At each of your prenatal appointments, your healthcare provider will check your blood pressure, heart rate, temperature and urine for protein (and glucose) as well as checking your baby’s growth and heart rate.
Hypertension, or high blood pressure, is a blood pressure reading of 140/90 or more on two separate readings, ideally taken by the same person, with the same device and same arm each time.
If the hypertension newly develops in the pregnant woman after the twentieth week of pregnancy, and she tests negative for protein in her urine, she has gestational hypertension (GH), also known as pregnancy induced hypertension (formerly called toxemia). GH affects up to 10% of all pregnancies.
If the hypertension pre-existed before pregnancy, this is chronic hypertension.
Although the exact cause of GH is unknown, it may have something to do with how the placenta interacts with the cardiovascular system of some women. Other risk factors to developing GH are:
Pre-existing kidney disease
Hypertension with a previous pregnancy
Pregnant woman younger than 20 or older than 40 years of age
Pregnant with multiples (twins or more)
Being overweight, smoking, poor diet and stress are additional factors
Naturopathic medicine can help prevent the development of gestational hypertension, especially if you have these additional risk factors. Naturopathic medicine can help treat GH in the early stages (along with the medical advice of your primary healthcare provider during your pregnancy).
How does hypertension affect the baby and mother? Healthy blood pressure is needed to properly send blood, oxygen and nutrients to the developing baby and to all of the body organs in mother. Hypertension restricts blood flow in both mother and baby.
Blood flow is restricted to the uterus and placenta. The baby receives less oxygen and nutrients which can affect growth and possibly lead to stillbirth.
Reduced blood flow can also reduce the amount of amniotic fluid produced — low amniotic fluid is itself a medical problem for the baby.
The health of the placenta can be affected too, causing complications such as placenta abruption (the placenta prematurely separates from the wall of the uterus).
Hypertension in the woman can lead to problems with her kidneys, liver, brain and uterus.
When left untreated and uncontrolled, GH can lead to the following life threatening conditions:
Pre-eclampsia: When untreated GH progresses it can lead to increased protein in her urine (kidney damage), low number of platelets, impaired liver function, fluid in the lungs, severe headaches, or visual disturbances.
Eclampsia: A severe form of pre-eclampsia that can lead to seizures that can be fatal for both the woman and her baby.
HELLP Syndrome: A rare condition that is a variant of eclampsia that begins in the third trimester featuring Hemolysis (blood cell damage), Elevated Liver enzymes (liver damage) and Low Platelet count. It may be accompanied by heartburn like pain, general malaise and nausea and vomiting.
When these serious conditions develop, the only treatment is the immediate delivery of the baby.
Possible symptoms of gestational hypertension:
Increased blood pressure
Protein in the urine (to diagnose gestational hypertension or preeclampsia)
Sudden weight gain
Visual changes such as blurred or double vision
Right-sided upper abdominal pain or pain around the stomach
Urinating small amounts
Changes in liver or kidney function tests
GH usually develops later in pregnancy (third trimester)
A woman with gestational hypertension may not have any symptoms.
Medical treatment for gestational hypertension may include:
Bedrest, either at home or in the hospital
Increased monitoring of the baby which may include:
Fetal movement counting. Keeping track of fetal kicks and movements. A change in the number or frequency may mean the baby is under stress.
Nonstress testing. A test that measures the fetal heart rate in response to the baby’s movements.
Biophysical profile. A test that combines nonstress test with ultrasound to observe the baby.
Doppler flow studies. A type of ultrasound that uses sound waves to measure the flow of blood through a blood vessel.
Continued laboratory testing of urine and blood (to monitor for worsening GH)
Medications, called corticosteroids, to help to mature the lungs of the baby in case early delivery is likely
Preventing gestational hypertension
Early screening for risk factors
Taking proactive measures through diet, supplements and stress management that are safe during pregnancy
Recognition of signs and symptoms for early detection