Preeclampsia and gestational hypertension

Pregnancy is a beautiful adventure. As new parents to be, you may have many questions and concerns. Our PSST! guide, From belly to baby, is a great reference to support you during the next nine months. During the various follow-ups with your physician, they will most likely check the blood pressure of the mother-to-be. Why?

Blood pressure and hypertension

The heart pumps blood throughout the body. The pressure exerted by the blood on the walls of the vessels is called blood pressure. The maximum pressure is called the systolic pressure, and the minimum pressure (when the heart relaxes) is called the diastolic pressure. The unit of measurement used to quantify blood pressure is millimetres of mercury (mmHg). Normal blood pressure is usually around 120/80 mmHg.

When your blood pressure becomes too high, it is called hypertension. Although the values may vary depending on your medical condition, high blood pressure is defined as values above 140/90 mmHg.

High blood pressure over a long period of time can have an impact on various organs. This is especially true for pregnant women and their fetuses.

What is gestational hypertension?

Blood pressure is one of the things assessed during follow-up appointments with your physician during pregnancy.  If they diagnose hypertension in a woman who is more than 20 weeks pregnant, it is called gestational hypertension.

What is preeclampsia?

If a woman with gestational hypertension has organ damage, then preeclampsia is at cause. A urine test showing the presence of high levels of protein in the urine may be a sign of kidney failure. This urine test, combined with a blood test, is often used for diagnosis.

Postpartum preeclampsia can also occur after delivery.  It usually returns to normal after a few weeks.

What are the risk factors?

Several factors can increase the risk of developing gestational hypertension or preeclampsia, including:

• Having a multiple pregnancy
• Being obese
• Having diabetes
• Being in their first pregnancy
• Be over 40 years old
• Have a family or personal history of gestational hypertension or preeclampsia

What are the symptoms of preeclampsia?

Hypertension is often called a "silent disease" because the symptoms are often not felt or very subtle. In fact, women will usually not have any symptoms of hypertension. However, in preeclampsia, some women will experience symptoms and should be given special attention to:

• Sudden and severe headaches
• Blurred vision
• Chest pain
• Swelling
• Difficulty breathing (may be related to fluid build-up in the lungs)

If these symptoms arise, it is important to consult your healthcare professional quickly to be evaluated.

What are the possible complications?

Normally, gestational hypertension without organ damage will not have a significant impact on the course of the pregnancy. Preeclampsia, on the other hand, can lead to several complications:

• Slowed fetal growth, resulting in a low birth weight baby
• Placental abruption with a high risk of preterm delivery
• In severe cases, the mother may experience convulsions or bleeding disorders

What will the physician do?

Each pregnancy is unique, and your physician will decide what to do based on your medical history. Typically, women with gestational hypertension or preeclampsia will be monitored more closely. Hospitalization may be required.  Medication may be prescribed to regulate blood pressure for gestational hypertension without preeclampsia. In the case of severe preeclampsia, the doctor may also decide that it is best to induce delivery before the expected due date for the safety of the mother and their unborn child. If the pregnancy is not full-term, medications to stimulate the maturation of the baby's lungs may be given before delivery.

Are there any preventive measures?

Gestational hypertension can be prevented by adopting healthy lifestyle habits:

• Have a varied and balanced diet
• Have an active lifestyle, according to your abilities
• Have a reasonable weight gain

As with any other pregnancy, it is recommended to avoid alcohol and smoking.

In some instances, your physician may prescribe medication. It is important to follow their recommendations.

In a nutshell

Gestational hypertension and preeclampsia should not be taken lightly. Therefore, blood pressure monitoring is an integral part of pregnancy follow-up appointments.  If you have any doubts or concerns, do not hesitate to consult your healthcare professional.