High systolic blood pressure pregnancy

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.

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FAQ034
Last updated: April 2022
Last reviewed: April 2022

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.

High blood pressure during pregnancy

High blood pressure can cause problems for you and your baby during pregnancy, including preeclampsia and premature birth.

High blood pressure usually doesn’t cause signs or symptoms. Go to all of your prenatal care visits so your provider can check your blood pressure.

If you need medicine to keep your blood pressure under control, take it every day.

If you’re at high risk for preeclampsia, your provider may want you to take low-dose aspirin to help prevent it.

What is high blood pressure?

Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body. Each time your heart beats, it pumps blood to the arteries. If the pressure in your arteries becomes too high, you have high blood pressure (also called hypertension). High blood pressure can put extra stress on your organs. This can lead to heart attack, heart failure, stroke and kidney failure.

Some women have high blood pressure before they get pregnant. Others have high blood pressure for the first time during pregnancy. About 8 in 100 women (8 percent) have some kind of high blood pressure during pregnancy. If you have high blood pressure, talk to your health care provider. Managing your blood pressure can help you have a healthy pregnancy and a healthy baby.

How do you know if you have high blood pressure?

Your blood pressure reading is given as two numbers:

Systolic blood pressure. This is the upper (first) number in your reading. It’s the pressure when you heart contracts (gets tight). Your blood pressure is highest when your heart beats and pumps blood.
Diastolic blood pressure. This is the lower (second) number in your reading. It’s the pressure when your heart relaxes. Your blood pressure falls because your heart is at rest between beats.

Your blood pressure reading fits into one of five categories:

Normal. Your blood pressure is less than 120/80.
Elevated. This is when your systolic blood pressure is between 120-129 and your diastolic pressure is less than 80.
Stage 1 high blood pressure. This is when your systolic pressure is between 130-139 or your diastolic pressure is between 80-89.
Stage 2 high blood pressure. This is when your systolic pressure is at least 140 or your diastolic is at least 90.
Hypertensive crisis. This is when your systolic pressure is higher than 180 and/or your diastolic pressure is higher than 120. Call your health care provider right away if your blood pressure is this high.

At each prenatal care checkup, your provider checks your blood pressure. To do this, she wraps a cuff (band) around your upper arm. She pumps air into the cuff to measure the pressure in your arteries when the heart contracts and then relaxes. If you have a high reading, your provider can recheck it to find out for sure if you have high blood pressure. Your blood pressure can go up or down during the day.

What pregnancy complications can high blood pressure cause?

High blood pressure can cause problems for you and your baby during pregnancy, including:

Problems for moms include:

Preeclampsia. This is when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Signs and symptoms of preeclampsia include having protein in the urine, changes in vision and severe headaches. Preeclampsia can be a serious medical condition. Even if you have mild preeclampsia, you need treatment to make sure it doesn’t get worse. Without treatment, preeclampsia can cause serious health problems, including kidney, liver and brain damage. In rare cases, it can lead to life-threatening conditions called eclampsia and HELLP syndrome. Eclampsia causes seizures and can lead to coma. HELLP syndrome is when you have serious blood and liver problems. HELLP stands for hemolysis (H), elevated liver enzymes (EL), low platelet count (LP).
Gestational diabetes. This is a kind of diabetes that only pregnant women get. It’s a condition in which your body has too much sugar (also called glucose). Most women get a test for gestational diabetes at 24 to 28 weeks of pregnancy.
Heart attack (also called myocardial infarction).
Kidney failure. This is a serious condition that happens when the kidneys don’t work well and allow waste to build up in the body.
Placental abruption. This is a serious condition in which the placenta separates from the wall of the uterus before birth. If this happens, your baby may not get enough oxygen and nutrients in the womb. You also may have serious bleeding from the vagina. The placenta grows in the uterus and supplies the baby with food and oxygen through the umbilical cord.
Postpartum hemorrhage (also called PPH). This is when a woman has heavy bleeding after giving birth. It’s a serious but rare condition. It usually happens 1 day after giving birth, but it can happen up to 12 weeks after having a baby.
Pulmonary edema. This is when fluid fills the lungs and leads to shortness of breath.
Stroke. This is when blood flow to your brain stops. Stroke can happen if a blood clot blocks a vessel that brings blood to the brain or when a blood vessel in the brain bursts open.
Pregnancy related death. This is when a woman dies during pregnancy or within 1 year after the end of her pregnancy from health problems related to pregnancy.

