Average blood pressure for pregnant women
Normal blood pressure in pregnancy: Levels and management
During pregnancy, a person’s blood pressure should stay within the normal range. Very high or low blood pressure requires medical attention.
According to the American Heart Association (AHA), a healthy person should have a blood pressure reading of less than 120/80 millimeters of mercury (mm HG).
The top number, or systolic, measures blood pressure when the heart contracts. The lower number, or diastolic, measures the blood pressure when the heart is between beats.
Keep reading for more information on blood pressure during pregnancy and steps a pregnant woman can take to keep their blood pressure under control.
Share on PinterestA pregnant woman should monitor their blood pressure during pregnancy to ensure it stays within the normal range.The American College of Obstetricians and Gynecologists (ACOG) state that a pregnant woman’s blood pressure should also be within the healthy range of less than 120/80 mm Hg.
If blood pressure readings are higher, a pregnant woman may have elevated or high blood pressure. If high blood pressure occurs during pregnancy, it may indicate serious complications such as preeclampsia.
It is important to track and manage blood pressure throughout pregnancy.
Blood pressure is the amount of pressure the blood places against the blood vessels walls with each heartbeat. A person can experience elevated or high blood pressure, or hypertension, during pregnancy. This is when the blood puts more pressure than normal against the artery walls.
According to the AHA, people living with untreated high blood pressure are at a greater risk of developing a heart attack, stroke, or other health issues, such as kidney disease.
During pregnancy, high blood pressure is also known as gestational hypertension. Gestational hypertension occurs if the woman’s blood pressure is within the normal range for the first 20 weeks of pregnancy and then increases to 140/90 mm Hg or higher during the second half of the pregnancy.
Risk factors
Experts do not know the exact cause of gestational hypertension, but according to Cedars-Sinai, potential risk factors include:
- having kidney disease
- being younger than 20 or older than 40
- being of African American descent
- having diabetes
- having a history of high blood pressure
- having multiple pregnancies
In most cases, hypertension goes away after delivery.
Complications
ACOG indicate that gestational hypertension can cause complications or increase the risk of complications, such as:
- preeclampsia and other hypertensive disorders of pregnancy typically occur after the 20th week of pregnancy and can lead to problems with the liver, kidney, or other organs
- preterm delivery.
- fetal growth restriction, which is a condition in which a lack of nutrients and oxygen can lead to lower birth weight
- cesarean delivery
- placental abruption, which occurs when the placenta separates from the wall of the uterus
- stillbirth
Women who have high blood pressure before pregnancy should talk to their doctor or midwife. Their provider will likely closely monitor them and the fetus to make sure they are safe during the pregnancy.
Symptoms
In some cases, high blood pressure during pregnancy may not cause any symptoms.
If high blood pressure occurs as a result of preeclampsia, common symptoms include:
- swelling, especially in the hands or face
- a headache that does not go away with medication
- rapid weight gain
- only able to make small amounts of urine
- visual disturbances
- vomiting or nausea that begins or worsens after the 20th week of pregnancy
- changes in vision
- pain near the stomach or on the upper right side of the abdomen
Learn more about high blood pressure during pregnancy.
The AHA identify the first 24 weeks of pregnancy as a risk factor for developing low blood pressure. It can cause symptoms such as:
- dizziness
- fainting
- blurred vision
- inability to concentrate
- cold or clammy skin
- rapid breathing
- fatigue
- dehydration
For most adults, healthy blood pressure is usually less than 120/80 mm Hg. Low blood pressure, or hypotension, occurs when the blood pressure drops below 90/60 mm Hg.
Some people have a naturally low blood pressure, but a sudden drop can cause symptoms to develop.
Learn more about low blood pressure during pregnancy here.
Any pregnant woman who has any concerns over their health or the developing fetus should talk to or see their doctor or midwife.
People who have high blood pressure or are at greater risk of developing high blood pressure might want to monitor their blood pressure at home.
A healthcare provider can likely recommend the best blood pressure cuffs to use.
If home monitoring indicates that blood pressure is too high or too low, contact a healthcare provider.
Any pregnant woman who experiences signs or symptoms of preeclampsia must seek immediate medical assistance.
Learn more about preeclampsia here.
There are several ways for a pregnant woman to manage blood pressure safely.
According to March of Dimes, a person can take the following steps:
- take approved blood pressure medication daily
- monitor blood pressure at home
- eat foods rich in nutrients and avoid salt, processed foods, and added sugars
- go to all medical checkups
- avoid drinking, smoking, and recreational drug use
- stay active through walking or other exercises unless otherwise instructed
Women who have high blood pressure during pregnancy should follow all instructions from their healthcare provider. They should notify their doctor or midwife if they have any changes in their blood pressure or feelings.
It is not always possible to prevent high blood pressure, but a person can take steps to keep their blood pressure at normal levels before and during pregnancy.
