Screenings are very important during pregnancy and should be attended. In case of persistent symptoms such as dizziness, ringing in the ears and headaches in the second half of pregnancy, the doctor should be informed to rule out pregnancy-related high blood pressure.
What is high blood pressure during pregnancy?
Pregnancy-related high blood pressure (preeclampsia) is a condition that can only occur during pregnancy. In about five to eight percent of all pregnant women, preeclampsia develops in the second half of pregnancy, starting at 20 weeks. At an earlier stage of pregnancy, the first signs sometimes appear, initially accompanied by palpitations. In ten percent of all women, blood pressure increases during pregnancy without preeclampsia subsequently manifesting itself. The condition is manifested by elevated blood pressure with values above 140/90 mmHg and increased protein excretion in the urine. The pregnant woman notices this mainly through headaches, ringing in the ears and dizziness. There is also increased water retention in the tissues, especially in the hands and feet. In the past, it was assumed that the mother’s complaints were triggered by the unborn child, which was suspected of poisoning the mother. However, this theory could not be confirmed in pregnancy-related hypertension.
Causes
The causes of pregnancy-induced hypertension are currently unknown. However, there are a number of speculations about possible triggers of the condition. For example, the expectant mother may experience inflammation of the blood vessels, which disrupts placental development. The inflammatory reaction is a kind of overreaction of the body to the pregnancy. Furthermore, there is the possibility that the higher blood volume required by the uterus cannot be produced by the body. It reacts with an increase in blood pressure to ensure the stability of the circulation. Malnutrition of the mother is also discussed as a cause of pregnancy-induced hypertension.
Symptoms, complaints, and signs
The initial and subtler symptoms of pregnancy toxicity include increased pregnancy blood pressure, increased excretion of protein through the urine, retention of fluids in the hands, face, and feet, and decreased urine output. In addition, severe cases are characterized with sudden and severe weight gain, headache, nausea or vomiting, sensitivity to light and visual disturbances. In particular, pregnant women should pay attention to possible pain in the right upper abdomen. The clinical signs of preeclampsia also denote changes in the blood, i.e. the proportion of erythrocytes in the volume of blood is often increased, as well as other blood parameters. The disease of preeclampsia is sometimes difficult to distinguish from kidney disease with combined hypertension. Rising uric acid levels or underlying dysfunction of the central nervous system, liver, or other organs, may indicate pregnancy-related disease. In more than 80% of pregnant women, edema can be seen even without preeclampsia present. Again, it is possible to have preeclampsia without showing signs of edema. If gestational hypertension persists for a longer period of time, the blood vessels of the placenta may be damaged. This reduces the supply of nutrients and oxygen to the unborn child.
Diagnosis and course
Pregnancy-related hypertension is detected during prenatal care. During these appointments, blood pressure levels are checked. In addition, the pregnant woman must provide urine, which is tested for its protein content. Checking the weight also provides information about a sudden increase due to water retention. Edema develops in most pregnant women without the presence of preeclampsia. However, regular checks allow early treatment of the condition. Existing high blood pressure damages the vessels in the placenta, so that the child can no longer be supplied adequately. It is very important to keep the check-up appointments, because if the disease is left untreated, eclampsia may develop.Seizures originating in the brain occur, which can be life-threatening for both the mother and the baby.
Complications
High blood pressure during pregnancy is usually harmless; however, sometimes it can lead to complications. Chronic high blood pressure, which occurs as early as the first or second trimester, increases the risk for full-blown preeclampsia. The disorder reduces the supply of nutrients and oxygen to the embryo and affects the baby’s growth; it also causes seizures and headaches. Other complications can include kidney failure, cerebral edema, thrombosis, hemorrhage, retinal damage, and placental death. If preeclampsia develops into eclampsia, severe complications such as convulsions, severe headaches and eye fibrillation are possible. Often these warning signs occur as early as chronic hypertension, and have an immediate impact on the well-being of both mother and baby. Rarely, eclampsia can lead to decreased blood flow to the placenta, resulting in insufficient blood supply or death of the baby. Thus, high blood pressure during pregnancy can affect the health of the baby. In addition, the elevated pulse increases the risk of premature birth, internal bleeding and coagulation disorders such as HELLP syndrome, which in turn can be accompanied by life-threatening side effects. Medical evaluation of hypertension usually prevents serious complications and ensures healthy development of the child.
When should you go to the doctor?
High blood pressure is generally considered a risk factor for many cardiovascular diseases. However, special caution is required during pregnancy. This is true even if hypertension has been present before. Pregnant women should have their blood pressure checked regularly. Values of 140/90 mmHg and above are considered to be in need of treatment in pregnant women. If excessive blood pressure is detected, affected women should see a doctor promptly, as these could be the first signs of pre-eclampsia. This is a disorder in which pregnant women suffer from excessively high blood pressure, and at the same time too much protein is excreted through the urine. If left untreated, a hypertensive pregnancy disorder can lead to life-threatening complications for the mother, trigger a premature birth or cause damage to the child. A visit to the doctor is therefore strongly advised. The doctor can also recognize possible complications such as eclampsia or HELLP syndrome in time and initiate the necessary therapeutic measures. In addition to nausea, vomiting and severe pain in the upper abdomen, HELLP syndrome can also lead to a number of accompanying symptoms that are life-threatening for the mother. These include, for example, pulmonary edema, cerebral hemorrhage or acute kidney failure. Pregnant women should therefore take high blood pressure during pregnancy very seriously and always consult a doctor promptly.