If you have high blood pressure during pregnancy, you’re also more likely have a cesarean birth (also called c-section). This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.

Problems for babies include:

Premature birth. This is birth that happens too early, before 37 weeks of pregnancy. Even with treatment, a pregnant woman with severe high blood pressure or preeclampsia may need to give birth early to avoid serious health problems for her and her baby.
Fetal growth restriction. High blood pressure can narrow blood vessels in the umbilical cord. This is the cord that connects the baby to the placenta. It carries food and oxygen from the placenta to the baby. If you have high blood pressure, your baby may not get enough oxygen and nutrients, causing him to grow slowly.
Low birthweight. This is when a baby is born weighing less than 5 pounds, 8 ounces.
Fetal death. When a baby dies spontaneously in the womb at any time during pregnancy.
Neonatal death. This is when a baby dies in the first 28 days of life.

What kinds of high blood pressure can affect pregnancy?

Two kinds of high blood pressure that can happen during pregnancy:

Chronic hypertension. This is high blood pressure that you have before you get pregnant or that develops before 20 weeks of pregnancy. It doesn’t go away once you give birth. About 1 in 4 women with chronic hypertension (25 percent) has preeclampsia during pregnancy. If you’re at high risk for preeclampsia, your provider may treat you with low-dose aspirin to prevent it.
If you have chronic hypertension, your provider checks your blood pressure and urine at each prenatal care visit. You may need to check your blood pressure at home, too. Your provider may use ultrasound and fetal heart rate testing to check your baby’s growth and health. Your provider also checks for signs of preeclampsia.
If you were taking medicine for chronic hypertension before pregnancy, your provider makes sure it’s safe to take during pregnancy. If it’s not, he switches you to a safer medicine. Some blood pressure medicines, called ACE inhibitors and angiotensin receptor blockers, can harm your baby during pregnancy.
During the first half of pregnancy, blood pressure often falls. If you have mild hypertension and took medicine for it before pregnancy, your provider may lower the dose of medicine you take. Or you may be able to stop taking medicine during pregnancy. Don’t stop taking any medicine before you talk to your health care provider. Even if you didn’t take blood pressure medicine in the past, you may need to start taking it during pregnancy.
Gestational hypertension. This is high blood pressure that only pregnant women can get. It starts after 20 weeks of pregnancy and usually goes away after you give birth. It usually causes a small rise in blood pressure, but some women develop severe hypertension and may be at risk for more serious complications later in pregnancy, like preeclampsia.

During pregnancy, your provider checks your blood pressure and urine at every prenatal care checkup. She may use ultrasound and fetal heart rate testing to check your baby’s growth and health. Your provider may ask you to check your blood pressure at home and do kick counts to see when and how often your baby moves. Here are two ways to do kick counts:

Every day, time how long it takes for your baby to move ten times. If it takes longer than 2 hours, tell your provider.
See how many movements you feel in 1 hour. Do this three times each week. If the number changes, tell your provider.

We don’t know how to prevent gestational hypertension. But if you’re overweight or obese, getting to a healthy weight before pregnancy may lower your chances of having this condition. And even though gestational hypertension usually goes away after birth, you may be more likely to develop hypertension later in life. Healthy eating, staying active and getting to a healthy weight after pregnancy can help prevent high blood pressure in the future.

How can you manage high blood during pregnancy?

Here’s what you can do:

Go to all your prenatal care checkups, even if you’re feeling fine.
If you need medicine to control your blood pressure, take it every day. Your provider can help you choose one that’s safe for you and your baby.
Check your blood pressure at home. Ask your provider what to do if your blood pressure is high.
Eat healthy foods. Don’t eat foods that are high in salt, like soup and canned foods. They can raise your blood pressure.
Stay active. Being active for 30 minutes each day can help you manage your weight, reduce stress and prevent problems like preeclampsia.
Don’t smoke, drink alcohol or use street drugs or abuse prescription drugs.

What can you do about high blood pressure before pregnancy?

