February 18, 2009 | No comments | Health
High Blood Pressure in Pregnancy
UNDERSTANDING WHAT BLOOD PRESSURE IS-
Blood is circulated throughout our body by the pumping action of the heart and the blood pressure is the amount of force exerted by the blood against the walls of arteries. At the height of pumping action the pressure is maximum and is called the SYSTOLIC pressure, and when the heart rests the pressure goes down to its resting level and is called DIASTOLIC pressure. Therefore the blood pressure has two values and is written as eg 120(Systolic)/ 80(diastolic).The normal average blood pressure is 120/80 millimeters of mercury(mmHg) but any value less than 140/90 is normal. Low blood pressure is almost always normal and does not give rise to problems in healthy people.
WHAT IS RAISE BLOOD PRESSURE IN PREGNANCY
Raise blood pressure is just one event of the spectrum of a disease condition peculiar to pregnancy called ‘ hypertensive disorders of pregnancy’. If it is ‘pregnancy induced ‘high blood pressure ,it usually occurs after 20 weeks of your pregnancy .If your blood pressure is high before 20 weeks it is more likely to be chronic hypertension(ie preexisting or occurring before pregnancy).Therefore it of paramount importance to check your blood pressure within first 12 weeks of pregnancy. The mildest form is elevated blood pressure as an isolated finding mainly in the latter part of the pregnancy and is called “pregnancy induced hypertension” . The most severe form is called eclampsia with seizures (fits, convulsions)in mother endangering life of both fetus and mother. In between condition is known as “preeclampsia”.
Preeclampsia is a condition where there is appearance of protein in urine, with swelling of feet , ankles and face in addition to raise blood pressure. This condition ranges from mild to severe form. Severe form is called impending eclampsia. Most of the vital organs in the body can get affected in this condition.There can be abnormal liver functions , abnormal blood clotting , abnormal
kidney functions and symptoms like severe headache visual disturbance, abdominal pain etc…Preeclampsia commonly occurs in the late pregnancy but symptoms may appear for the first time after birth. Also, pregnancy induced hypertension can progress to any of the above conditions eventually.
HOW COMMON IS THIS CONDITION
About 8-10% of all pregnancies are affected by this condition and 70% of them are in their first pregnancy. Many of them do not have any complications and belong to pregnancy induced hypertension (5%-6%) and about 1-4% have preeclampsia and in about 1 in 2000 pregnancies women have eclampsia which is the most severe form.
WHAT IS MY RISK OF GETTING THIS?
1. If you are in the first pregnancy (primips) you are at a higher risk .It is rare to get this for the first time in your second pregnancy .
2. Family history- If your mother or sister have had this disorder before you are at a higher risk. There is some tendency for this condition to run in families.
3. Age- The older you are the higher the chance. Usually it’s more common above 40 years.
4. Multiple Pregnancy (twins or higher order)- Are at a higher risk.
5. Other associated medical conditions- Chronic diabetics, chronic kidney disease, pre existing high blood pressure are risk factors.
6. Obesity- If the body mass index(BMI) is more than 35 you are at a higher risk. BMI is a ratio of your body weight to your height. Normal BMI is between 20 – 25 .
ARE THERE ANY TESTS TO PREDICT THIS.
Unfortunately there are no reliable tests to predict this condition. Only test you have is an Ultrasound scan done at 23 weeks of pregnancy to look for the blood flow in the vessels to the womb to see if it is normal. If this is abnormal we can predict some patients who are risk of developing severe form of disease.
IS THERE ANY TREATMENT TO PREVENT THIS
Unfortunately there is no treatment to prevent this condition in the first pregnancy. But giving low dose aspirin is believed to have some effect in preventing severe complications only in patients who have had severe form of the disease. Lot of research is been carried out in this area currently. Calcium supplementation, fish oil, vitamin E etc have been tried with no evidence to prove they are effective.
WHAT IS THE CAUSE OF THIS DISORDER.
The cause is not known clearly. It is thought to arise primarily due to some hormonal imbalance in the first half of the pregnancy resulting in some defect during the formation of the placenta.
WHAT ARE THE SIGNS AND THE SYMPTOMS OF THIS DISORDER
Signs-Swelling of feet, ankles, hand and face, abdominal tenderness, raised blood pressure and appearance of albumin (a Protein) in urine. Symptoms – Headache, visual disturbances, heart burn, abdominal pain, nausea, vomiting and seizures.
Some of the symptoms are commonly seen in normal pregnancy (Eg- heart burn and swelling of feet)





