressure medications may be necessary to manage hypertension, but they should always be prescribed by a medical professional to ensure the safety of both mom and baby.

For pregnant women with high risk of preeclampsia, it is recommended to take low-dose aspirin daily. This can help reduce the severity and complications if pre-eclampsia were to occur.

Lifestyle modifications that can help control blood pressure include:

• Eating a nutritious, varied diet

• Exercising (as advised by your healthcare provider)

• Not smoking or drinking alcohol

• Managing stress levels

Planning for delivery in cases of hypertension during pregnancy depends on the severity of the condition and the gestational age of the baby. Although premature delivery is not ideal, the only definitive therapy for preeclampsia is delivery.

Talk to your doctor for advice on how to achieve e the best possible outcome for both mother and infant.

Prevention and Preparation

Lowering the risk of high blood pressure during pregnancy can be achieved through prevention and pre-pregnancy preparation. This includes regular prenatal checkups, continuing healthy eating, increasing physical activity, stopping smoking and drinking alcohol, managing stress levels, and maintaining a healthy weight gain during pregnancy.

Some couples choose preconception counseling, which is a type of medical care recommended for women who have high blood pressure or other risk factors for developing high blood pressure during pregnancy. These meetings involve discussing the potential risks and advantages of pregnancy, as well as lifestyle changes that may help reduce the risk of developing high blood pressure during pregnancy, such as consuming a nutritious diet, exercising regularly, and quitting smoking.

In order to prevent high blood pressure, pregnant women should:

• Attend regular prenatal checkups, where blood pressure is monitored

• Eat a healthy diet (low sodium, low sugar, and high in whole foods and whole grains)

• Get a good amount of exercise

• Manage stress throughout pregnancy

• Don't gain too much weight during pregnancy

Breastfeeding and Postpartum Considerations

For women with high blood pressure, breastfeeding is usually safe, but postpartum observation is necessary for the health of both mother and baby. Research shows that breastfeeding during high blood pressure in pregnancy might result in lower postpartum blood pressure and could protect mothers from hypertension. However, it’s important to discuss any blood pressure medication you are taking with your healthcare provider.

Breastfeeding safety while dealing with high blood pressure

Breastfeeding while managing high blood pressure is generally considered safe, and studies show that it may even provide benefits, including lower postpartum blood pressure and protection against hypertension. However, it is essential to monitor your blood pressure regularly while breastfeeding and to adhere to your healthcare provider’s instructions on managing your high blood pressure. Check with your healthcare provider regarding any blood pressure medication you are taking to ensure they are compatible with breastfeeding.

Postpartum monitoring is important too.

Postpartum observation can ensure the continued health of both mom and baby, particularly for women who had high blood pressure during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) recommends monitoring blood pressures in patients with high blood pressure in pregnancy for the immediate 72 hours postpartum, and again within a period of 7-10 days postpartum. Additionally, watching for signs and symptoms of preeclampsia and HELLP syndrome, as well as signs of infection, is vital during the postpartum period.

High blood pressure can be monitored and controlled during pregnancy. 

Understanding and managing high blood pressure during pregnancy is important for the health and well-being of both mother and baby. By staying informed about the causes, symptoms, and treatment options, as well as taking preventive measures and prioritizing postpartum monitoring, you can ensure a healthy pregnancy journey, even if you do develop high blood pressure. Remember to consult with your doctor for personalized advice and support, and embrace this beautiful journey to parenthood with confidence and care.