Here’s what you can do:

Get a preconception checkup. This is a medical checkup you get before pregnancy to take care of health conditions that may affect your pregnancy.
Use birth control until your blood pressure is under control. Birth control is methods you can use to keep from getting pregnant. Condoms and birth control pills are examples of birth control.
Get to a healthy weight. Talk to your provider about the weight that’s right for you.
Eat healthy foods.
Do something active every day.
Don’t smoke. Smoking is dangerous for people with high blood pressure because it damages blood vessel walls.

Last reviewed: February, 2019

See also: Preeclampsia, HELLP syndrome

Hypertension in pregnancy

High blood pressure during pregnancy

Changes in blood pressure (BP) in women during pregnancy are observed quite often, which can adversely affect the mother and fetus. Blood pressure is one of the most important indicators of the functioning of the circulatory system in the body. During pregnancy, all organs and systems of the mother work with increased stress, especially the cardiovascular system. Therefore, it is necessary to regularly measure blood pressure to prevent the development of severe complications. At the beginning of pregnancy, blood pressure, as a rule, decreases slightly, which is associated with the action of hormones. In later pregnancy, as the fetus grows and blood flow increases to feed it, blood pressure may increase relative to pre-pregnancy physiological values. Hypertension is said to occur when a pregnant woman's blood pressure exceeds 140/9.0 mmHg However, in women with low blood pressure before pregnancy, arterial hypertension may be at blood pressure levels that are usually considered normal. Therefore, it is important to know your normal blood pressure.

Why is high blood pressure dangerous during pregnancy?

High blood pressure during pregnancy poses a great danger to the mother and fetus. Against this background, vasoconstriction occurs and the blood supply to all vital organs, including the placenta, is disrupted. Due to the lack of essential nutrients and oxygen, the process of growth and development of the fetus slows down. There is a serious danger of placental abruption, which is accompanied by bleeding and threatens the life of the mother and fetus. High blood pressure during pregnancy can lead to the development of a dangerous pregnancy complication - preeclampsia. Edema, large weight gain, and the presence of protein in the urine can also be a manifestation of preeclampsia. Very dangerous symptoms of preeclampsia are: headache, blurred vision ("flies", "veil" before the eyes), pain in the upper abdomen. Deterioration of the general condition may be accompanied by dizziness, tinnitus, nausea, vomiting. Pre-eclampsia can provoke a formidable complication - eclampsia. In this condition, the pregnant woman loses consciousness and convulsions occur. nine0005

Register for pregnancy at the antenatal clinic as early as possible!

A very important feature of arterial hypertension during pregnancy is that often even with high blood pressure numbers, the patient feels normal. High blood pressure is detected by chance, at the next appearance in the antenatal clinic. The absence of clinical manifestations of elevated blood pressure does not exclude the development of dangerous complications.

In order to detect unwanted deviations during pregnancy in time and prevent the development of complications in the mother and fetus, pregnant women need to regularly monitor their blood pressure. It is very important to register for pregnancy in a antenatal clinic in a timely manner. The doctor will promptly detect changes in blood pressure and prescribe the optimal therapy to maintain blood pressure in the normal range. If a woman had high blood pressure before pregnancy, and she is taking medications, it is necessary to adjust the treatment and individually select the drugs that can be taken during pregnancy. To prevent high blood pressure, a pregnant woman should eat a healthy and balanced diet, observe a drinking regimen, and monitor weight gain. The correct recommendations on these issues will also be given by the doctor of the antenatal clinic. A pregnant woman must follow the recommendations and not violate the prescribed therapy. nine0005

What to do if a pregnant woman has high blood pressure?

If a pregnant woman regularly monitors blood pressure on her own and notes even a slight increase with good health, she should visit the doctor of the antenatal clinic as soon as possible (before the scheduled next visit). Self-administration of drugs in this case is strictly prohibited. Before visiting a doctor, you can reduce blood pressure by taking a mild sedative based on motherwort or valerian. nine0005

If necessary, you can consult with an obstetrician-gynecologist of the remote medical advisory panel of the Ambulance and Emergency Medical Care Station. A.S. Puchkov, Moscow by phone: (495) 620-42-44.

When is it necessary to call an ambulance?

