Gestational hypertension is a complication during pregnancy. In this case, blood pressure values exceed a limit of 140/90 mmHg in successive measurements. If bed rest and dietary changes do not lower blood pressure, drug therapy may be used.
What is gestational hypertension?
In gestational hypertension, significantly elevated blood pressure occurs during pregnancy. The phenomenon is therefore also known as gestational hypertension. Hypertensive blood pressure is said to occur when the systolic blood pressure is permanently or situationally above 140 mmHg or the diastolic blood pressure is permanently or situationally above 90 mmHg. Gestational hypertension may be either absent or associated with proteinuria and edema. When combined with proteinuria and edema, the condition is no longer referred to as pure gestational hypertension but as preeclampsia. If the pregnant woman has had arterial hypertension before pregnancy, gestational hypertension is not present. Gestational hypertension is one of the most common causes of infant mortality during childbirth, accounting for about 30 percent of all cases, and as a complication it also increases the risk of maternal mortality.
Causes
Gestational hypertension affects the expectant mother in nearly a quarter of all pregnancies. Gestational hypertension occurs almost exclusively in first-time pregnancies. The main cause of gestational hypertension is thought to be an increase in the amount of blood in the mother’s circulatory system. This increase in blood volume is around 40 percent during pregnancy. In addition, the metabolism changes. Both carbohydrate and fat metabolism are affected by these changes. Blood sugar and blood lipids, for example, increase during pregnancy. These changes in metabolism may also be related to the phenomenon of gestational hypertension. To date, however, the causes of hypertension are rather speculative and have not been conclusively clarified scientifically.
Symptoms, complaints, and signs
Usually, hypertension begins in the 20th week of pregnancy or later. Gestational hypertension makes the pregnant woman complain of typical hypertension symptoms. Headaches or feelings of pressure may be present. Visual disturbances of greater or lesser severity are equally common. The hypertension may cause dizziness and nausea. Since vascular pressure is also elevated in hypertension, sufferers often urinate more frequently than before the hypertensive condition. In addition, edema due to water retention was formerly reported as one of the leading symptoms. In the meantime, however, edema is no longer understood as a typical symptom of gestational hypertension. In fact, water retention accompanies most pregnancies. Within three months after birth, the phenomenon recedes in 85 percent of cases. The remaining 15 percent suffer from chronic hypertension after pregnancy.
Diagnosis and course
The diagnosis of gestational hypertension is made by measuring blood pressure. A value of 140/90 mmHg is considered the cutoff value. Measurements are taken at rest. A single measurement is not sufficient for diagnosis. Gestational hypertension is only present if the value exceeds the specified limit in two consecutive measurements. A urine test is performed to differentiate pure gestational hypertension from the special form of preeclampsia. Mild gestational hypertension is considered to have a relatively favorable prognosis. Thus, mildly elevated levels are usually not a major risk to the mother and fetus. However, if gestational hypertension matures into preeclampsia and thus promotes further complications, the prognosis worsens. Both the fetus and the mother may thus be at increased risk.
Complications
In most cases of gestational hypertension, there is a sharp increase in blood pressure during pregnancy. The child is usually unaffected by the condition, but different complications may arise for the mother. For example, there is an increased incidence of headaches and dizziness during pregnancy. This can be associated with feelings of pressure and nausea, so that the patient’s quality of life is greatly reduced. The increased blood pressure can also cause heart problems in the patient, which can be life-threatening.In the worst case, death can result from a heart attack. As a rule, gestational hypertension can be diagnosed relatively quickly and at an early stage, so that treatment can also be started at an early stage. In severe cases, gestational hypertension can lead to premature birth. This can be associated with consequential damage and, in the worst case, with the death of the child. However, the disease can be controlled relatively easily with a change in diet, so that there are no further complications and discomfort. In some cases, treatment with the help of medication is necessary.
When should you go to the doctor?
The recommendation for the expectant mother is to participate in all offered examinations for preventive care or control during pregnancy. In this way, the best checkup of the health condition takes place for both mother and child. In the routine treatments there is a measurement of blood pressure, so that irregularities are detected early and a quick diagnosis is possible. If irregularities occur outside of the examinations, a doctor should be consulted as soon as possible. Severe palpitations, irregularities of the cardiovascular system or circulatory problems must be discussed with a physician immediately. If there is a persistent feeling of inner heat, sweating or hot flashes, a visit to the doctor is necessary. If there is internal restlessness, a feeling of illness or increased body temperature, a doctor is needed. If the pregnant woman has a diffuse feeling that there are irregularities in the development of the child, she should see a doctor. If there is a general weakness, an unusual drop in performance, sleep disturbances or problems with concentration, a visit to the doctor is necessary. If there are disturbances in the existing vision or if the expectant mother suffers from headaches, she should consult a doctor. Consultation with a doctor is necessary in case of dizziness, persistent nausea or vomiting from the second trimester onwards. An unusually strong urge to urinate must be clarified.