The Centers for Disease Control and Prevention (CDC) recommend a person take the following measures to prevent high blood pressure:
- talking to a healthcare provider before pregnancy about any existing health problems and medications
- getting regular and early prenatal care
- making sure all medications are safe to continue during pregnancy
- eating healthful foods
- exercising regularly
If a pregnant woman shows signs of low blood pressure, they should talk to their provider about the best course of action.
General treatment options for a person with low blood pressure include:
- increasing the amount of sodium in the diet
- increasing fluids
- maintaining light to moderate exercise
- standing from a sitting or lying position slowly
- avoiding alcohol
A pregnant woman should maintain their normal blood pressure throughout pregnancy.
Women with previous high blood pressure, multiples, or other risk factors have a greater chance of developing high blood pressure in later pregnancy.
High blood pressure during pregnancy has associations with serious pregnancy complications, including preeclampsia and other hypertensive disorders.
If blood pressure gets too high or low, a person should talk to their healthcare provider to determine the best course of treatment.
Preeclampsia and High Blood Pressure During Pregnancy
-
Blood pressure is the force of blood pushing against the walls of blood vessels called arteries. The arteries bring blood from the heart to your lungs, where it picks up oxygen and then moves to your organs and tissues. The organs and tissues use the oxygen to power their activities. Blood vessels called veins return the blood to the heart.
-
High blood pressure (also called hypertension) can lead to health problems at any time in life. High blood pressure usually does not cause symptoms. During pregnancy, severe or uncontrolled high blood pressure can cause problems for you and your fetus.
Some women have high blood pressure before they get pregnant. Others develop it for the first time during pregnancy. A serious high blood pressure disorder called preeclampsia can also happen during pregnancy or soon after childbirth.
-
A blood pressure reading has two numbers separated by a slash. A blood pressure reading of 110/80 mm Hg, for example, is referred to as “110 over 80.” The first number is the pressure against the artery walls when the heart contracts. This is called the systolic blood pressure. The second number is the pressure against the artery walls when the heart relaxes between contractions. This is called the diastolic blood pressure.
-
-
Normal: Less than 120/80 mm Hg
-
Elevated: Systolic between 120 and 129 mm Hg and diastolic less than 80 mm Hg
-
Stage 1 hypertension: Systolic between 130 and 139 mm Hg or diastolic between 80 and 89 mm Hg
-
Stage 2 hypertension: Systolic at least 140 mm Hg or diastolic at least 90 mm Hg
-
-
Your obstetrician–gynecologist (ob-gyn) should check your blood pressure at each prenatal care visit. Blood pressure changes often during the day. If you have one high reading, another reading may be taken later during your office visit.
-
Chronic hypertension is high blood pressure that a woman has before getting pregnant or that develops in the first half of pregnancy (before 20 weeks of pregnancy). If you were taking blood pressure medication before you got pregnant—even if your blood pressure is currently normal—you have been diagnosed with chronic hypertension.
-
When you are pregnant, your body makes more blood to support the fetus’s growth. If blood pressure goes up during pregnancy, it can place extra stress on your heart and kidneys. This can lead to heart disease, kidney disease, and stroke. High blood pressure during pregnancy also increases the risk of preeclampsia, preterm birth, placental abruption, and cesarean birth.
-
High blood pressure may reduce blood flow to the placenta. As a result, the fetus may not get enough of the nutrients and oxygen needed to grow.
-
In the first half of pregnancy, blood pressure normally goes down. If your hypertension is mild, your blood pressure may stay that way or even return to normal during pregnancy. But if your blood pressure is 140/90 mm Hg or higher, your ob-gyn may recommend that you start or continue taking blood pressure medication during pregnancy.
-
Your blood pressure should be checked at every prenatal care visit. You may also need to monitor your blood pressure at home. Ultrasound exams may be done throughout pregnancy to track the growth of the fetus. If growth problems are suspected, you may have other tests that monitor the health of the fetus. This testing usually begins in the third trimester of pregnancy.
-
If your condition remains stable, delivery 1 to 3 weeks before your due date (about 37 weeks to 39 weeks of pregnancy) generally is recommended. If you or the fetus develop complications, delivery may be needed even earlier.
-
After delivery, you will need to keep monitoring your blood pressure at home for 1 to 2 weeks. Blood pressure often goes up in the weeks after childbirth. You may need to resume taking medication, or your medication dosage may need to be adjusted.
Talk with your ob-gyn about blood pressure medications that are safe to take if you plan to breastfeed. Do not stop any medications without talking with your ob-gyn.
-
You have gestational hypertension when:
-
You have a systolic blood pressure of 140 mm Hg or higher and/or a diastolic blood pressure of 90 mm Hg or higher.
-
The high blood pressure first happens after 20 weeks of pregnancy.
-
You had normal blood pressure before pregnancy.
Most women with gestational hypertension have only a small increase in blood pressure. But some women develop severe hypertension (defined as systolic blood pressure of 160 mm Hg or higher and/or diastolic blood pressure of 110 mm Hg or higher). These women are at risk of very serious complications.
