Department of Obstetrics and Gynecology
UI Maternity Care

High Blood Pressure in Pregnancy

Hypertension During Pregnancy

High blood pressure is a serious health problem that affects 35 million Americans or one out of every six people. It can be found in all races, age groups and in both sexes. Many people do not know they have high blood pressure because there are often no symptoms. High blood pressure in pregnancy can be more serious because you and your baby are affected.

What is high blood pressure?
Your blood pressure is the measurement of the pressure of blood pushing against the walls of your blood vessels as it is pumped through your body. The top number of a blood pressure, or the systolic pressure, measures the pressure during a heart beat. The diastolic pressure is the bottom number and measures the pressure between heart beats. When your systolic pressure rises 30 points or more and your diastolic pressure rises 15 points or more from previous readings you are considered to have high blood pressure. For example, if your normal blood pressure is 100/60, and it rises to 130/80, you are considered to have high blood pressure.

What causes high blood pressure?
For the majority of women the cause is not known. Kidney disease, diabetes, blood vessel conditions and other health problems may cause high blood pressure.

Why should I be concerned about high blood pressure during my pregnancy?
High blood pressure during pregnancy can cause serious complications. It can cause a decrease in the blood and oxygen supply available to mother and baby. In the mother it can lead to kidney problems, breathing problems, seizures, strokes and even death in very rare cases. Babies may have problems with growing, getting enough oxygen and other complications.

Due to these risks you must be followed closely the remainder of your pregnancy, during delivery and after delivery. In this way, complications can be treated promptly if they occur.

Five to ten out of one hundred pregnant women will develop high blood pressure during their pregnancy. Certain women are at a higher risk for developing it than others, including:
• Women with their first pregnancy who are under age 17 or over age 35.

• Women with a family history of high blood pressure.
• Women who are pregnant with twins or triplets.
• Women with poor diets during pregnancy.
• Women who are overweight.
• Women who smoke.
• Women with other health problems, such as blood vessel conditions, kidney disease, diabetes, etc.

High blood pressure, if it does develop, usually occurs sometime after the 24th week of pregnancy.

High blood pressure will go away after the baby is born for most women. A few women may continue to have high blood pressure after the baby is born because they have kidney disease, diabetes or other health problems.

How will high blood pressure make my pregnancy different?
Since high blood pressure can cause serious complications, the doctor may:

• Want to see you more frequently.
• Do special blood tests.
• Have you collect your urine for 24 hours to find out how well your kidneys are working.
• Do non-stress tests to monitor how well your baby is doing.
• Order other tests as needed.
• Ask that you get plenty of rest at home. You should rest on your left side with legs elevated for at least one hour in the morning, afternoon, early evening and bedtime. This gives you and your baby more oxygen.
• Ask that you remain on strict bedrest at home if your blood pressure rises.
• Admit you to the hospital if your blood pressure rises and/or your 24-hour urine shows kidney problems. In this way you can be watched more closely for any serious complications that may develop and be treated.

What complications may develop?
A common complication of high blood pressure in pregnancy is a condition called pre-eclampsia (also called "toxemia").
Warning signs and symptoms are:

• Headaches that will not go away.
• Blurred vision or spots before your eyes.
• Epigastric pain - dull aching pain in your upper abdomen.
• Heartburn.
• Increased swelling, especially face and hands (rings fit very tight).
• Decrease in baby's movements.

If you experience any of these signs/symptoms or are having other problems, please call the Obstetrics and Gynecology Clinic at 319-356-2294 between 8:00 a.m. and 5:00 p.m. and ask to speak with an OB nurse. At all other times call Labor and Delivery at 319-356-2615 and ask for a nurse or doctor.

KEEPING YOUR APPOINTMENTS IS ONE OF THE MOST IMPORTANT PARTS OF YOUR CARE!

If you have any questions about your appointment or need to reschedule, please call OB/GYN Clinic Scheduling at 319-356-2294 between 8:00 a.m. and 5:00 p.m.

Peer Review Status: Internally
Peer Review Date: 2004