Hypertension in pregnancy

Hypertension in pregnancy

Hypertension in Pregnancy: A Patient Education Guide

Hypertension (high blood pressure) during pregnancy can be serious for both the mother and the baby if not managed properly. It is important to understand its types, possible complications, and management.

Types of Hypertension in Pregnancy:

  1. Chronic Hypertension: Present before pregnancy or diagnosed before 20 weeks of pregnancy.
  2. Gestational Hypertension: High blood pressure that develops after 20 weeks of pregnancy without protein in the urine.
  3. Preeclampsia: High blood pressure after 20 weeks, often with protein in the urine or signs of organ damage.
  4. Chronic Hypertension with Superimposed Preeclampsia: Chronic hypertension worsens during pregnancy with signs of preeclampsia.

Why is it Important?

  • High blood pressure can affect blood flow to the placenta, potentially leading to growth restrictions, preterm delivery, or placental abruption.
  • Severe cases may lead to eclampsia (seizures) or HELLP syndrome, both of which can be life-threatening.

Symptoms to Watch For:

  • Persistent headache
  • Visual disturbances (blurry vision, seeing spots)
  • Severe upper abdominal pain
  • Sudden swelling in hands, feet, or face
  • Rapid weight gain
  • Decreased fetal movements

Do's and Don'ts for Managing Hypertension in Pregnancy

Do's:

  • Attend Regular Check-ups: Monitor your blood pressure and baby's growth closely.
  • Eat a Balanced Diet: Focus on fruits, vegetables, whole grains, lean protein, and low-sodium foods.
  • Stay Hydrated: Drink plenty of water daily.
  • Rest: Take breaks during the day and try to sleep on your left side to improve blood flow to the baby.
  • Monitor Blood Pressure: Keep a home monitor to track readings.
  • Take Prescribed Medications: Use medications as directed by your doctor.

Don'ts:

  • Avoid Excessive Salt: Limit foods high in sodium like chips, canned soups, and processed snacks.
  • Avoid Alcohol and Smoking: Both can increase blood pressure and harm the baby.
  • Avoid Overexertion: Manage stress and avoid heavy lifting or strenuous activities.
  • Do Not Skip Medications: Even if you feel fine, stopping medications suddenly can be harmful.

Medications for Hypertension in Pregnancy

Safe Medications in Pregnancy:

  1. Labetalol: Commonly used; both effective and safe.
  2. Methyldopa: Long history of use during pregnancy.
  3. Nifedipine (extended-release): A calcium channel blocker used in certain cases.

Medications to Avoid During Pregnancy:

  • ACE inhibitors (e.g., Enalapril, Lisinopril)
  • ARBs (e.g., Losartan, Valsartan)
  • Diuretics (in certain cases, unless specifically prescribed)

Safe Medications for Breastfeeding Mothers:

  • Enalapril
  • Labetalol, Bisoprolol, Atenolol, Metoprolol, Carvedilol
  • Nifedipine, Amlodipine

When to Seek Emergency Help:

  • Severe headache that does not improve
  • Chest pain or shortness of breath
  • Sudden vision changes
  • Seizures
  • Severe abdominal pain

Conclusion:

Managing hypertension in pregnancy requires close monitoring, lifestyle adjustments, and appropriate medications. Partner with your healthcare team to ensure a safe and healthy pregnancy for you and your baby.