-
-
All women with gestational hypertension are monitored often (usually weekly) for signs of preeclampsia and to make sure that their blood pressure does not go too high.
-
Although gestational hypertension usually goes away after childbirth, it may increase the risk of developing high blood pressure in the future. If you had gestational hypertension, keep this risk in mind as you take care of your health. Healthy eating, weight loss, and regular exercise may help prevent high blood pressure in the future.
-
Preeclampsia is a serious disorder that can affect all the organs in your body. It usually develops after 20 weeks of pregnancy, often in the third trimester. When it develops before 34 weeks of pregnancy, it is called early-onset preeclampsia. It can also develop in the weeks after childbirth.
-
It is not clear why some women develop preeclampsia. Doctors refer to "high risk" and "moderate risk" of preeclampsia.
Factors that may put you in the “high risk” category include
-
preeclampsia in a past pregnancy
-
carrying more than one fetus (twins, triplets, or more)
-
chronic hypertension
-
kidney disease
-
diabetes mellitus
-
autoimmune conditions, such as lupus (systemic lupus erythematosus or SLE)
-
having multiple moderate risk factors (see below)
Factors that may put you in the “moderate risk” category include
-
being pregnant for the first time
-
being pregnant more than 10 years after your previous pregnancy
-
body mass index (BMI) over 30
-
family history of preeclampsia (mother or sister)
-
being age 35 or older
-
complications in previous pregnancies, such as having a baby with a low birth weight
-
in vitro fertilization (IVF)
-
Black race (because of racism and inequities that increase risk of illness)
-
lower income (because of inequities that increase risk of illness)
-
-
-
Preeclampsia can lead to a condition that causes seizures and stroke.
-
Preeclampsia can cause HELLP syndrome. HELLP stands for hemolysis, elevated liver enzymes, and low platelet count. HELLP syndrome damages or destroys red blood cells and interferes with blood clotting. It can also cause chest pain, abdominal pain, and bleeding in the liver. HELLP syndrome is a medical emergency. Women can die from HELLP syndrome. They can also have lifelong health problems from the condition.
-
-
For women with preeclampsia, early delivery may be needed in some cases. Preterm babies have an increased risk of problems with breathing, eating, staying warm, hearing, and vision. Some preterm complications last a lifetime and require ongoing medical care.
-
Women who have had preeclampsia—especially those whose babies were born preterm—have an increased risk later in life of kidney disease, heart attack, stroke, and high blood pressure. Also, having preeclampsia once increases the risk of having it again in a future pregnancy.
-
Preeclampsia can develop quietly without you being aware of it. Symptoms can include
-
swelling of face or hands
-
headache that will not go away
-
seeing spots or changes in eyesight
-
pain in the upper abdomen or shoulder
-
nausea and vomiting (in the second half of pregnancy)
-
sudden weight gain
-
difficulty breathing
If you have any of these symptoms, especially if they develop in the second half of pregnancy, call your ob-gyn right away.
A woman with preeclampsia whose condition is worsening will develop “severe features.” Severe features include
-
low number of platelets in the blood
-
abnormal kidney or liver function
-
pain in the upper abdomen
-
changes in vision
-
fluid in the lungs
-
severe headache
-
systolic pressure of 160 mm Hg or higher or diastolic pressure of 110 mm Hg or higher
-
-
A high blood pressure reading may be the first sign of preeclampsia. If your blood pressure reading is high, it may be checked again to confirm the results. You may have a urine test to check for protein. You may also have tests to check how your liver and kidneys are working and to measure the number of platelets in your blood.
-
You and your ob-gyn should talk about how your condition will be managed. The goal is to limit complications for you and to deliver the healthiest baby possible.
-
Women who have gestational hypertension or preeclampsia without severe features may be treated in a hospital or as an outpatient. Being an outpatient means you can stay at home with close monitoring by your ob-gyn. You may need to keep track of your fetus’s movement by doing a daily kick count. You may also need to measure your blood pressure at home. Visits to your ob-gyn may be once or twice a week.
At 37 weeks of pregnancy, you and your ob-gyn may talk about delivery. Labor may be induced (started with medications). If test results show that the fetus is not doing well, you may need to have the baby earlier. Women with preeclampsia can have vaginal deliveries, but if there are problems during labor, cesarean birth may be needed.
-
If you have preeclampsia with severe features, you may be treated in the hospital. If you are at least 34 weeks pregnant, you and your ob-gyn may talk about having your baby as soon as your condition is stable.
If you are less than 34 weeks pregnant and your condition is stable, it may be possible to wait to deliver your baby. Delaying delivery for just a few days may be helpful in some cases. It allows time to give corticosteroids, which can help the fetus’s lungs mature. Delaying can also give you time to take medications to reduce your blood pressure and help prevent seizures. If your health or the fetus’s health worsens, you and your ob-gyn should discuss immediate delivery.
Read Preterm Labor and Birth or Extremely Preterm Birth to learn more.