Treatment and therapy
Treatment of pregnancy-related hypertension depends on the severity of the condition. If the condition is mild, physical rest or bed rest is the primary treatment. The woman should pay special attention to her diet. A high-calorie diet, rich in protein and sufficiently salted, is considered beneficial in this case. If necessary, antihypertensive drugs must be taken. If blood pressure levels continue to rise, hospitalization is necessary to ensure constant monitoring. The main concern here is to prevent possible seizures. Antihypertensive drugs are also administered in this case. A complication in the course is the HELLP syndrome. This is a severe preeclampsia with additional liver dysfunction that can lead to internal bleeding. The mother must be monitored intensively. The urine values are constantly checked via a permanent catheter. It is difficult to estimate how the syndrome will develop. A sudden deterioration can occur at any time. This condition is life-threatening for the mother and the baby, so the pregnancy must be terminated by cesarean section if the maturation of the baby’s lungs allows it.
Outlook and prognosis
Hypertension during pregnancy is considered a concern because of its unpredictability. It may increase during pregnancy, occur sporadically, or be measured only once.In some patients, there is a possibility that, despite all efforts, there will be no relief of the symptoms until the birth of the child. This is explained by the fact that often the cause of the high blood pressure cannot be found. Despite rest, balance, a healthy diet and little physical exertion, the symptoms can continue unabated until the birth. To avoid triggering complications, complete bed rest is often the only treatment option. Thus, hypertension poses an increased risk to the health of the mother and the unborn child. In severe cases, life-threatening conditions are imminent. These can occur in the mother as well as in the child. With early treatment of hypertension, various countermeasures can be initiated. In these cases, there is a very good chance of alleviating the symptoms. Nevertheless, a prognosis must always be evaluated on an individual basis. The return of hypertension can occur even with timely and comprehensive medical care. Some pregnant women experience a permanent reduction in blood pressure after a single treatment. Nevertheless, complete freedom from symptoms does not occur until after the birth of the child.
Prevention
To prevent pregnancy-related hypertension, it is important to attend regular screening appointments. The earlier preeclampsia is detected, the more favorable the conditions are for a mild course of pregnancy-related hypertension.
Follow-up
There are several points to consider in the follow-up of hypertension during pregnancy. One of the most important points is breastfeeding. There are medications which can be used to reduce elevated blood pressure after pregnancy. Since almost all medications taken by the mother can also be detected in breast milk, it is essential to make sure that they do not affect the development and health of the child. Which medication is the right one should always be discussed with a doctor beforehand. The advantages and disadvantages of the individual preparations should also be discussed. Alpha-methyldopa is often prescribed as an antihypertensive for the follow-up of preeclampsia. These synthetically produced amino acids can even stimulate milk flow, but should not be used if the mother has known depressive moods, as these can be exacerbated. Calcium antagonists are prescribed most frequently, as these preparations achieve only a very low concentration in breast milk. Another important point in the follow-up of hypertension during pregnancy is a balanced lifestyle with a healthy diet, sufficient exercise and adequate sleep. In the diet, particular attention should be paid to caffeine and salt, as these substances can additionally increase blood pressure. Sufficient sleep and exercise promote the cardiovascular system and also contribute to lowering blood pressure.
What you can do yourself
In addition to medication to treat high blood pressure during pregnancy, it is advisable for those affected to take it easy and avoid stress. Restful sleep, rest breaks and a combination of exercise and a balanced diet can already lower blood pressure. Alkaline foods in particular have a tonic effect and help to relieve the organism and have a positive influence on the cardiovascular system. These include all cereals, all cabbage vegetables, garlic, spices such as turmeric, dill and cumin, and citrus and berry fruits. Caution, on the other hand, is advised with very fatty foods, conventional salt, red meat and highly processed foods. Affected individuals should therefore prepare mainly market-fresh ingredients in order to achieve the best possible nutrient supply and lower blood pressure. In addition, it makes sense to get enough exercise, with walks in the woods being particularly suitable for pregnant women. The de-stressing effect alters hormone levels, resulting in the lowering of cortisol and noradrenaline. In addition, the exhalations of forest plants have an antioxidant effect, stimulating the immune system and reducing the level of inflammation in the body. The better blood circulation and oxygen supply relaxes the blood vessels and provides the kidney with more oxygen, which lowers the blood pressure stimulation by the kidney.Swimming is also a great way to exercise the entire body in a way that is easy on the joints, while also counteracting water retention so that blood vessels are relieved.