If blood pressure rises suddenly, you feel unwell, urgent hospitalization is necessary, and it is advisable for the patient to immediately call an ambulance team. Such signs as: headache, feeling of flashing dots or "flies", a veil before the eyes, pain in the upper abdomen, nausea, vomiting, agitation or depression, along with this - an increase in blood pressure should alert. There may be a high convulsive readiness, which is manifested by twitching of the muscles of the face, neck, upper limbs, loss of consciousness, convulsions are possible. nine0005

What to do before the ambulance arrives?

First of all, go to bed, if possible, eliminate all unwanted irritants (turn off all sources of noise, close the curtains), do not leave the pregnant woman alone, as convulsions may occur and help will be needed. Give it a position with a raised head end. It is possible to take pressure-lowering drugs prescribed by a doctor. If a woman has not previously taken antihypertensive drugs, then drugs should not be taken on the advice of others. nine0005

If an attack of convulsions occurs, the pregnant woman should be laid on a flat surface, turn her head to the side (to prevent aspiration of vomit), protect from damage (cover with a blanket), do not hold physically. After an attack, clean the oral cavity with a napkin from vomit, blood and mucus. Wait for the ambulance to arrive!

The ambulance will arrive quickly and provide the necessary assistance. Hospitalization in this condition is mandatory. Only in a hospital is it possible to fully monitor the condition of the mother and child, complete therapy and determine the delivery plan. nine0005

We wish you health and happy motherhood!

Chief Specialist

in Obstetrics and Gynecology Arkhipova N.L.

High blood pressure during pregnancy

But its meaning is not always correctly controlled and interpreted. Let's see how to properly control blood pressure during pregnancy , what kind of blood pressure is considered elevated, why it can rise and what should be done with it, and what should not be done.

Blood pressure measurement

Blood pressure is monitored using a tonometer: electronic, semi-automatic or mechanical. You can buy any that you can handle and the cuff of which suits you in diameter. The only thing to consider is that the blood pressure cuff should be worn on the upper arm, carpal blood pressure monitors are too inaccurate and cannot be relied upon. nine0005

Measurement of blood pressure is best done in a sitting position, and after you have spent about fifteen minutes in this position, in a state of physical and emotional rest, you do not need to talk while measuring blood pressure.

The cuff is worn on the shoulder freed from clothing, its lower edge should be a few centimeters above the elbow. The arm on which blood pressure is measured should be in a relaxed position, the cuff should be located approximately at the level of the heart. Measurement is performed on one arm, measurement on two arms, which was previously required for all pregnant women, is now excluded from all clinical recommendations. nine0005

When measuring with a mechanical sphygmomanometer , air is inflated into the cuff to the digits, approximately twenty to thirty mm. rt. Art. higher than expected blood pressure. The air from the cuff is released slowly, the appearance of sound marks the numbers of systolic blood pressure, the disappearance of the sound - diastolic. This is not "cardiac" and "renal" pressure, but - systolic and diastolic.

Measurement of blood pressure is carried out at each visit to the obstetrician-gynecologist - office measurement of blood pressure, at home of the pregnant woman herself or her relative - outpatient measurement of blood pressure. If necessary, the doctor may recommend that the patient keep a blood pressure diary - measure blood pressure several times a day for some time, writing down the numbers. Ceteris paribus, more reliable information is obtained from outpatient (at home) measurements. nine0005

If there is doubt about the correctness of the patient's blood pressure measurement or if there is a suspicion of an increase in blood pressure at night, the doctor may prescribe the patient 24-hour blood pressure monitoring (ABPM), in which blood pressure is measured automatically at certain intervals within one day.

In general, during pregnancy, blood pressure in the first trimester is lower than normal for the patient, in the second or third it returns to her usual numbers, by the third trimester it may be slightly higher, but within the normal range. Blood pressure below 140/9 is considered normal during pregnancy.0 mm. rt. Art.

If the patient is prone to arterial hypotension (low blood pressure), elevated blood pressure is still considered to be blood pressure above 140/90 mm. rt. Art., lower figures do not require any additional examination or treatment, even if they are higher than usual for the patient. None of the clinical guidelines for the treatment of arterial hypertension during pregnancy indicate the need for treatment with higher blood pressure than usual, but not reaching a value of 140/90 mm. rt. Art.

