Hypertension in Pregnancy: A Comprehensive Guide for Expecting Mothers

Introduction

Hypertension (high blood pressure) during pregnancy is a rising concern and can pose serious risks to both the mother and the baby. Also known as pregnancy-induced hypertension (PIH), this condition requires early diagnosis and consistent monitoring.

Dr. Mini Salunkhe from Momstory Sahyadri Hospital, Hadapsar explains the causes, types, complications, and management strategies for hypertension during pregnancy.

What Is Hypertension in Pregnancy?

Hypertension in pregnancy refers to elevated blood pressure that occurs during gestation. It may either pre-exist before conception or develop after the 20th week of pregnancy.

If left unmanaged, it can lead to complications for both mother and baby—including organ damage, seizures, placental issues, or even stillbirth.

Risks for Mother and Baby

For the Mother:

• Swelling of the body

• Protein in the urine (proteinuria)

• Severe headaches or blurred vision

• Risk of seizures (eclampsia)

• HELLP syndrome (affecting liver and platelets)

• Organ damage (kidney, liver, brain)

For the Baby:

• Intrauterine growth restriction (IUGR)

• Low birth weight

• Premature delivery

• Stillbirth

• Placental abruption (sudden separation of the placenta)

Types of Hypertension During Pregnancy

1. Chronic Hypertension

   • Pre-existing before pregnancy or diagnosed in early pregnancy

   • May continue post-delivery

   • Requires long-term monitoring and medication

2. Preeclampsia (PIH or PET – Pre-Eclamptic Toxemia)

   • Occurs after 20 weeks of pregnancy

   • Common in first-time mothers

   • Severe swelling, high BP, proteinuria

   • Can lead to eclampsia if untreated

3. Gestational Hypertension

   • Develops after 20 weeks of pregnancy

   • Typically milder

   • Does not involve protein in the urine

   • Often seen in IVF or twin pregnancies

How Is It Diagnosed?

Early and regular monitoring is key. Doctors monitor BP at every prenatal visit and look for symptoms or signs such as:

• Protein in urine (via urine tests)

• Abnormal liver enzymes and low platelets (HELLP syndrome)

• Kidney function tests

• Ultrasound and Doppler scans to assess fetal growth and placental blood flow

If previous pregnancy had hypertension, additional precautions are taken from the start.

Symptoms You Should Not Ignore

• Persistent or severe headaches

• Blurred vision or flashes of light

• Sudden weight gain

• Swelling in face, hands, or legs

• Reduced fetal movements

• Upper abdominal pain

• Sudden breathlessness

Management and Treatment

✅ Mild Hypertension (Early Stage):

• Lifestyle changes: low-sodium diet, regular walks, stress management

• Regular BP monitoring at home

• Frequent checkups, blood, and urine tests

Medical Management:

• Antihypertensive medications may be prescribed

• Serial ultrasounds to monitor fetal growth

• Close attention to Doppler readings in high-risk cases

Labor and Delivery with Hypertension

• BP often rises during labor due to pain and stress

• High-risk patients may require:

  • Induced labor or

  • Cesarean section before 37 weeks if growth is restricted or complications arise

• Post-delivery monitoring is essential for 6 weeks, especially the first 48 hours

Postpartum Considerations

Even after delivery:

• Blood pressure can fluctuate, especially in the first 2 weeks

• Mothers must continue monitoring BP at home

• Lack of sleep, breastfeeding stress, and fatigue can cause spikes

• Conditions like PRES syndrome (Posterior Reversible Encephalopathy Syndrome) can occur in rare cases

If you had chronic hypertension before pregnancy, regular monitoring and long-term care is necessary even after 6 weeks.

How Can You Prevent It?

• Maintain healthy weight before pregnancy

• Manage underlying conditions like PCOS, thyroid disorders, or diabetes

• Regular exercise and low-sodium diet

• Preconception checkups and early prenatal care

Once your BP is controlled, you can plan a safe and healthy pregnancy.

Takeaway: Prioritize Monitoring and Lifestyle

Hypertension during pregnancy is manageable with the right care, monitoring, and timely intervention.

For any symptoms or questions, visit Momstory Sahyadri Hospital, Hadapsar, and consult with experts like Dr. Mini Salunkhe.