Metro Plus
Bangalore
Chennai
Coimbatore
Delhi
Hyderabad
Kochi
Handling BP during pregnancy
|
How does high BP affect the health of mother and baby?
|
Sabrina has just come back from a check up with her doctor. She is 34 weeks pregnant and her blood pressure today was 140/90. Her doctor has told her to rest and to come back after two days to check her blood pressure again. Sabrina is naturally conc
erned. Will the blood pressure remain high? How will the high blood pressure affect her and her baby?
Having a normal blood pressure is an important component of good health at any time of life. In pregnancy too, a normal blood pressure through the course of the pregnancy will ensure good health for the mother and the baby growing inside her.
Up to 5 per cent of women have hypertension before they become pregnant. This is called chronic hypertension or essential hypertension. As many as 5 to 8 per cent of women will develop hypertension during pregnancy. This is called gestational hypertension or pregnancy induced hypertension. If not treated, hypertension during pregnancy can cause serious complications for mother and baby.
Your blood pressure reading
A blood pressure reading has two numbers, separated by a slash: for example, 110/80 (referred to as “110 by 80.”) The first number is the pressure in the arteries when the heart contracts. This is called the systolic pressure. The second number is the pressure in the arteries when the heart relaxes between contractions. This is the diastolic pressure.
In most pregnant women, readings of 120/80 or less are normal. If you are pregnant and your systolic pressure is 140 or the diastolic pressure is 90 on more than two occasions, you are considered to have high blood pressure.
How does hypertension affect pregnancy?
When high blood pressure occurs in pregnancy, the blood flow through the placenta is affected. This causes growth restriction in the foetus, resulting in low birth weight. This effect is seen most severely in women who develop hypertension before 32 weeks of pregnancy or those who have uncontrolled chronic hypertension.
Hypertension also increases the risk of preterm delivery (before 37 weeks of pregnancy). Premature and low birth weight babies face an increased risk of health problems during the newborn period and lasting disabilities, such as learning problems and cerebral palsy.
Types of high blood pressure in pregnancy:
Chronic hypertension is high blood pressure that has been present for some time before pregnancy or that is diagnosed before the 20th week of pregnancy. This form of hypertension will persist even after the delivery. During pregnancy, chronic hypertension may affect the growth of the foetus. A woman may need to switch to a different medication that still helps control her blood pressure, but is safe to use during pregnancy. 25 per cent of women with chronic hypertension may develop a form of gestational hypertension called preeclampsia, which poses special risks.
Gestational hypertension or pregnancy induced hypertension (PIH)
When high blood pressure is first detected after the 20th week of pregnancy, it is known as gestational hypertension. This kind of blood pressure usually returns to normal once the baby is born.
Preeclampsia:
When gestational hypertension is associated with one or more of the following signs, then the condition is called preeclampsia: protein (albumin) in the urine, persistent headache, visual problems like blurring, double vision, rapid weight gain , swelling (oedema) of the hands and face, pain in the upper right part of the abdomen
Eclampsia:
When preeclampsia becomes severe, seizures (fits) will occur. This is called eclampsia. This is a severe and dangerous situation for both the mother and the baby. Immediate delivery is sometimes the only way of saving the mother. Fortunately, eclampsia is rare in women who receive regular antenatal care.
Treatment
Decreasing activity and taking blood pressure medication may control the blood pressure till the baby is mature enough for delivery. Salt restriction is advised only for women with chronic hypertension.
In most cases, delivery of the baby is the only “cure” for preeclampsia. The decision on when to deliver depends on the severity of the condition and the duration of the pregnancy. If the woman is close to her due date and the conditions are favourable, labour may be induced. If the mother is medically unstable or the foetus cannot tolerate labour, a caesarean section will be performed.
(The author is a Chennai-based obstetrician and gynaecologist with a special interest in women’s health issues.)
GITA ARJUN
Printer friendly
page
Send this article to Friends by
E-Mail
Metro Plus
Bangalore
Chennai
Coimbatore
Delhi
Hyderabad
Kochi
|
