Complications of Hypertension in Pregnancy: Risks for Both Mother and Baby

Author :-

Dr.Sreejaya

General Medicine & Diabetology

Introduction to Hypertension in Pregnancy

What is hypertension, and How Does It Affect Pregnancy?

In the US, 1 in 12–17 pregnant women develop hypertension. It is important to monitor blood pressure before, during, and after pregnancy. High blood pressure during pregnancy can damage organs and cause premature delivery and low birth weight.

Overview of Hypertension in Expecting Mothers

Hypertension during pregnancy might deprive the placenta of blood and oxygen. The drop in blood and nutrients can cause IUGR, or low birth weight.

Causes of hypertension in pregnancy

Common causes and risk factors

Many studies have identified obesity, a family history of hypertension, alcohol use, heart failure, stroke, left ventricular hypertrophy, and smoking as risk factors for hypertensive problems in pregnancy.

Genetic, Lifestyle, and Pregnancy-Related Triggers

Children of hypertensive parents can inherit a gene that increases their risk of hypertension. Family lifestyle risk factors, including smoking and poor eating, can also cause familial hypertension.

Types of Hypertension in Pregnancy

Chronic Hypertension: Pre Existing High Blood Pressure

Chronic or pre-existing hypertension in pregnancy is present during the booking visit or before 20 weeks of gestation.

Gestational hypertension: developing high blood pressure during pregnancy

GHD is pregnancy-related high blood pressure. Post-20-week pregnancy. You seldom experience additional symptoms. Often, the symptoms don't affect either you or your child and disappear within 12 weeks after delivery.

Preeclampsia: Hypertension with Organ Complications

Preeclampsia can harm the kidneys, liver, lung, heart, eyes, and brain. Damage to other organs varies according to preeclampsia severity. Cardiovascular illness.

Eclampsia: Severe preeclampsia leading to seizures

Severe pre-eclampsia causes eclampsia. Less than 1% of pre-eclampsia women suffer seizures. The mother and fetus are at risk from eclampsia. A seizure dramatically diminishes the foetal oxygen supply.

Symptoms of Hypertension in Pregnancy

Recognising high blood pressure symptoms

Terrible headaches.
Chest discomfort.
Dizziness.
Difficulties breathing.
Nausea.
Vomiting.
Eyesight changes like blurring.
Anxiety.

Other Warning Signs of Preeclampsia and Eclampsia

Proteinuria is one of the signs of renal disease.
Low platelets (thrombocytopenia)
High liver enzymes suggest liver disease.
Severe headaches.
Vision changes, such as momentary blindness, impaired vision, or light sensitivity, can occur.

Complications of Hypertension for the Mother

Risks of organ damage, stroke, and seizures

High blood pressure can cause these complications for mothers and babies; the woman may have preeclampsia, eclampsia, stroke, labor induction, and placental abruption.

Placental Abruption and Maternal Health Risks

Prenatal placental abruption occurs when the placenta separates from the uterine wall. Placental abruption deprives the baby of oxygen and nourishment and causes significant bleeding in the mother. Sometimes early delivery is essential. Placental abruption generally occurs unexpectedly.

Postpartum complications related to hypertension

Haemolysis, high liver enzymes, poor platelets.
Persistent hypertension.
CHD.
Cardiac failure.
Possible complications include renal failure, eclampsia, pulmonary oedema, and stroke.

Complications of Hypertension for the Baby

Risks of Preterm Birth and Low Birth Weight

Risks of pregnancy-related high blood pressure: Reduced placenta blood flow. If the placenta doesn't get enough blood, the fetus may receive less oxygen and nutrients. This can cause intrauterine growth restriction, low birth weight, and preterm birth.

Intrauterine Growth Restriction (IUGR)

Non-normal infant weight during pregnancy. Placenta abnormalities, high maternal blood pressure, infections, smoking, alcohol, and diabetes can all lead to internal uterine growth limitation. An infant with this syndrome weighs less than 90% of other newborns at the same gestational age. Obstetric ultrasounds track infant weight. Testing may result in an early delivery of the baby.

Long-Term Health Implications for the Baby

Babies can have lifelong issues from premature birth. A premature infant is more likely to have health issues. Some of these issues may not appear until maturity. Early detection and treatment of health issues and prevention of preterm delivery can help newborns live longer, healthier lives.