-
Prevention involves identifying whether you have risk factors for preeclampsia and taking steps to address them.
-
Low-dose aspirin may reduce the risk of preeclampsia in some women. Your ob-gyn may recommend that you take low-dose aspirin if
Low-dose aspirin may also be considered if you are Black or if you have a low income, even if you have no other risk factors.
Talk with your ob-gyn about whether you should take aspirin. Do not start taking aspirin on your own without talking with your ob-gyn.
-
If you have high blood pressure and want to get pregnant, see your ob-gyn for a check-up. Your ob-gyn will want to know if your high blood pressure is under control and if it has affected your health.
You may have tests to check how your heart and kidneys are working. Your medications should be reviewed to see if you need to switch to others that are safer during pregnancy. You should also talk about the signs and symptoms of preeclampsia.
-
Arteries: Blood vessels that carry oxygen-rich blood from the heart to the rest of the body.
Body Mass Index (BMI): A number calculated from height and weight. BMI is used to determine whether a person is underweight, normal weight, overweight, or obese.
Cesarean Birth: Birth of a fetus from the uterus through an incision (cut) made in the woman’s abdomen.
Chronic Hypertension: Blood pressure that is higher than normal for a person’s age, sex, and physical condition.
Complications: Diseases or conditions that happen as a result of another disease or condition. An example is pneumonia that occurs as a result of the flu. A complication also can occur as a result of a condition, such as pregnancy. An example of a pregnancy complication is preterm labor.
Corticosteroids: Drugs given for arthritis or other medical conditions. These drugs also are given to help fetal lungs mature before birth.
Diabetes Mellitus: A condition in which the levels of sugar in the blood are too high.
Diastolic Blood Pressure: The force of the blood in the arteries when the heart is relaxed. It is the lower reading when blood pressure is taken.
Fetus: The stage of human development beyond 8 completed weeks after fertilization.
Gestational Hypertension: High blood pressure that is diagnosed after 20 weeks of pregnancy.
HELLP Syndrome: A severe type of preeclampsia. HELLP stands for hemolysis, elevated liver enzymes, and low platelet count.
High Blood Pressure: Blood pressure above the normal level. Also called hypertension.
Hypertension: High blood pressure.
In Vitro Fertilization (IVF): A procedure in which an egg is removed from a woman’s ovary, fertilized in a laboratory with the man’s sperm, and then transferred to the woman’s uterus to achieve a pregnancy.
Kick Count: A record kept during late pregnancy of the number of times a fetus moves over a certain period.
Kidneys: Organs that filter the blood to remove waste that becomes urine.
Lupus: An autoimmune disorder that affects the connective tissues in the body. The disorder can cause arthritis, kidney disease, heart disease, blood disorders, and complications during pregnancy. Also called systemic lupus erythematosus or SLE.
Nutrients: Nourishing substances found in food, such as vitamins and minerals.
Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.
Oxygen: An element that we breathe in to sustain life.
Placenta: An organ that provides nutrients to and takes waste away from the fetus.
Placental Abruption: A condition in which the placenta has begun to separate from the uterus before the fetus is born.
Preeclampsia: A disorder that can occur during pregnancy or after childbirth in which there is high blood pressure and other signs of organ injury. These signs include an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver function, pain in the upper abdomen, fluid in the lungs, or a severe headache or changes in vision.
Prenatal Care: A program of care for a pregnant woman before the birth of her baby.
Preterm: Less than 37 weeks of pregnancy.
Stroke: A sudden interruption of blood flow to all or part of the brain, caused by blockage or bursting of a blood vessel in the brain. A stroke often results in loss of consciousness and temporary or permanent paralysis.
Systolic Blood Pressure: The force of the blood in the arteries when the heart is contracting. It is the higher reading when blood pressure is taken.
Trimester: A 3-month time in pregnancy. It can be first, second, or third.
Ultrasound Exams: Tests in which sound waves are used to examine inner parts of the body. During pregnancy, ultrasound can be used to check the fetus.
Veins: Blood vessels that carry blood from various parts of the body back to the heart.
Don't have an ob-gyn? Search for doctors near you.
FAQ034
Last updated: April 2022
Last reviewed: April 2022
Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.
Pre-eclampsia prediction during extended combined prenatal screening of the first trimester of pregnancy
DOI
https://dx.doi.org/10.18565/aig.2017.12.52-59
State Institution Republican Scientific and Practical Center "Mother and Child" , Minsk, Belarus
Purpose of the study. To assess the possibility of using medical history, biophysical parameters and biochemical markers of combined prenatal screening to predict preeclampsia in the first trimester of pregnancy.
Material and methods. We examined 511 patients (27 with preeclampsia) with singleton pregnancy at 10–13 weeks' gestation. Anamnestic data, mean arterial pressure (MAP), pulsation index (PI) of uterine arteries, trophoblastic proteins were studied. The diagnostic threshold (cut-off point) of the analyzed factors was determined using ROC analysis.
