High blood pressure is a common problem during pregnancy. Also known as a hypertensive disorder, it happens when the blood in the blood vessels moves at a higher pressure than normal.
Hypertensive disorders are of various types and pregnancy-induced hypertension (PIH) is one form that affects around 5 to 8% of pregnant women (1). So, if you are diagnosed with PIH, or suspect having it, then you should read this MomJunction post.
We tell you about the different types of high blood pressure in pregnancy, the causes of PIH, its symptoms, management, and more.
Different Forms Of High Blood Pressure During Pregnancy
High blood pressure presents itself in different ways during pregnancy. They differ in severity and impact they might have on the body (2).
- Chronic hypertension: It is the high blood pressure that occurs before the 20th week, or is present before conception, or continues even after delivery. In some cases, you will not even know you had high blood pressure until your first prenatal checkup.
- Gestational hypertension: This occurs after the 20th week and normalizes after delivery. It will not show any associated symptoms.
- Preeclampsia: Both chronic and gestational hypertension, if left untreated, can lead to preeclampsia. It causes protein in the urine and could lead to complications for both the mother and the baby if timely medical intervention is not sought.
In this post, let’s understand about PIH or gestational hypertension.
What Is Pregnancy-induced Hypertension?
PIH is a form of high blood pressure that is also referred to as gestational hypertension. If left untreated, it could lead to preeclampsia or toxemia.
It develops after the 20th week of pregnancy and could cause problems in the mother and the baby if not treated on time. Some important characteristics of PIH are:
- The blood pressure is higher than 140/90mmHg
- Protein is present in the urine
- Swelling (edema)
- Normalizes within six weeks after delivery (3).
PIH could happen in any pregnant woman, but certain risk factors increase the chances of getting it.
Causes And Risks Of PIH
Although the cause of pregnancy-induced hypertension is unknown, the risk is higher in those with the following factors (4):
- First-time pregnancy
- Family history of PIH
- Twins or multiple pregnancies
- The woman’s age is below 20 or above 40
- Hypertension or kidney disease prior to pregnancy
If you have one of these risks or suspect that your blood pressure is fluctuating, then notice the symptoms of gestational hypertension.
Symptoms Of Pregnancy-induced Hypertension
You may experience the following signs that are common in any high blood pressure (5).
- Systolic blood pressure of more than 140
- Diastolic BP of more than 90
- Sudden weight gain
- Visual changes such as double or blurred vision
- Upper abdominal pain, or stomach pain
- Recurrent headaches
- Excessive sweating on the palms and soles
- Buzzing sound in the ears
- Rapid heartbeat
Your blood pressure is checked during all your regular checkups because high blood pressure poses certain risks both to the mother and the baby.
Risks Of PIH To The Mother And The Baby
With the increased blood pressure, there is also an increase in the resistance of the blood vessels. This could prevent the flow of blood to different organs, including the brain, kidneys, liver, uterus, and placenta.
When the placenta does not receive enough blood, the fetus gets less oxygen and food. It can lead to low birth weight and other developmental problems (2).
Other complications include:
- Eclampsia that is high BP accompanied by seizures
- Placental abruption (early detachment of the placenta from the uterus)
- Intrauterine growth restriction (poor fetal growth)
- Premature delivery (6)
PIH could be detected early if you have regular prenatal checkups. Early diagnosis means early treatment of the problem.
Diagnosis Of Pregnancy-induced Hypertension
Like we said earlier, your BP is checked at every visit to the doctor during pregnancy. An abnormal rise can be indicative of PIH. If your BP is found to be high in two or three consecutive monthly checkups, your doctor will ask you to take a urine test to detect any protein content in your urine.
During the visits, your doctor will monitor and tabulate your BP, weight gain, and urine protein for future reference. If you continue to feel abnormally fatigued or suffer from other symptoms of PIH, the doctor will prescribe additional tests including (7):
- Assessment of edema
- Eye tests for checking retinal changes
- Blood clotting tests
- Liver and kidney functioning tests
If PIH is diagnosed or even suspected, the doctor will order a non-stress test to monitor your growing baby. Doctors typically use an ultrasound transducer to record your baby’s heart rate. This test also uses a toco transducer to view and record the uterine activity.
When your baby is active, the fetal heart rate tends to increase. So, these tests help map and understand if your child is growing well.
Treatment For Pregnancy-induced Hypertension
Treatment for PIH depends on the following findings (8):
- Your pregnancy stage, medical history, and overall health
- The extent of the condition
- Your tolerance to specific medications, procedures, and therapies
The main goal of the treatment is to prevent the condition from becoming worse and causing complications. Therefore, a combination of the following treatment options is prescribed:
- Bed rest, either at the hospital or at home
- Close monitoring of blood pressure levels
- Antihypertensive medications such as magnesium sulfate
- Monitoring of fetal health through (9):
- Fetal kicks and movements — a change in frequency indicates the baby is under stress
- Non-stress test that measures fetal heart rate in relation to fetal movements
- Biophysical profile, a combination of non-stress test and ultrasound to observe fetal growth, development, and movements
- Doppler flow studies, an ultrasound test that employs sound waves to measure fetal blood circulation
- Continued urine and blood tests to track abnormal changes
- Corticosteroids to speed up lung growth in the baby
- Delivery, if other treatments do not work and the mother or fetus is found to be at high risk.
Simultaneously, you should take self-care measures that help in controlling hypertension:
- Have enough rest, and lie on your left side to remove the pressure from the major blood vessels. This way, the maximum amount of blood and nutrients are delivered to the fetus.
- Consume less salt
- Drink adequate water
- Go for regular prenatal checkups
Since the cause of PIH is unknown, it cannot be prevented. But some of the factors contributing to hypertension can be monitored and controlled.
Prevention Of PIH
You may try these simple measures:
- Consume around ten glasses of water every day
- Increase protein intake and quit junk foods
- Perform low impact exercises about half an hour every day (after discussing with your doctor)
- Keep a pillow or a wedge underneath your feet while sleeping. It promotes blood circulation to the rest of the body
- Eat healthily to maintain steady weight gain
- Limit caffeine intake
- Get your BP levels checked regularly
PIH is not a serious condition if detected and treated in time. It can be easily diagnosed through the regular prenatal checkups during pregnancy. All that you need to do is go for the checkups every month, follow a healthy and active lifestyle, observe the symptoms if any, and seek medical attention if anything seems out of the ordinary.
Have you experienced high blood pressure during pregnancy? Let us know about it in the comment section below.
2. High blood pressure during pregnancy; Center for Disease Control and Prevention (2018)
3. P Rachael James and Catherine Nelson-Piercy; Management of hypertension before, during, and after pregnancy; Heart (2004)
4. Risk factors for the development of pregnancy induced hypertension; Spencer S. Eccles Health Sciences Library, Utah
5. Signs and symptoms of mild and severe pregnancy induced hypertension; Spencer S. Eccles Health Sciences Library, Utah
6. Reem Mustafa et al.; A comprehensive review of hypertension in pregnancy; J Pregnancy (2012)
7. Stepan et al.; Diagnosis and treatment of hypertensive pregnancy disorders. Guideline of DGGG (S1-Level, AWMF Registry No. 015/018, December 2013); Geburtshilfe Frauenheilkd (2015)
8. Andrea G. Kattah and Vesna D. Garovic; The management of hypertension in pregnancy; Adv Chronic Kidney Dis (2014)
9. Hypertensive disorders in pregnancy; New York State Department of Health (2013)