Preeclampsia and high blood pressure during pregnancy: What to remember

This is an automatically translated article.

The article is professionally consulted by Specialist Doctor II Huynh Thi Hien - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Nha Trang International Hospital
High blood pressure during pregnancy can lead to dangerous complications, even threatening the mother's health, one of the most serious consequences is preeclampsia.

1. High blood pressure during pregnancy

1.1. What is high blood pressure?

Blood pressure is the pressure the blood exerts on the walls of the arteries when the heart contracts to pump blood around the body. High blood pressure (also called hypertension) can lead to health problems. During pregnancy, severe or uncontrolled high blood pressure can cause complications for the mother and fetus.
Gestational hypertension is when high blood pressure develops in the second half of pregnancy (after the 20th week) in women whose pre-pregnancy blood pressure readings were completely normal. Although pregnant women usually recover after giving birth, high blood pressure during pregnancy can increase the risk of developing high blood pressure later in life.
Blood pressure is determined as follows:
Normal blood pressure: Below 120/80 mmHg High normal blood pressure: systolic pressure between 120 - 129 and diastolic blood pressure less than 80 mmHg Grade 1: Blood pressure systolic pressure between 130 - 139 or diastolic pressure between 80 - 89 mmHg Grade 2 hypertension: systolic blood pressure 140 or higher or diastolic blood pressure 90 mmHg or higher

1.2. What problems can high blood pressure during pregnancy cause?

High blood pressure during pregnancy can make your heart and kidneys work harder, increasing your risk of cardiovascular disease, kidney disease, and stroke. Other possible complications include:
Fetal growth restriction – High blood pressure can reduce the flow of nutrients through the placenta, which can result in problems with fetal development pediatric. Preeclampsia – Happens more often in women with chronically high blood pressure than in those with normal blood pressure. Preterm birth – Can occur when the placenta does not provide enough nutrients and oxygen to the baby Placenta abruption – A condition that occurs when the placenta prematurely separates from the uterine wall. Pregnant women with placental abruption need immediate emergency care. Caesarean section - The percentage of pregnant women with high blood pressure is likely to have to have a cesarean section higher than those with normal blood pressure. The risks of a cesarean section include infection, organ damage, and bleeding during the surgery.

1.3. How to treat and monitor high blood pressure during pregnancy?

Your blood pressure will be closely monitored throughout your pregnancy (which may include self-monitoring your blood pressure at home). Pregnant women will have periodic ultrasounds to monitor the development of the fetus. In case a problem with fetal development is suspected, usually in the last 3 months, there will be tests to monitor the health of the baby. If there is only mild hypertension, it is likely that during pregnancy, the blood pressure readings of pregnant women will remain the same, or even decrease to normal levels, then the drug can be stopped or the treatment dose reduced. If severe hypertension, or high blood pressure during pregnancy, is causing health problems, you may need to take blood pressure medication during pregnancy.

2. Preeclampsia

2.1 What is preeclampsia?

Preeclampsia is a dangerous blood pressure disorder that can affect every organ in a woman's body. Preeclampsia is the result of high blood pressure during pregnancy and signs of organ dysfunction (such as Proteinuria – abnormal amount of protein in the urine). Severe signs and symptoms associated with severe preeclampsia include: low blood platelet count, liver and kidney function abnormalities, upper abdominal pain, vision changes, pulmonary effusion, severe headache, very high blood pressure.

2.2 When does preeclampsia appear?

Usually occurs after the 20th week of pregnancy (usually in the last 3 months of pregnancy). Preeclampsia that occurs before 32 weeks of pregnancy is called early-onset preeclampsia. Preeclampsia can also occur in the postpartum period.

2.3 What causes preeclampsia?

To date, the pathogenesis of preeclampsia is not fully understood. However, there are several factors that can contribute to an increased risk of preeclampsia:
First pregnancy Having had preeclampsia in a previous pregnancy, or a family history of preeclampsia Have a history of chronic hypertension, kidney disease. Are 40 years old or older Pregnant with multiples Have health problems such as diabetes, hypercoagulability syndrome, lupus. Obesity In vitro fertilization (IVF)

2.4 What are the risks to mother and baby with preeclampsia?

Risk to the baby: If preeclampsia occurs during pregnancy, termination of pregnancy may be required at any gestational age. Premature birth increases the risk of serious complications for the baby, including complications requiring lifelong cohabitation and ongoing medical treatment. Babies born too early can die.
Risks to the mother:
Increased risk of cardiovascular disease and kidney disease for women with pre-eclampsia – especially in those who have to give birth prematurely – including heart attack, stroke, high blood pressure . A history of preeclampsia increases the risk of preeclampsia in future pregnancies.
In addition, preeclampsia is also a cause of eclampsia and HELLP syndrome.
2.5 Signs and symptoms of preeclampsia Swelling of the face and hands Headaches that don't go away Spotting in front of the eyes, or changes in vision Pain in the upper abdomen or shoulders Nausea and vomiting (in the second half of pregnancy) Sudden weight gain suffocating Shortness of breath

3. How is gestational hypertension and mild preeclampsia treated?

If gestational hypertension or preeclampsia is not serious, pregnant women can be monitored in the hospital or outpatient (medical staff closely monitor at home). Pregnant women can count the number of kicks during the day and measure their blood pressure at home, seeing their healthcare provider at least once a week or sometimes twice a week. You may be able to deliver at 37 weeks, or sooner if test results show your baby is unwell.
Pregnant women with severe preeclampsia are usually treated at the hospital. Pregnant women from 34 weeks onwards are often recommended to give birth as soon as the condition is stable. Mothers in the period before the 34th week of pregnancy with stable health can wait for the time to give birth. Corticosteroids can be used to promote lung maturation. In addition, the mother will be prescribed medication to lower blood pressure and prevent seizures. Prompt delivery is required if the mother or fetus's condition worsens.

4. What can be done to prevent preeclampsia and high blood pressure during pregnancy?

For prevention, it is necessary to determine if the pregnant woman is at risk of preeclampsia, if so, to find out the risk factors. Women with high blood pressure and planning to become pregnant need to have a health check before pregnancy to check whether blood pressure can be controlled or not, whether high blood pressure affects health or not. Overweight people are advised to lose weight before becoming pregnant. Women with certain medical conditions, such as diabetes, are often advised to control their condition before becoming pregnant.

The Maternity Package at Vinmec International General Hospital includes a full range of antenatal check-ups and necessary tests during pregnancy, in order to minimize risk factors during pregnancy, including preeclampsia and high blood pressure during pregnancy. Customers registered for Maternity Package are fully cared for and checked for health of mother and baby before birth - during childbirth and after birth, fully and conscientiously.
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References: Acog.org