High Blood Pressure During Pregnancy

Topic Overview

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This topic is about high blood pressure that some women get while they are pregnant. For information about preeclampsia, a more serious kind of high blood pressure, see the topic Preeclampsia.

What is high blood pressure?

It's normal for blood pressure to go up and down throughout the day. But if it stays up, you have high blood pressure. Another name for high blood pressure is hypertension.

High blood pressure increases the risk of stroke, heart attack, and other problems. You and your doctor will talk about your risks of these problems based on your blood pressure.

Your doctor will give you a goal for your blood pressure. Your goal will be based on your health and your age.

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 some women have high blood pressure while they are pregnant. They may have:

• High blood pressure that started before pregnancy. This is called chronic high blood pressure. It usually doesn't go away after the baby is born.
• Very high blood pressure that starts in the second or third trimester. This is called gestational hypertension. It usually goes away after the baby is born.

Sometimes high blood pressure during pregnancy is a first sign of preeclampsia. This condition can be dangerous for both mother and baby.

Having high blood pressure during pregnancy doesn't mean that you will get preeclampsia. But it does mean that you need to have your blood pressure checked often. And you may need treatment.

Why is high blood pressure during pregnancy a concern?

If your blood pressure is very high, it could keep your baby from getting enough blood and oxygen. This could limit your baby's growth, or it could cause the placenta to pull away from the uterus too soon. (This is called placenta abruptio.) It also could lead to stillbirth.

What are the symptoms?

High blood pressure usually doesn't cause symptoms. You will probably feel fine, even if your blood pressure is too high.

Tell your doctor right away if you have any signs of very high blood pressure or preeclampsia, such as:

• A severe headache.
• Blurry vision.
• Pain in your upper belly.
• Rapid weight gain—more than 2 lb (0.9 kg) in a week or 6 lb (2.7 kg) in a month.

How is high blood pressure diagnosed?

High blood pressure is usually found during a prenatal visit. This is one reason it's so important to go to all of your prenatal checkups.

At each prenatal visit, your doctor, nurse, or midwife will:

• Check your blood pressure. A sudden increase in blood pressure often is the first sign of a problem.
• Test your urine for protein. Too much protein in the urine is a sign of kidney damage caused by preeclampsia.
• Check your weight. Rapid weight gain can be a sign of preeclampsia.

If you have high blood pressure while you're pregnant, you will have regular tests to check your baby's health. These may include:

• Electronic fetal heart monitoring. This records your baby's heart rate.
• Fetal ultrasound. This test is done to check on your baby, the placenta, and the amount of amniotic fluid.
• Doppler ultrasound. This checks how well the placenta is working.

If your doctor thinks you are at high risk for preeclampsia, you may have other tests, including:

• Blood tests to check for problems such as kidney damage.
• A creatinine clearance test to check your kidney function.

How is it treated?

You may need to take medicine if your doctor thinks your blood pressure is too high. Medicines used to treat high blood pressure during pregnancy include methyldopa and nifedipine.

Some common blood pressure medicines are not safe during pregnancy. If you take medicine for chronic high blood pressure:

• Talk to your doctor about the safety of your medicine before you become pregnant or as soon as you learn you are pregnant.
• Be sure that your doctor has a complete list of all the medicines you take.

To reduce your risk for preeclampsia, your doctor may recommend that you take low-dose aspirin during the second and third trimesters of your pregnancy.

What can you do to take care of yourself?

To help control your blood pressure and have a healthy pregnancy:

• Don't smoke. This is one of the best things you can do to help your baby be healthy. If you need help to quit smoking, talk to your doctor.
• Be sure to go to all of your prenatal checkups so your doctor or midwife can check your blood pressure. You may also want to check your blood pressure at home.
• Gain an amount of weight that is healthy for you. Your doctor or midwife can help you set a pregnancy weight goal.
• If your doctor says it's okay, get regular exercise during pregnancy. Walking or swimming several times a week can help lower blood pressure. And it's good for you and your baby.
• Try to keep your stress level low. This may be hard to do, especially if you continue to work, have young children, or have a hectic schedule. But try to find some time to relax.