Pregnancy Induced Hypertension
Pregnancy Induced Hypertension by Elisa Ross, MD reviewed and revised by Marjorie Greenfield, M.D. Did you ever wonder why your blood pressure is measured at almost every prenatal visit? And why your urine is checked for protein? Your practitioner is watching for a condition of pregnancy known as pregnancy induced hypertension. It is also called toxemia, or pre-eclampsia.
Blood pressure changes throughout pregnancy Most expectant mothers experience a decrease in blood pressure in the second trimester. Later in the pregnancy, blood pressure usually returns to normal, but about seven percent of women will overshoot the mark and develop high blood pressure.
How high is too high? A blood pressure of 140/90 or above is typically considered to be elevated. Some women have blood pressures in that range even when not pregnant; for them, a “high” blood pressure during pregnancy may be less of a concern, since they always run high. On the other hand, if a woman’s blood pressure usually runs low, a rise in blood pressure during pregnancy (even if the pressure stays below 140/90) might still be considered elevated.
What is the problem with higher than normal blood pressure? In most cases, a slightly elevated blood pressure causes no harm to mother or baby. However, if mildly elevated blood pressure is accompanied by protein in the urine, swelling in the hands and face, or changes in certain blood tests, the diagnosis is pre-eclampsia. Pre-eclampsia ranges in effects from very mild to very severe.
Symptoms vary in severity The symptoms of pre-eclampsia are different for each patient, but in rare, severe cases, they can include seizures (“eclampsia”) or temporary liver or kidney dysfunction. Very high blood pressures can lead to a stroke. This level of hypertension is quite rare in pregnant women who have not had blood pressure problems before.
Who is at risk? Many women who get pre-eclampsia have no risk factors other than that this is their first full-term pregnancy. There is also an increased likelihood of pre-eclampsia in women who are carrying twins or triplets, are over 40 or less than 16 years of age, already have high blood pressure (or had hypertension in a previous pregnancy), are diabetic, and/or are obese.
Signs and symptoms Many of the symptoms of pre-eclampsia can also occur in normal pregnancies. These can include:
Women who experience any of these symptoms should tell their doctor or practitioner right away. They might need to be seen in the office to make sure that they are not developing pre-eclampsia.
Prevention is not possible Nothing has been shown to prevent pre-eclampsia in first-time, low risk mothers. Some prevention strategies for higher risk patients have been proposed, but none has found wide acceptance.
The cure for pre-eclampsia is delivery Pre-eclampsia is a temporary condition which resolves very promptly after delivery. Symptoms start to resolve within minutes to hours in most cases. Blood pressure may take a few weeks to return to normal, but usually is out of the dangerous zone before you leave the hospital.
RELATED INFORMATION The Developing Fetus, Weeks 25-40 Why Pregnancy Causes Swollen Feet Multiple Pregnancy High Blood Pressure in Pregnancy
Created September 09, 2000 Reviewed and revised September 09, 2004
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