We check your blood pressure at every visit because high blood pressure (hypertension) in pregnancy can cause some complications for you or your baby or both of you.
What happens when you have hypertension during pregnancy?
When there is hypertension, there can be:
A condition called pre-eclampsia
A possible association of poor growth for baby
In some cases, an early delivery of your baby before 37 weeks may be needed to protect you and/or the baby.
Are there different types of hypertension?
There can a few types of hypertension that can affect pregnant women and they are:
Gestational Hypertension where women develop high blood pressure, usually during the third trimester of their pregnancy. It usually does not include effects on other organs. Sometimes this may change, and women can develop pre-eclampsia and it is important that we monitor for this.
Pre-eclampsia (see below).
Pre-existing hypertension. In some women, hypertension may have already been present even before the pregnancy and you may need to be on blood pressure medications throughout your pregnancy. There is also an increased risk of developing pre-eclampsia, so we would also monitor you closely.
What is pre-eclampsia?
Pre-eclampsia is a serious condition that can affect your blood pressure and commonly also your kidneys, leading to an excretion of protein in your urine. It can also progress to affect other organs including your lung, liver and blood. In this situation, we would need to monitor your pregnancy closely possibly with more frequent visits, baby monitoring - CTG or ultrasounds and blood tests. Sometimes, we may need to deliver your baby preterm if it is severe either through an Induction of Labour or Caesarean Section.
Will I get Pre-eclampsia?
In Australia, about 3-4% of all pregnant women develop pre-eclampsia. It is quite variable in the way it presents or progresses. In some women, it is very mild and we can manage it without medications whereas some others, it can be severe where pregnant ladies might need to be on multiple medications, baby’s growth could be restricted or baby could be distressed and sometimes an early delivery is recommended.
What are the risk factors and causes for pre-eclampsia?
There are some conditions that can increase the risk of developing pre-eclampsia and they may include:
History of pre-eclampsia
History of high blood pressure before pregnancy
History of autoimmune disease (i.e lupus, antiphospholipid)
History of diabetes
Pre-eclampsia can be mild but in some severe cases, women can develop neurological symptoms such as headaches, visual disturbances. At the same time, there may also be injuries to the blood system, kidneys, liver and lung. When it is severe, it is not uncommon to see that the baby’s growth affected.
What if I’m diagnosed with pre-eclampsia and how is pre-eclampsia managed?
When pre-eclampsia is suspected or diagnosed, a number of tests may need to be performed and they are:
Blood test to check for your platelets, kidney and liver
Urine test to check for protein in your urine
Baby monitor (CTG)
Growth ultrasound to check on your baby’s growth and wellbeing
Sometimes, you may also need to attend the hospital for your blood pressure to be checked over several hours a couple of times a week. Occasionally, women also need to be admitted to monitor their blood pressure. If blood pressure remains elevated, we may also recommend some medications to protect you and your baby. One of the treatments for pre-eclampsia is the delivery of your baby and placenta, and we would discuss this with you.
Even after the delivery of your baby, sometimes the blood pressure may remain elevated and we may need to monitor this in the post-partum period. I would also check your urine again at 6 weeks time, to check for protein.
Some women do not have any symptoms at all and instead, it is picked up during your antenatal visit. That is why it is important to attend all your visits and is also the reason why I would see you more frequently towards the end of pregnancy (as it is more common towards the end of pregnancy). If you have any symptoms at all, please remember to let me know.
It is important to know that pre-eclampsia can recur again in your future pregnancies, so please let your doctor know if you have had it in the past.
If you have any concerns at all, please call the rooms during business hours at 02 9629 3559.
Dr Adeline Chan is a female obstetrician in Sydney, servicing the Western Sydney and Hills District region.