Hypertension Treatment in Pregnancy

Medications for Managing Hypertension During Pregnancy

Emergency preeclampsia therapy includes IV hydralazine, labetalol, and oral nifedipine. The ACOG Practice Bulletins advocate methyldopa and labetalol as first-line medicines and not beta-blockers or ACEIs.

Monitoring and Lifestyle Adjustments for Blood Pressure Control

Regular exercise...
Maintain weight.
Healthy, balanced diet...
Reduce salt.
Drink moderately...
Take recommended medications.

Emergency Treatments for Severe Cases

Following beta blockade, the blood pressure may rise, necessitating the administration of intravenous nitroglycerin or nitroprusside. Intravenous nitroglycerin, clevidipine, or nitroprusside are useful hypertensive emergency medications for acute pulmonary oedema.

Prevention and self-care for hypertension in pregnancy

Tips for Preventing High Blood Pressure

Healthy eating. Choose nutritious meals and snacks to avoid high blood pressure and its effects.

Watch your weight.
Get moving.
Don't smoke...
Control alcohol intake.
Get adequate rest.

Self-Care Practices to Reduce Risk

Hypertensives can lower their blood pressure with frequent exercise. Fitness activities, including walking, running, cycling, swimming, and dancing, can reduce blood pressure. High intensity interval training is also beneficial.

Diet and Exercise Recommendations

Keep alcohol low.
Low-fat milk
Losing weight
Sleep well.
Pick poultry and lean.

Hypertension Medicines and Their Safety During Pregnancy

Commonly prescribed hypertension medications

Water medications, or diuretics, assist the body in eliminating excess salt and water. Controls blood pressure. Different diuretics are used alongside other drugs.

Commonly prescribed diuretics:
Lasix is furosemide.
Bumetanide (Bumex)
Torsemide (Demadex)
Midamor and Hydro-ride are amiloride.
Esidrix, Hydrodiuril—HCTZ
Indapamide (Lozol)
Dyrenium triamterene
Chlorthalidone (Thalitone)
Spironolactone (Aldactone)
Eplerenone (Inspra)

Commonly prescribed diuretics:

Lasix is furosemide.

Bumetanide (Bumex)

Torsemide (Demadex)

Midamor and Hydro-ride are amiloride.

Esidrix, Hydrodiuril—HCTZ

Indapamide (Lozol)

Dyrenium triamterene

Chlorthalidone (Thalitone)

Spironolactone (Aldactone)

Eplerenone (Inspra)

Safe vs. Unsafe Medications for Expecting Mothers

Pregnant women who have well-controlled blood pressure can continue their treatment, except for angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers.

Adjusting Medications to Protect Mother and Baby

Pregnancy medications can pass through the placenta and affect the fetus. Infant drug withdrawal, low birth weight, early birth, miscarriage, and stillbirth are potential outcomes.

Conclusion

Awareness of hypertension and other cardiac problems is crucial. Regular blood pressure checks are required for newborns and older. Professional and academic stress raises blood pressure. Thus, lifestyle adjustments are vital to avoid hypertension. Learn more at Ovum Hospitals.

FAQs

1: What are pregnant medication risks?

Avoiding or quitting a drug during pregnancy may be worse than taking it. However, several pregnancy medications can raise the risk of birth abnormalities, preterm birth, and pregnancy loss.

2: Are maternal-foetal medicines risky?

Even if you're having a good pregnancy, you may benefit from consulting a maternal-foetal medicine expert.

3: After pregnancy, what causes high blood pressure?

It can happen within days or six weeks of giving birth. Postpartum preeclampsia's causes are unknown; however, specialists suspect many variables. Rapid hormonal and fluid changes might impact blood pressure.

4: How does preeclampsia terminate organ damage?

Preeclampsia, characterized by first-time high blood pressure after 20 weeks, can cause harm to the brain, liver, and kidneys. You may develop proteinuria, headaches, hazy vision, and seizures.

5: Can a high-risk pregnancy cause hypertension?

BP readings between 140/90 mm Hg and < 160/110 mm Hg signify nonsevere pregnancy hypertension. The diagnostic threshold for severe hypertension in pregnancy is BP ≥160/110 mm Hg, which is linked to increased risk of maternal stroke.