High Blood Pressure (Gestational Hypertension, Essential Hypertension, Toxemia):
About 25 % of people have high blood pressure or Hypertension, including women in their reproductive years. Women with high blood pressure who become pregnant will need early consultation to discuss the risks during pregnancy to their health and to the health of their babies. There are two types of hypertension in pregnancy: preexisting hypertension (essential hypertension), and Gestational Hypertension and that is also known as Toxemia and pre-eclampsia.
Gestational Hypertension/ Preeclampsia/ Toxemia:
This disorder may affect up to 5-7% of pregnant women especially those with risk factors (long standing high blood pressure, diabetes, extremes of age, twins and triplets). This complication of pregnancy usually takes place in the third trimester, however rarely this can take place earlier, and can have serious complications both for you and your Baby if severe. There is a risk to you of stroke, heart and kidney failure; and to the baby in the form of severe growth restriction and the potential for a premature delivery, in addition to increased risk of stillbirth.
Mild cases of gestational hypertension will need close follow-up with frequent ultrasound evaluation for fetal growth and weekly or twice weekly fetal well-being testing such as Non Stress Testing and Biophysical Profile. Severe cases will require an early delivery and observation in a critical care set up both for you and your Baby.
If you have a preexisting Hypertension, the likelihood for a good pregnancy outcome is directly related to the severity of your hypertension before pregnancy. If your hypertension has been under good control and is generally considered mild to moderate in severity, your chances for a successful outcome are very good. If you were on medications to control your Blood Pressure before pregnancy, you will likely need to continue taking medication, although the type of medication could be changed for safety reasons to you and your baby. Because you have hypertension, you are at increased risk to develop superimposed gestational hypertension/toxemia and you will need to be watched carefully.
If your pre-existing hypertension is classified as severe, the potential consequences can be quite serious for both you and the baby. There is a risk to you of stroke, heart and kidney failure, and to the baby in the form of severe growth restriction and the potential for a premature delivery, in addition to increased risk of stillbirth.
Management of high blood pressure during pregnancy includes early evaluation and blood pressure assessment, adjustment of medications, frequent evaluation for Preeclampsia, repeated measurements of the baby for growth, and evaluation of fetal well being on a regular basis. If you have a history of severe hypertension, consultation with one of our High Risk Perinatologists is advisable before considering pregnancy and is important if you become pregnant.