Results. The range of normal values of SBP is 0.94–1.10 MoM, PI is 0.87–1.27 MoM, median PLGF is 1.02 (0.67–1.59) MoM. A preeclampsia prediction scorecard has been developed using 9factors, a diagnostic coefficient (value in points) was calculated for each. With a score of (-2) or more (cut-off point), the patient is at high risk of developing preeclampsia.
Conclusion. The developed method for predicting preeclampsia in the first trimester of pregnancy has a useful assessment (AUC=0.82±0.052, LR+ - 3.21 and LR- - 0.29) and can be used in clinical practice.
pre-eclampsia
combined prenatal screening
Full text of Article
available from the Physician's Library
1. World Health Organization. Recommendations for prevention and treatment of pre-eclampsia and eclampsia. Geneva: WHO Press; 2011. 38p.
2. Roberge S., Nicolaides K.H., Demers S., Villa P., Bujold E. Prevention of perinatal death and adverse perinatal outcome using low-dose aspirin: a meta-analysis. Ultrasound Obstet. Gynecol. 2013; 41(5): 491-9. doi: 10.1002/uog.12421.
3. Villa P.M., Kajantie E., Raikkonen K. Pesonen A.K., Hamalainen E., Vainio M. et al. Aspirin in the prevention of pre-eclampsia in high-risk women: a randomized placebo-controlled PREDO Trial and a meta-analysis of randomized trials. BJOG. 2013; 120(1): 64-74. doi: 10.1111/j.1471-0528.2012.03493.x.
4. The Fetal Medicine Foundation. Protocol for measurement of uterine artery pulsatility index. Available at: https://fetalmedicine.org/research/assess/preeclampsia/background
5. National Heart Foundation of Australia. Guideline for the diagnosis and management of hypertension in adults. 2016. Available at: https://www.heartfoundation.org.au/images/uploads/publications/PRO-167_Hypertension-guideline-2016_WEB.pdf
6. Poon L.C., Zymeri N.A., Zamprakou A., Syngelaki A., Nicolaides K.H. Protocol for measurement of mean arterial pressure at 11-13 weeks gestation. Fetal Diagn. Ther. 2012; 31(1): 42-8. doi: 10.1159/000335366.
7. Petri A., Sabin K. Visual statistics in medicine. Per. from English. ed. V.P. Leonov V.P., red. Moscow: GEOTAR-Media; 2015. 216s.
8. Ministry of Health of the Republic of Belarus, State Institution “Republican Scientific and Practical Center for Medical Technologies, Informatization, Management and Economics of Healthcare”. Health care in the Republic of Belarus: official statistical compilation for 2015. Minsk: GU RNMB; 2016. 281p.
9. Akolekar R., Syngelaki A., Sarquis R., Zvanca M., Nicolaides K.H. Prediction of early, intermediate and late pre-eclampsia from maternal factors, biophysical and biochemical markers at 11-13 weeks. Prenat. Diagn. 2011; 31(1): 66-74. doi: 10.1002/pd.2660.
10. Gregg A.R. Preeclampsia. In: Rimoin D.L., Pyeritz R.E., Bruce R.K., eds. Emery and Rimoin's principles and practice of medical genetics. 6th ed. Elsevier Ltd.; 2013: 1470-83.
11. Audibert F., Boucoiran I., An N., Aleksandrov N., Delvin E., Bujold E. et al. Screening for preeclampsia using first-trimester serum markers and uterine artery Doppler in nulliparous women. Am. J. Obstet. Gynecol. 2010; 203(4): 383. e1-8. doi: 10.1016/j.ajog.2010.06.014.
12. The Darwin Web Server. Interpreting diagnostic tests: the area under an ROC curve. Available at: http://gim.unmc.edu/dxtests/roc3.htm
13. Nicolaides K. Ultrasound examination at 11-13+6 weeks of pregnancy. Per. from English. Mikhailov A., Nekrasova E. St. Petersburg: Petropolis; 2007. 144p. Available at: http://www.fetalmedicine.com/synced/fmf/FMF-Russian.pdf
Received 08/16/2017
Accepted for publication 09/22/2017
Tatyana Vladimirovna Lemeshevskaya, obstetrician-gynecologist, ultrasound specialist , post-graduate student of the laboratory of medical genetics and monitoring of congenital malformations of the State Institution Republican Scientific and Practical Center "Mother and Child". Address: 220053, Republic of Belarus, Minsk, st. Orlovskaya, 66. Phone: (37517) 233-25-86. E-mail: [email protected]. ORCID ID 0000-0003-3911-2715
Oksana Vladimirovna Pribushenya, Candidate of Medical Sciences, Associate Professor, Head of the Laboratory of Medical Genetics and Monitoring of Congenital Malformations of the State Institution Republican Scientific and Practical Center "Mother and Child". Address: 220053, Republic of Belarus, Minsk, st. Orlovskaya, 66
For citation: Lemeshevskaya T.V., Pribushenya O.V. Prediction of preeclampsia during extended combined prenatal screening in the first trimester of pregnancy. Obstetrics and gynecology. 2017; 12:52-9.
https://dx.doi.org/10.18565/aig.2017.12.52-59
Pregnancy and blood pressure
Pressure and pregnancy
Pregnancy is a period when the female body uses its full potential, all its reserves to provide everything necessary for the full bearing of the child.