AD 140/90 mm. rt. Art. and above must be recorded 2 or more times with an interval between measurements of at least 4 hours to be considered hypertension.

Causes of high blood pressure

There are three causes of high blood pressure during pregnancy: chronic arterial hypertension, gestational arterial hypertension and preeclampsia.

Chronic arterial hypertension is the general name for all cases of high blood pressure that existed before pregnancy. Chronic arterial hypertension is not divided into primary (due to unknown causes) and secondary (resulting from a disease), in contrast to arterial hypertension detected outside of pregnancy. Also, chronic arterial hypertension includes situations when a woman did not control blood pressure before pregnancy, and for the first time an increase in blood pressure was detected only in the first half (up to 20 weeks) of pregnancy. nine0005

Gestational hypertension occurs from the twentieth week until the end of the term, and is not accompanied by the excretion of protein in the urine.

Pre-eclampsia, in contrast to gestational hypertension, also develops after the 20th week of pregnancy, and is accompanied by the release of protein into the urine (proteinuria). Preeclampsia can also occur after delivery. Signs of an increase in the severity of preeclampsia are the appearance of a headache, dizziness, visual disturbances, pain in the solar plexus and / or in the right hypochondrium, pain under the right shoulder blade, respiratory failure, and some changes in blood tests. These signs require urgent hospitalization. nine0005

The extreme case of preeclampsia - eclampsia - is characterized by the occurrence of convulsions and threatens the life of both the mother and the child, therefore, it requires an emergency delivery, regardless of the gestational age, only in this way it becomes possible to save the life of the mother and child.

Since an increase in blood pressure may occur before proteinuria in preeclampsia, it is possible to distinguish gestational arterial hypertension from preeclampsia only in retrospect - if blood pressure increased, and protein did not appear in the daily urine, it can be said with certainty that this increase in blood pressure was due to specifically gestational hypertension. nine0107 Preeclampsia may be associated with chronic arterial hypertension that existed before pregnancy.

Treatment of Hypertensive Disorders

Hypertensive disorders are an important cause of maternal and perinatal death, increase the rate of preterm birth, and are indeed a serious problem and should not be ignored.

The only one to date proven effective in preventing preeclampsia drug is acetylsalicylic acid. It is prescribed starting from the 13th week of pregnancy at a low dose and at this dosage does not lead to impaired fetal development, unlike high doses.

Treatment of any arterial hypertension during pregnancy is prescribed only by a doctor.

In chronic arterial hypertension uncomplicated by damage to other organs, treatment is started at BP 150/90 mm. rt. Art. and more, with gestational arterial hypertension and preeclampsia - with blood pressure 140/90 mm. rt. Art. and more.

BP should be maintained at 130-150/80/95 mmHg during treatment. rt. Art., since a more radical decrease in blood pressure is fraught with impaired blood supply to the fetus and is not recommended.

There are several groups of antihypertensive drugs, the use of which during pregnancy can lead to impaired fetal development or death, so they should not be used during pregnancy. These are angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists. Do not use during pregnancy and diuretics (drugs with a diuretic effect). nine0107 Treatment is usually initiated with methyldopa, but it is also possible to use certain drugs from the group of beta-blockers and some drugs from the group of calcium antagonists, which are best studied from the point of view of safety in pregnancy. It is possible to use combinations of these drugs.

Separately, a few words should be said about magnesium sulfate (magnesium sulphate). This drug has practically no antihypertensive effect, and its use during pregnancy is limited only to preeclampsia, which threatens the development of eclampsia. It is needed to prevent the development of seizures (neuroprotective effect). It should not be used to influence elevated blood pressure. nine0005

Hypertension during pregnancy, delivery is usually through the natural birth canal, except in cases of severe pre-eclampsia, eclampsia and their complications, requiring emergency delivery by caesarean section, regardless of the gestational age for health reasons.

Chronic arterial hypertension that persists during lactation and is not complicated by damage to other organs does not require medical treatment for blood pressure less than 150/95 mm. rt. Art. Arterial hypertension after childbirth does not require stopping breastfeeding; on the contrary, the protective effect of lactation in arterial hypertension has been proven.

If it is necessary to prescribe drug therapy , drugs are selected that are the least likely to be excreted into breast milk, the use of which has not been recorded serious side effects in the child.