Contents:
- Medical Video: Gestational and Chronic Hypertension - CRASH! Medical Review Series
- What is chronic hypertension?
- What are the dangers if pregnant women experience chronic hypertension?
- What is the danger for the fetus if the mother experiences chronic hypertension while pregnant?
- Can I take blood pressure medication while pregnant?
- How low is blood pressure in pregnancy?
- If I am pregnant and have hypertension, what do I need to watch out for?
- What can I do to get pregnant healthy?
- Will I be able to breastfeed while taking blood pressure medication?
Medical Video: Gestational and Chronic Hypertension - CRASH! Medical Review Series
Many women are diagnosed with hypertension (blood pressure 140/90 mm Hg) during pregnancy. Hypertension that occurs before pregnancy is called chronic hypertension. This type of hypertension affects at least 5% of pregnancies. If handled properly, most women with chronic hypertension can get pregnant in good condition and give birth to healthy babies.
To achieve this goal, it is important for women with chronic hypertension to tell their doctor when they plan to become pregnant, so that they can receive pregnancy counseling and appropriate hypertension drugs can be made if needed.
What is chronic hypertension?
There are two types of chronic hypertension: primary hypertension and secondary hypertension. The cause of primary hypertension is unknown, but because hypertension is generally a congenital disease, genes contribute to this disease. A small percentage of people experience secondary hypertension, which means that hypertension is caused by other conditions, such as kidney disease, narrowing of the arteries to the kidneys, and adrenal tumors.
In cases like this, hypertension will heal after treatment for this problem. If you undergo an evaluation of the secondary form of hypertension, you should treat it before becoming pregnant. The third type of hypertension is called hypertension due to pregnancy.
Some women experience new hypertension in pregnancy, which can occur in the second half of pregnancy, usually in the third trimester.
What are the dangers if pregnant women experience chronic hypertension?
Most women with chronic hypertension remain in good condition during pregnancy. In a normal pregnancy, blood pressure decreases at the end of the first semester and then increases to the pre-pregnancy value in the third trimester.
For most women with chronic hypertension, blood pressure follows the same pattern. However, some women experience an increase in blood pressure during pregnancy, which can increase the risk of stroke and other complications so that it may require more aggressive antihypertensive treatment. Doctors must monitor you to make sure the complications associated with hypertension do not develop.
The more worrying complication of chronic hypertension is the emergence of gradual preeclampsia. Preeclampsia is a serious condition that can affect the organ system and cause impaired liver function, kidney failure, and more easily experience bleeding, and over time can develop into eclampsia spasms.
Gradual preeclampsia is more common in women who cannot control hypertension, have kidney disease, and diabetes mellitus. At present, there is no treatment for preeclampsia except by giving birth to a baby. For this reason, babies whose mothers experience this condition, are often premature.
Other complications of chronic hypertension that may cause premature birth are placental abruption. Abruption is the separation of the initial placenta from the uterine wall which usually results in strong contractions, bleeding, and early childbirth.
What is the danger for the fetus if the mother experiences chronic hypertension while pregnant?
Even with medication, if blood pressure continues to increase until you run the risk of stroke or other organ complications, or if you experience gradual preeclampsia that causes damage to organs in the body, your doctor may suggest giving birth earlier.
Early birth is related to prematurity. If you give birth earlier than planned, your body may not be ready to give birth to a baby through the vagina, so you may have to undergo a Caesarean section. Hypertension may also affect placental development, which is important for food and fetal growth. Thus, some babies may be affected by low levels of amniotic fluid and / or obstruction of growth in the uterus.
Can I take blood pressure medication while pregnant?
Some medications should not be taken during pregnancy, and your doctor may need to change medications before you become pregnant. If you are not pregnant, blood pressure medication only affects you, but if you are pregnant, this drug may cross the placenta and affect the fetus.
It is not known what type of blood pressure medication should be used during pregnancy, so the recommended medication is usually the drug used for the longest time without serious problems. There are several classes of drugs that are not used by pregnant women.
The enzyme inhibitor that converts angiotensin is very commonly used to treat chronic hypertension. This class of drugs can cause problems for the fetus, including an increased risk of birth and kidney failure.
The angiotensin II receptor blockers should also be avoided in pregnancy because they have many of the same effects as enzyme inhibitors that change these angiotensin and the use of these drugs during pregnancy is associated with kidney failure in the fetus.
Aldosterone receptor inhibitors must be avoided until adequate information is available. If you use this class of medicine, you should see a doctor before becoming pregnant, so that your medication can be changed.
How low is blood pressure in pregnancy?
Outside of pregnancy, the blood pressure limit for non-diabetic women is 140/90 mm Hg, to prevent complications of hypertension such as heart attacks and strokes. In pregnancy, the blood pressure limit may be loosened because it is important for the fetus to receive adequate blood flow.
In addition, because pregnancy lasts only 9 months, problems at that time do not focus too much on long-term hypertensive complications. The doctor will discuss blood pressure limits in pregnancy.
If I am pregnant and have hypertension, what do I need to watch out for?
You may learn how to measure blood pressure at home. If you realize that your blood pressure is higher than usual, you should contact your doctor. If you experience a headache, you should check your blood pressure and contact your doctor.
Many women experience edema (swelling) in the legs and ankles during a normal pregnancy. If you notice your hands and face or your calves are swollen, contact your doctor. You should also pay attention to the movements of the baby, which must occur several times in the third trimester of pregnancy. If you notice the baby's movements are reduced, contact your doctor.
What can I do to get pregnant healthy?
Women with chronic hypertension can and many have healthy babies. Before becoming pregnant, you should talk to your doctor about whether you should change the blood pressure medication you are using.
Your doctor may want to do a basic test of kidney function. In addition, overweight women are more at risk of developing preeclampsia, so if you are overweight, you must lose weight before becoming pregnant. During pregnancy, you should keep an eye on blood pressure as often as possible according to the doctor's advice and make sure to keep visiting the doctor. The doctor will also check your blood pressure every time you visit.
Will I be able to breastfeed while taking blood pressure medication?
Most blood pressure medications given during pregnancy are considered safe to drink during breastfeeding, including methyldopa, calcium channel blockers, and labetalol. Because of the limited information about drug-type inhibitors that convert angiotensin, angiotensin II receptor blockers, and diuretic drugs such as hydrochlorothiazide, you should discuss the use of these drugs while breastfeeding with your doctor.