Blood pressure is one of the main parameters of blood flow intensity in the body. During the period of bearing a baby, a woman’s body is faced with the need to provide oxygen and nutrition not only for herself, but also for her unborn child. A change in the level of pressure during pregnancy becomes an indicator of disturbances in the functioning of the body that threaten the health of a woman and a child, and can also complicate the course of childbirth.
When blood pressure is measured
Blood pressure must be measured at every appointment with an obstetrician-gynecologist or therapist in the antenatal clinic of the expectant mother. But visits to the doctor's office should not be limited. It is necessary to independently measure this indicator in the morning and in the evening, so that the results can be compared, they must be recorded daily in a special notebook. Particular attention to their pressure should be shown by those women who previously had toxicosis of pregnancy, miscarriages, miscarriages. Women with hypertension, overweight, neurocircular and vegetovascular dystonia, diseases of the kidneys, heart, blood vessels should be on a special account, and measure pressure as often as recommended by the doctor.
The hourly measurement of blood pressure in at-risk pregnant women is called 24-hour monitoring. It is done three times during the entire period of pregnancy. The first time - at the very beginning of pregnancy, to identify a woman's tendency to hypertension, the second time - at 24-28 weeks of pregnancy, to identify a predisposition to preeclampsia or late toxicosis of pregnant women, the third time - before childbirth, to determine the degree of risk to the woman and the fetus , as well as to resolve the issue of the method of obstetrics.
If there are problems with pressure in a pregnant woman, then it is necessary to visit a cardiologist and a therapist who can advise what needs to be done to solve the problem of pressure during pregnancy.
Types of blood pressure monitors
There are two types of blood pressure monitors (blood pressure monitor) - mechanical and electronic.
- Mechanical blood pressure monitor used by physicians. It gives the most accurate results. You can learn how to use a mechanical tonometer at home. However, taking blood pressure on your own is very difficult, so if you want to use this type of blood pressure monitor, you will need an assistant.
- Electronic blood pressure monitor is easier to use. It is enough to put the cuff on your arm and press the button. The device itself will do the rest, and you will only have to read the results on the electronic scoreboard. An electronic tonometer shows the value of blood pressure and pulse, memorizing the indicators. There are blood pressure monitors, the cuff of which can be worn on the shoulder, on the wrist and even on the finger. For the home, the most suitable device is the cuff of which is worn on the shoulder. Wrist or finger gauges can be used to measure blood pressure at work or while traveling.
Correct measurement of blood pressure
Do not immediately panic about high or low pressure during pregnancy, you need to make sure that the measurement is correct.
There are several important rules for the correct determination of blood pressure:
- Before measuring, sit down and rest for a couple of minutes, think about something pleasant. Stress is one of the factors in the short-term increase in pressure.
- Place the cuff on your bare arm or thin fabric. It must be sized.
- Measure blood pressure on both arms.
- Never round the received numbers and write them down.
- It is not recommended to determine the level of blood pressure after a meal or after exercise.
Blood pressure during pregnancy: norm and deviations
Blood pressure is the pressure force of blood flow on the wall of blood vessels. It is measured in millimeters of mercury (mm Hg) and is written in two numbers separated by a slash.
The first digit shows the pressure at the moment of maximum contraction of the heart (systolic blood pressure), and the second - at the time of its complete relaxation (diastolic blood pressure). If blood pressure is normal, we can safely say that the mother’s cardiovascular system is doing its job, which means that all organs receive a sufficient amount of oxygen and nutrients brought with the bloodstream.
Outside of pregnancy, normal blood pressure ranges from 100/60 to 130/80 mmHg. Art. During pregnancy, the pressure may differ slightly from the original: if it is 10% lower or higher than usual, then such changes are still within the normal range. If the pressure is lower or higher than usual by 15–20% or more, then we are dealing with arterial hypotension (low blood pressure) or arterial hypertension (high blood pressure). It is desirable for a woman to know her usual level of pressure, which was before pregnancy, so that the doctor can draw the right conclusions.
1.1 What is the danger of changes in blood pressure
During pregnancy, nutrients and oxygen are constantly supplied to the fetus through the vasculature of the placenta, and the products of its vital activity are returned to the mother.
This exchange is only possible at an optimum pressure level. Changes in blood pressure in one direction or the other can have adverse consequences.
Under reduced pressure, transport deteriorates and the amount of substances needed by the child decreases, which can lead to fetal growth retardation syndrome. And a significant increase in blood pressure can cause damage to microvessels, foci of hemorrhages are formed, which can lead to placental abruption. That is why during pregnancy it is so important to control blood pressure and keep it at an optimal level.