Treatment and therapy
Expectant mothers with gestational hypertension are initially well monitored. Monitoring is required not only during the rest of pregnancy but especially during delivery. The expectant mother is also educated by the physician about gestational hypertension and its possible consequences and causes. This educational talk ideally gives her enough understanding of the condition to take as much care of herself as possible during the rest of the pregnancy. Through education and monitoring, hypertension has serious consequences for the rest of the pregnancy or birth in only a few cases. Drug therapies are used to lower blood pressure in a timely manner to reduce the risk of deficiency development or premature birth. However, gestational hypertension cannot be treated causally, but only symptomatically. In the case of severely elevated values, the doctor prescribes bed rest. Any activity can further increase blood pressure. Physical rest for the mother is therefore indispensable to keep the risks to a minimum. As a rule, the mother is also advised to follow a balanced diet that is in line with pregnancy requirements. A change in diet is often successful, especially in the case of mild hypertension. For drug therapy of hypertension, the risks and benefits must be weighed. Therefore, drug intervention is usually advised only in severe hypertension. Not only extremely high values, but also persistently elevated values argue for drug therapy. For example, alphamethyldopa, beta-blockers, or hydralazine may be used as antihypertensive drugs.
Outlook and prognosis
Gestational hypertension is a temporary health condition that can be diagnosed exclusively in pregnant women. It occurs during pregnancy and normally resolves on its own immediately after delivery. The unborn child is not affected by the disease. It does not show any irregularities. Nevertheless, the high blood pressure can lead to an unwanted premature birth. Rather rarely, the death of the infant is documented as a result. This depends on the timing of the premature birth as well as the circumstances and medical care options for mother and child.Although gestational hypertension causes various health problems and disorders in the expectant mother, the condition can be positively influenced independently by lifestyle and diet during pregnancy. This minimizes existing complaints and increases the general well-being. In some patients, the course of the disease is chronic until delivery, despite all efforts. Increased vigilance is required here and blood pressure should be checked at regular intervals several times during the day. There is a possibility of inpatient stay until the end of pregnancy. Within outpatient or inpatient medical care, sufficient regulation of blood pressure takes place so that serious complications can be avoided in most patients. After delivery, spontaneous healing occurs.
Prevention
Gestational hypertension cannot be prevented because the cause is the physiologic increase in blood during pregnancy. Nevertheless, the course of gestational hypertension can be influenced. Pregnant women with elevated blood pressure need to take it easy and ideally change their diet to prevent levels from rising further.
Follow-up
With gestational hypertension, options for follow-up care are very limited. First and foremost, medical treatment with the help of medications is necessary to relieve the symptoms of gestational hypertension and prevent further complications. In the worst case, this disease can lead to the death of the affected person if left untreated. This disease usually requires permanent monitoring by physicians, and treatment in the patient’s own home is not possible. For this reason, early diagnosis of gestational hypertension is particularly important to ensure early treatment. Sufferers of this condition need to rest and take it easy on their bodies. Strenuous activities and other unnecessary activities should therefore always be avoided. Sporting activities and stress should also be avoided. In many cases, a change in diet is also necessary to alleviate the symptoms of gestational hypertension. A healthy lifestyle with a balanced diet has a very positive effect on the course of the disease. When taking medication, care must be taken to ensure that it is taken regularly. The patient’s life expectancy is usually not reduced by gestational hypertension if treatment is successful.
Here’s what you can do yourself
In addition to medical treatment of gestational hypertension using medications, natural home remedies can also help keep blood pressure down. It is crucial to pay attention to fluid balance and ensure that enough is drunk. In addition, pregnant women who suffer from elevated blood pressure during pregnancy should take plenty of vitamin D. The vitamin helps the body to maintain blood pressure. The vitamin helps the body keep blood pressure under control. Moreover, a deficiency of vitamin D, makes the blood pressure drop immediately. Natural vitamin D is primarily produced by sunlight on the skin. Therefore, outdoor walks are particularly suitable. Moreover, sufficient exercise through a walk can alleviate the accompanying symptoms of pregnancy and have a very positive effect on the well-being of pregnant women. Taking onion, garlic, peppermint tea, plenty of fruits and vegetables, and a low-salt diet also help to lower elevated blood pressure. Various home remedies with additions of different oils and herbs, can also help lower blood pressure. However, this is not recommended without further ado, because not all herbs and oils are compatible, especially during pregnancy.
