High blood pressure during pregnancy (gestational or pregnancy hypertension)

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What is it about ?

During pregnancy, high blood pressure (hypertension) can be a sign of preeclampsia. Pre-eclampsia is a dangerous condition with significant risks for both mother and child. A malfunction of the placenta would be the cause.

The risk of preeclampsia is higher in women:

  • Who have several fetuses, twins for example (multiple pregnancy);
  • Whose relative suffered from pre-eclampsia;
  • Who are under 20 or over 40;
  • Who suffers from obesity;
  • Who already had hypertension before pregnancy;
  • Who are diabetic;
  • Who have chronic kidney disease.

What is its frequency?

Hypertension affects 6 to 8 in every 100 pregnant women.

How to recognize it?

By “pregnancy-induced hypertension” is meant a blood pressure greater than 14/9 after the 20e week of pregnancy.

If it is associated with the presence of certain proteins (albumin) in the urine, it can suggest pre-eclampsia. The disease is not always easy to recognize. Possible symptoms are:

  • Swelling (edema) of the face, hands and feet;
  • A severe headache;
  • Visual disturbances such as having “flies” in front of the eyes, seeing double or seeing flashes of light;
  • Intense stomach pain;
  • Feeling unwell;
  • A baby who moves less in the tummy.

How is the diagnosis made?

Each time you check-up during pregnancy, the doctor measures your blood pressure, weighs you and examines the presence of protein in the urine. Hypertension associated with more than 0.5 grams of protein per day in the urine confirms the diagnosis.

What can you do ?

The simple act of seeing the doctor causes a rise in blood pressure in a large number of people. This phenomenon is known as white coat hypertension. It may therefore be helpful to check your blood pressure yourself at home. Blood pressure should be measured with a validated blood pressure monitor (ask your doctor for advice) with the cuff placed on the upper arm. The measurement is carried out after at least 15 minutes of rest.

In a normal pregnancy, blood pressure usually drops a little. Any increase should therefore be closely monitored. Go to your doctor if your blood pressure exceeds 14/9.

What can your doctor do?

Treatment depends on the severity of the rise in blood pressure.

In the event of moderate elevation, it is indicated to take rest and to limit the salt intake. If these measures are not enough, you will be referred to your gynecologist who will prescribe a treatment to lower your blood pressure (hypotensive treatment). However, it is important that blood pressure does not drop too quickly. Too much drop reduces blood flow in the placenta, which is not safe for the baby.

In severe cases, hospitalization is necessary. Blood pressure will be regulated there and doctors will take care of existing illnesses (eg development of diabetes and kidney disease).

Treatment for preeclampsia is always aimed at preventing dangerous complications, such as seizures and bleeding disorders in the mother, premature birth or death of the child.

When preeclampsia is diagnosed, delivery can be induced by doctors at or before 37 weeks gestation if symptoms are severe. After childbirth, the mother usually makes a full recovery.

Afterwards, examinations will be carried out in order to detect any underlying conditions which were not yet known and which can be treated.

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