Normal blood pressure during pregnancy
The norms of blood pressure accepted in general medicine range from 100/60 to 120/80 mm Hg. But during pregnancy, these indicators may change somewhat. Usually in the early stages (the entire 1st trimester and up to 20 weeks), these numbers slightly decrease, which is associated with a change in the hormonal background of the whole organism and a restructuring of metabolic processes.
Later, as the fetus grows and develops more intense blood flow to feed it, the pressure may increase relative to "non-pregnant" values. Because of this, the average norms for expectant mothers lie in a wider range - from 105/60 to 139/89 mmHg
Significant deviations from this range upwards are called gestational hypertension, and downwards are called hypotension.
Low blood pressure during pregnancy or hypotension
In the first months of pregnancy, the hormonal background of the expectant mother undergoes significant changes, works with great stress, creating a favorable background for the development of the child, and these changes are often accompanied by a decrease in blood pressure, hypotension.
1.1.1 Possible causes of hypotension
Sometimes it is impossible to determine the cause that provoked the appearance of such a violation, but the following may play a role in its development:
- Hormonal changes;
- NDC for hypotonic type;
- Infectious diseases;
- Liver pathology;
- Taking certain medications;
- Features of woman's emotionality.
Pregnancy hypotension is often not perceived as a serious threat to the health and progress of pregnancy. However, it can be a serious pathogenic factor that provokes various disorders of the course of pregnancy:
- Termination of pregnancy
- Fetal growth retardation
- Oxygen starvation baby
- Weak labor activity
- Possible bleeding after separation of the placenta
- Relaxation of the uterus after childbirth and rebleeding
1.1.2 Main symptoms of hypotension:
- Nausea, vomiting
- Headache
- Tinnitus
- Shortness of breath
- Dizziness
- Increased fatigue
- Drowsiness
- Pale skin
- Increased perspiration
- Loss of consciousness
1.1.3 How to increase blood pressure or what to do with low blood pressure
As a general rule, women with low blood pressure are not hospitalized unless there is a risk to the baby. Expectant mothers are observed by an obstetrician-gynecologist, a therapist and, if necessary, a cardiologist. Most often, in the third trimester, the pressure returns to normal.
Pregnant women should adhere to the following recommendations:
- Get at least 8 hours of sleep (optimally 9-10 hours) and rest during the day if possible.
- Spend more time outdoors (at least 2 hours a day).
- Food should be taken in small portions, but throughout the day.
- Moderate physical activity recommended - do prenatal gymnastics; if possible, swim.
- Useful water treatments - showers, douches, contrast foot baths, as well as massage; physiotherapy (electrosleep, salt-coniferous and mineral baths) and acupuncture are successfully used for treatment.
- If necessary, doctors can prescribe drug therapy: usually, pregnant women are prescribed herbal preparations that increase the tone of the autonomic nervous system, such as eleutherococcus extracts, radiols, tinctures of magnolia vine, aralia, zamaniha in combination with sedatives (valerian, motherwort), as well as drugs based on caffeine.
If a pregnant woman has lost consciousness due to a sudden drop in blood pressure, the first thing to do is to lay her horizontally on her side and call an ambulance. Then open the door or window, unfasten the collar, give a sniff of ammonia. You can massage the area between the nose and lip or act on the fingertips on the hands.
High blood pressure during pregnancy or hypertension
Arterial hypertension is a disease characterized by a persistent increase in blood pressure. The changes that occur in the body during pregnancy predispose to the development of hypertension and therefore pregnant women are at a higher risk of developing hypertension than the general population. Arterial hypertension is a risk factor for various complications of pregnancy and ranks second in the list of causes of maternal death. At the same time, the diagnosis and treatment of arterial hypertension in pregnant women requires a special approach.
If before pregnancy you noted that your blood pressure was higher than normal, took pills, visited the appropriate doctors, be prepared that this problem will come up now. And, most likely, it will manifest itself with greater force.
Remember: now the situation is completely different, you do not need to take the same pills as before pregnancy.
Forms of arterial hypertension during pregnancy
Arterial hypertension of pregnancy is an increase in blood pressure during pregnancy. It is regarded as a persistent increase in systolic blood pressure above 140 mm Hg. and diastolic blood pressure above 90 mmHg in women with normal blood pressure before pregnancy. Women with such an increase in pressure require close medical supervision.
There are several types of arterial hypertension during pregnancy:
- Chronic hypertension is characterized by the presence of high blood pressure before pregnancy and its persistence after pregnancy.
- Arterial hypertension of pregnancy is a persistent increase in blood pressure that develops after the 20th week of pregnancy, which disappears at the end of pregnancy.
- Pre-eclampsia/eclampsia is a severe impairment of the cardiovascular system and kidneys during pregnancy, which includes: hypertension and impaired renal function.
