GESTATIONAL HYPERTENSION; SYMPTOMS, RISK FACTORS, AND TREATMENT
Most of us know what hypertension is, and understand the severity of having a blood pressure that is higher than normal. What is not as commonly known or as publicly acknowledged is gestational hypertension.
Gestational hypertension, also known as pregnancy-induced hypertension (PIH) is when a pregnant woman records a blood pressure measuring systolic above 145 or diastolic above 95 mmHg after 20 weeks’ gestation.
Meanwhile, the more commonly known hypertension, which affects people of all gender, is defined as having blood pressure greater than 140/90 mm Hg.
Gestational hypertension is said to affect between 6 to 10 percent of all pregnant women and needs to be carefully managed because it is not only the health and life of the pregnant mother that is at risk. Both mother and baby are at dire risk.
While some pregnant women suffering from gestational hypertension may not present any symptoms, there are a number of symptoms that are generally associated with the condition. They are:
- Increased blood pressure
- Continuous nausea and vomiting
- Headaches that go away for a little bit, then come back again unabated
- Sudden weight gain that cannot be explained by simply being pregnant
- Sensitivity to light
- Blurred vision
- Edema – swelling of small or large areas of the body
- Pain around the stomach or in the upper abdominal area
- Urinating in small amounts
- Changes in liver or kidney function
Different stages/levels/forms of hypertension during pregnancy
When a woman is first recorded to have a blood pressure that is higher than 145/95 at least on two different occasions after 20 weeks gestation and this high blood pressure is observed without the presence of protein in the urine, she is diagnosed as having gestational hypertension.
When this high blood pressure is observed with protein in the urine (not more than 300 milligrams of protein in a 24-hour urine sample), she is diagnosed as having pre-eclampsia.
Severe pre-eclampsia is then diagnosed when a blood pressure greater than 160/110 is recorded alongside other signs and symptoms.
Eclampsia is when a woman with pre-eclampsia starts to go into tonic-clonic seizures. In the past, it was called toxemia and occurs in about one in 1,600 pregnancies. It usually develops near the tail end of pregnancy.
Severe preeclampsia or eclampsia sometimes leads to HELLP syndrome. This is a group of physical changes in the woman’s body including adverse changes in the liver, the breakdown of red blood cells, and low platelets such that the woman has problems with her blood clotting.
Who is at risk of developing gestational hypertension?
While there are no hard and fast rules about who develops gestational hypertension or who do not, there are certain risk factors for the disease. Here they are:
- Overweight mothers: The more obese you are, the more you are at risk of developing gestational hypertension.
- Being either under 20 or over 40: If you are younger than 20 or older than 40 as at gestational age, you may be at a higher risk of becoming hypertensive during your pregnancy.
- Past history of diabetes, renal disease or high blood pressure: Women who suffered from diabetes, any renal disease or high blood pressure prior to becoming pregnant are more likely to develop hypertension than their counterparts who were relatively healthier.
- Multiple gestations: If you are carrying twins, triplets or other multiples, you are at a higher risk of developing gestational high blood pressure.
- Kidney donors: If you have ever donated a kidney and are currently living with only one kidney, you are more prone to develop gestational diabetes than someone who has both kidneys.
- Women who have placenta abnormalities such as placental ischemia and hyperplacentosis are more likely to become hypertensive during their pregnancies.
- Women with family histories of gestational hypertension and preeclampsia.
How gestational hypertension is diagnosed
Once a pregnant woman has consistently elevated blood pressure levels, most physicians will test for gestational hypertension using urine testing to rule out preeclampsia, frequent weight measurements, assessment of edema, liver, and kidney function tests and blood clotting tests.
Why gestational hypertension can be a cause for concern
Pregnancy or not, high blood pressure hinders blood flow in the different organ systems of the sufferer. When hypertension occurs in an expectant mother, the risk is heightened as blood flow is hindered not just to the kidneys, brain, and liver but to the placenta and uterus as well.
In some sufferers, placental abruption may occur. This means that the placenta prematurely detaches from the uterus, and the fetus no longer gets the sustenance it needs from its mother.
Gestational hypertension can also lead to poor fetal growth, and in some cases stillbirth. The fetus also becomes more prone to developing life-threatening conditions such as being born with immature lungs and breathing problems.
If not properly treated, severe gestational hypertension may lead to the death of mother and child.
How is gestational hypertension treated?
There is no one cure-all treatment for gestational hypertension. The only thing most doctors can do is to closely monitor the patient in order to quickly identify pre-eclampsia should gestational hypertension develop into such. Bedrest may be recommended.
In some cases, physicians treat patients with drugs even though many of them are careful to do this, as many hypertension medications may adversely affect the unborn baby. When the hypertension is severe and needs to be kept under check one way or the other, physicians turn to drugs such as methyldopa, labetalol, and hydralazine.
Because of the many risks involved with gestational hypertension pregnancies, most babies are often delivered early, sometimes even earlier than 37 weeks gestation. Prior to delivery, most doctors usually do fetal monitoring, keeping track of fetal kicks and movements to determine if the fetus is under stress.
What you can do as a pregnant woman
When gestational hypertension is caught in its infancy, the result is often brighter and the woman involved will usually not develop the complications of the disease. This is why it is important to be educated and report any warning signs to your doctor immediately they appear.
This means you can receive treatment on time and stop the disease from progressing further.