Gestational hypertension: All You Need to Know!
Are You Experiencing Gestational Hypertension? Here’s What You Need to Know
Gestational hypertension is a condition where blood pressure rises above 140/90 mmHg while pregnant. GH occurs in about 5% of pregnancies and may last until after delivery. Women who have had gestational hypertension before pregnancy are at higher risk of developing preeclampsia later in their pregnancy. Preeclampsia is a serious medical condition characterized by high blood pressure, proteinuria, edema, headache, visual disturbances, and liver problems.
Causes of Gestational Hypertension
The causes of gestational hypertension are not well understood. However, some factors that increase the chances of developing gestational hypertension include being overweight, having a family history of high blood pressure, smoking cigarettes, drinking alcohol, and taking certain medications. Other possible causes include excessive weight gain, diabetes, kidney disease, thyroid disorders, and chronic hypertension. Preeclampsia is characterized by an elevated systolic blood pressure greater than 140 mmHg and diastolic blood pressure greater than 90mm Hg after 20 weeks gestation. Eclampsia is a condition where seizures occur along with preeclampsia. Severe preeclampsia is marked by either severe hypertension or proteinuria, and if left untreated, results in serious complications including hypoxic damage to the fetal brain, kidney failure, pulmonary edema, stroke, liver dysfunction, etc.
Patients diagnosed with GH should receive lab tests to check their blood pressure, urine test, and complete blood count. Other tests include ANA, serum LDH, CMP, platelet counts, renal function tests, AST, ALT, and creatinine kinase. Ultrasound scans and Doppler studies can also be performed to look at the placenta and fetus for any abnormalities. Patients who experience severe symptoms should undergo a CT scan of the head.
Symptoms of Gestational Hypertension
Symptoms of gestational hypertension include headaches, blurred vision, leg swelling, nausea, vomiting, abdominal pain, backache, dizziness, fatigue, and shortness of breath. These symptoms often occur suddenly and worsen over time. If left untreated, gestational hypertension can lead to eclampsia, seizures, stroke, heart failure, and death.
Mild cases of GH only have mild headache, nausea, vomiting, swelling, dizziness, blurred vision, abdominal pain, fatigue, and shortness of breath. If the disease progresses to moderate or severe forms, patients develop these additional symptoms: fluid retention around the face, hands, feet, abdomen, extremities, and lower back; palpitations; leg cramping; visual disturbances; and increased urination. In some cases, the patient has a sudden onset of chest pains, headaches, and numbness.
Treatment Options for Gestational Hypertensive Patients
Treatment options for gestational hypertensive patients vary depending on the severity of the condition.
- In mild cases, treatment includes bed rest, salt restriction, and medication.
- In severe cases, women may need to deliver early.
- Lifestyle Changes: Lifestyle changes should always be considered first before any medication is prescribed. A patient’s lifestyle choices may have a significant effect on their blood pressure levels. If patients have hypertension, they should consider making some changes to their diet and exercise habits. These changes could help lower their blood pressure levels.
- Dietary Supplements: Many dietary supplements can be taken to treat gestational hypertensive disorders. One example would be folic acid. Folic acid helps prevent neural tube defects in developing fetuses. Ingesting adequate amounts of folic acid throughout pregnancy can reduce the risk of having a baby born with a neural tube defect. Another supplement that may be useful is vitamin B-12. Vitamin B-12 helps maintain normal red blood cells and prevents anemia. Taking these two supplements together can help improve symptoms associated with gestational hypertension.
- Medications: Medication treatment options for gestational hypertension include drugs known as antihypertensives. There are several different types of medications that can be effective at treating gestational hypertension. Examples include nifedipine, labetalol, methyldopa, and clonidine. Each of these medications has its own unique set of side effects. Before starting any type of medication, doctors should perform tests to determine if the drug is safe for use in pregnant women.
- Surgery: Surgery is not recommended for gestational hypertension unless necessary. However, if a woman is experiencing severe complications related to her high blood pressure, then surgery may be warranted.
Prevention of Gestational Hypertension
Prevention begins before conception. Its prevention involves avoiding conditions that cause high blood pressure, including obesity, diabetes, kidney disease, and thyroid disorders.
Also, gestational hypertension tends to run in families, so if you have a family member who has gestational hypertension, ask them to get the pre-eclampsia tests. Women planning to get pregnant should make sure they don’t smoke cigarettes and limit their intake of alcohol. Avoiding excessive salt intake helps reduce the risk of developing preeclampsia and reduces the chance of having a baby that is small for its age. Maintaining a normal weight before getting pregnant can help prevent GH.
Risks & Complications Gestational hypertension
- Premature Birth: Gestational hypertension can cause premature birth if not treated properly. A pregnant woman who experiences high blood pressure can have her baby delivered prematurely due to the increased risk of pre-term labor and low birth weight. If left untreated, high blood pressure can lead to placental abruption, which results in miscarriage.
- Preeclampsia: Preeclampsia occurs when a pregnant woman’s blood pressure increases after 20 weeks of pregnancy. Symptoms include headaches, blurred vision, nausea, vomiting, abdominal pain, and swelling. Preeclampsia symptoms may appear suddenly or gradually worsen over time. Women who experience preeclampsia are at greater risk of developing eclampsia, which includes seizures.
- Preterm Labor: Preterm labor is the labor that happens before 37 weeks gestation. In some cases, the placenta does not develop normally and babies are born early. Babies born prematurely often require intensive care. Preterm birth can result in serious problems for both mother and child.
- Low Birth Weight: Low birth weight (LBW) means less than 2,500 grams (less than 5 pounds). LBW infants are at higher risk for death and disability compared to normal birth-weight infants. Mothers who have experienced gestational hypertension are more likely to have LBW babies.
- Maternal Death: Maternal death refers to the death of a pregnant woman while she is carrying a fetus. Gestational hypertension also causes maternal deaths in about 1% of pregnancies.
What is gestational hypertension?
When a woman becomes pregnant, her blood pressure rises. If she does not have any underlying medical conditions, then her blood pressure should return to normal after giving birth. However, if her blood pressure remains high throughout pregnancy, then it is Gestational Hypertension (GH). Gestational hypertension may occur at any stage of pregnancy, but most often occurs between 20-24 weeks.
If my blood pressure is high, how can I tell?
Your doctor will check your blood pressure before you become pregnant. He/she will use a sphygmomanometer to measure it. We measure your blood pressure three times and record the average. A reading above 140/90 shows hypertensive traits.
Is GH harmful to me and my baby?
GH poses no threat to either you or your baby. Studies show that women who develop GH are less likely to have preeclampsia or eclampsia. Preeclampsia is a condition that has severe headaches and blurry vision, while eclampsia involves seizures. Both these complications are dangerous for both mother and child.
Can I prevent gestational hypertension?
Yes! You need to make sure that you eat a balanced diet, avoid smoking, alcohol consumption, and caffeine intake, get adequate sleep, exercise regularly, limit salt intake, maintain an ideal body weight, etc.
Should I take medication to lower my blood pressure?
No. Take medicine only if the doctor says otherwise you can skip medications. There are plenty of dietary changes that you can implement to help lower your blood pressure naturally.
When should I go to the hospital?
If you experience symptoms such as severe headaches, nausea, vomiting, chest pain, shortness of breath, swelling of hands or feet, dizziness, blurred vision, sudden loss of consciousness, or convulsions, you should immediately seek medical attention.