In pregnant women, arterial hypertension occurs with a frequency of 4-8%, which is a very high figure, especially if we take into account the young age of most expectant mothers. During pregnancy, the woman's body adapts to new conditions of functioning, which include ensuring the life and development of the fetus. On the part of the cardiovascular system in the body of a pregnant woman, the following changes occur:
- An increase in the volume of circulating blood and the appearance of a placental circulatory system is necessary for the nutrition and development of the child. In pregnant women, the volume of circulating blood increases by 25-30%, which, in addition to ensuring the nutrition of the child, allows women to lose part of the blood during childbirth, without significant damage to health.
- Increased heart rate.
- An increase in intra-abdominal pressure, an increase in the diaphragm and a change in the position of the heart in the chest due to a significant increase in the size of the uterus.
- Gradual weight gain in a pregnant woman.
Possible other causes of high blood pressure
- Exercise
- Drinking strong tea or coffee
- Chronic stress, fatigue, lack of sleep, emotional stress
- Smoking, alcohol abuse
- Unbalanced diet, lack of vitamins and minerals
- Obesity, overweight
- Multiple pregnancy
- Lack of physical activity
- Diseases of the thyroid gland
- Diseases of the adrenal glands
- Diabetes mellitus
- Head, brain and spinal cord injuries
- Encephalitis
- Myelitis
- Diseases of the heart and blood vessels
- Renal dysfunction
- Hereditary predisposition
Main symptoms of hypertension:
- Headache
- Nausea, vomiting
- Dizziness, weakness, impotence
- Redness of the skin of the hands and face
- Noise or ringing in the ears
- Visual impairment
- Edema
- Urinary protein excretion
- Convulsions
High blood pressure can cause complications such as retinal detachment or retinal haemorrhage, which can lead to partial or complete loss of vision.
If blood pressure began to rise in the second or third trimester of pregnancy, then we are probably dealing with a serious complication of pregnancy - preeclampsia.
Preeclampsia is a special condition that occurs only during pregnancy and ends with its completion. The manifestations of preeclampsia are varied, but the classic symptoms are:
- arterial hypertension
- edema
- proteinuria (protein in urine)
With preeclampsia, there is a violation of microcirculation in all vital organs: the blood supply to the brain worsens, kidney failure develops, the blood becomes viscous, and the resulting microthrombi disrupt the work of all organs and systems. Of particular danger is such damage to the vessels of the placenta and the brain. The most severe manifestation of preeclampsia - eclampsia - convulsive seizures, ending in a cerebral coma.
But preeclampsia often begins with a pathological increase in body weight. Expectant mothers often wonder why this doctor pays such attention to weight. Well, think about it, added a couple of extra pounds.
But after all, such an increase is due to fluid retention in the body, or the so-called latent edema.
And if treatment is not started in time, all manifestations of preeclampsia will not be long in coming. If there was an increase in blood pressure before the onset of pregnancy, then its successful course is possible only with good preparation and the correct selection of drugs that reduce pressure. With uncomplicated hypertension and a slight increase in pressure, only non-drug measures are sufficient.
More about preeclampsia
Treatment and prevention of arterial hypertension during pregnancy
Treatment of arterial hypertension during pregnancy is a complex and responsible task. Therefore, the basis of any type of treatment should be close cooperation between the patient and the doctor.
In the treatment of arterial hypertension in pregnancy, as well as in the treatment of arterial hypertension, the following methods are used: non-drug treatment and drug treatment.
Non-drug treatment, i.e. treatment without drugs, is the most appropriate treatment for hypertension during pregnancy, since many of the drugs used in the treatment of this disease can be dangerous to the fetus.
What to do with pressure, how to reduce pressure during pregnancy
Non-drug treatment and prevention of arterial hypertension includes:
- Diet. The main requirements for the diet of women suffering from hypertension are a reduction in the consumption of table salt, coffee, tea, and the rejection of bad habits. The allowable amount of salt per day for patients with hypertension is 5 grams, while the calculation must include not only the salt with which we season food, but also the salt contained in various foods.
- Physical activity. Moderate physical activity has a positive effect on the general condition of the body, promotes fat burning, normalizes metabolism, improves blood supply to internal organs and the fetus, increases muscle tone and helps to establish the correct position of the fetus in the uterus. For the treatment and prevention of arterial hypertension during pregnancy, daily physical activity in the form of gymnastics (preferably with an instructor), hiking in the fresh air, and swimming are recommended.
- Maintenance of normal body weight. The common expression that during pregnancy a woman "should eat for two" is not true. In fact, an "energy supplement" during pregnancy should not exceed 350 kcal. At the same time, maintaining normal body weight during pregnancy is extremely important for maintaining the health of the pregnant woman herself and her child (obesity contributes to the development of hypertension and diabetes). The normal weight gain of a pregnant woman by the end of pregnancy should not exceed 12 kg.
Drug treatment of hypertension during pregnancy should be carried out under the supervision of a specialist doctor and only with safe drugs.
- With a single slight increase in pressure, treatment begins with the appointment of sedative natural drugs, for example: valerian, motherwort, novopassitis and others.