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High blood pressure in pregnancy can have serious consequences for both mother and baby. High blood pressure can cause a woman's stroke or heart attack, as well as impaired development of the fetus. That is why it is so important to check the pressure during pregnancy regularly.
With dr. n.med. Tomasz Maciejewski, specialist gynecologist, obstetrician, clinical director of the Institute of Mother and Child, interviewed by Marta Radzik-Maj.
Does problems with hypertension in pregnancy affect women who have already had high blood pressure?
Yes, but not only. There are several types ofhypertensionin pregnant women. The first occurs before pregnancy and is usually a derivative of kidney, heart, circulatory system diseases, and endocrine problems. The second is pregnancy-induced hypertension, also known as pregnancy poisoning or gestosis. It appears after the 20th week of pregnancy. It may be accompanied by swelling and loss of protein in the urine, the so-called proteinuria.
Why pregnancy can cause high blood pressure?
There is no clear theory on this, there are several hypotheses. The most likely one seems to be an imbalance between the mother's tissues and the baby's tissues. Remember thatpregnancyis a kind of transplant, the mother's body has to accept it. To this end, a woman's blood produces substances that prevent the fetal tissue from being recognized as foreign by the mother's blood cells. When this process is disturbed, i.e. when there is no immune tolerance, the placenta tissues are destroyed and the mother is secreted of vasoconstrictors, which increases blood pressure. The vascular epithelium in the kidneys may also be damaged, which results in the loss of protein in the urine.
Is hypertension in pregnancy always dangerous?
Women who have had high blood pressure before and who do not have symptoms of gestational hypertension generally get pregnant just like he althy women. Sometimes we even observe better blood pressure control. However, it is important that the pregnancy of a woman with hypertension is planned, as it is often necessary to treat and regulate the pressure earlier. If you are taking any medications, you are changed to medications that are safe for the developing baby. If, on the other hand, the pre-pregnancy hypertension is combined with edema, proteinuria or in the pregnant womanpregnancy hypertension appears, then it can be dangerous. For both mother and baby.Important
According to the World He alth Organization (WH0), hypertension occurs when blood pressure exceeds 140/90 mmHg.
Pregnancy stops developing properly?
Yes, high blood pressure can cause hypoxia and developmental problems in your baby. For example, the fetus may stop intrauterine growth, the so-called hypotrophy, premature detachment of the placenta and even intrauterine fetal death. The mother is at risk of very serious complications, such as stroke, heart attack, and circulatory failure, especially if high blood pressure is accompanied by edema and proteinuria. An extremely dangerous complication of gestational hypertension is the so-called eclampsia, which can occur with very high blood pressure and proteinuria. It's a seizure like an epilepsy attack. The maternal and fetal mortality then exceeds 50 percent.
What can be done to avoid such complications?
The most important thing is to check the pressure regularly, so pregnant women have their blood pressure checked each time they visit the gynecologist. If its increased values are found, a number of other additional tests are performed. A pregnant woman with hypertension should avoid effort and stress, so if she works professionally, she is on a sick leave.You must do it
Do not underestimate the puffiness. If they appear suddenly or persist after a night's rest, consult your doctor.
Does a pregnant woman with high blood pressure have to lie down all the time?
No, but she should get plenty of rest and eat a proper diet. Once a s alt-free diet was recommended, it is now believed that it should be rather low-s alt. Therefore, you should not add extra s alt to your meals, eat s alty sticks, but this does not mean that the foods should be completely s alt-free. A pregnant woman with hypertension should also eat foods rich in magnesium and vitamins, so a lot of vegetables and fruits. We also recommend that you regularly check the pressure at home, because sometimes the increased measurement in the office is caused by the so-called the effect of the white coat, i.e. nervousness due to the visit. Therefore, pregnant women should buy a blood pressure monitor and measure them by themselves, 2 to 4 times a day. If the pressure at home is normal, there are no swellings or proteinuria, it is a sign that the increased result in the office was only a result of stress. And then there is no risk of complications. However, if the elevated values continue to appear, the pregnant woman is subject to greater supervision and control - medical consultations and ultrasound examinations are more frequent. It's necessary tocheck blood counts, kidney and liver efficiency, CTG records.
Is it necessary to take medication and stay in hospital?
We start pharmacological treatment when blood pressure regularly exceeds the value of 140/90 mmHg. If they are kept within the limits of 150-160 / 100 mmHg, there is no proteinuria, no edema increases, and the child's growth is normal, there is no need to stay in the hospital. When blood pressure values exceed 160/100 mmHg with fetal growth disorders and symptoms of proteinuria above 0.5 grams per day - the woman is referred to the pathology of pregnancy and is monitored there.
Do pregnancies with hypertension end in premature birth?
Due to the threat to the life of the mother or the fetus, termination is often premature, but I would like to emphasize that the aim of medical treatment is to keep the pregnancy as close as possible to the due date. The newborn of a mother with hypertension usually has a lower birth weight than indicated by the duration of pregnancy. This is the result of inferior blood supply, oxygenation, and thus inferior nutrition to the fetus.
How, in addition to measuring her blood pressure, can a woman know that she is at risk of pregnancy hypertension?
If suddenly there are swelling of the face or upper body, or puffiness that does not disappear after resting in the supine position, then she should definitely contact a gynecologist. Headaches, which have not occurred so far, and visual disturbances are also disturbing.
Is it possible to prevent hypertension during pregnancy?
It is believed that it is more common in women over 35, obese and those who already have diabetes or kidneys. Women with a family history of hypertension are also at increased risk. So if a woman from this group is planning a pregnancy, she should first of all take care of the correct weight and he alth. It's also important to know that gestational hypertension is pregnancy-related only, i.e. it usually resolves within weeks or months after the baby is born. Besides, the risk of its occurrence mainly concerns women who are expecting their first child.
Subsequent pregnancies do not increase the threat?
No. Although it cannot be ruled out that the hypertension will reappear, the risk is the same as in the first pregnancy, or even smaller.monthly "M jak mama"