Hypertension and Pregnancy: What are the Signs and Risks?

Hypertension and Pregnancy: What are the Signs and Risks?

Hypertension, Pregnancy, Gestational hypertension, Preeclampsia, Blood pressure, Chronic hypertension, Proteinuria, Stage 1 hypertension, Kidney problems, Monitoring

There are three types of hypertension during pregnancy: chronic hypertension, gestational hypertension, and preeclampsia. Each of these situations can lead to serious complications and requires rigorous management.

In pregnant women, hypertension can be either chronic or directly related to pregnancy. If it only appears during this time, doctors can diagnose gestational hypertension or preeclampsia (associated with proteinuria). During pregnancy, hypertension can cause serious health problems for both the woman and the fetus. It requires careful monitoring and specific measures tailored to each individual, such as medication, early delivery, rest, etc. To reduce the risk of complications, it is essential to be able to identify the main signs.

Definition of Pregnancy Hypertension

According to the Faculty of Medicine at the University of Texas, doctors distinguish three categories of hypertension during pregnancy:

Chronic hypertension: already present before pregnancy.

Pregnancy-induced hypertension, also known as gestational hypertension: a particularly common pregnancy complication, affecting 5 to 10% of pregnant women, according to the Sainte-Justine University Hospital Center. In these women, blood pressure becomes excessively high for the first time after the 20th week of pregnancy, and hypertension disappears in the weeks following childbirth.

Preeclampsia: hypertension associated with dysfunction of certain organs (kidneys, heart), leading to proteinuria (excess protein in the urine) and constituting an obstetric emergency.

Hypertension is defined as abnormally high blood pressure, exceeding 120/80. According to the American College of Obstetricians and Gynecologists, it can be classified as:

  • Elevated: 120-129/less than 80 mmHg.
  • Stage 1: 130-139/80-89 mmHg.
  • Stage 2: ≥ 140/90 mmHg.

Pregnancy-induced hypertension can be influenced by various risk factors, including obesity, maternal age over 40, diabetes, kidney problems, multiple pregnancies, personal or family history of preeclampsia, etc. It requires specific monitoring during pregnancy and after childbirth, as well as management that varies depending on the severity.

Signs and Symptoms of Pregnancy Hypertension

In the majority of women, hypertension does not cause specific symptoms. It is discovered incidentally during the course of pregnancy follow-up. However, sometimes certain clinical signs can help identify this complication. According to the American College of Obstetricians and Gynecologists, women with preeclampsia may experience various symptoms:

  • Severe and persistent headaches.
  • Vision disturbances: appearance of spots, blurred vision.
  • Stomach pain.
  • Sudden onset of nausea and vomiting after the 20th week of pregnancy.
  • Swelling of the entire body, especially in the hands or face.
  • Difficulty breathing.
  • Sudden weight gain.

In the most severe cases, preeclampsia can worsen and lead to new complications, such as fluid in the lungs, kidney or liver damage, and low platelet count. Women who experience symptoms of preeclampsia must consult as soon as possible, especially in the second half of pregnancy.

Risks and Complications of Pregnancy Hypertension

Generally, if well managed, chronic hypertension and gestational hypertension do not hinder the progress of pregnancy. However, they can impose additional stress on the kidneys and heart, increasing the risk of developing heart or kidney disease or a stroke. Moreover, hypertension can lead to a lack of blood flow to the placenta, resulting in a lack of oxygen and nutrients for the baby's growth. Finally, these two forms of hypertension can lead to preeclampsia, with the latter being particularly serious, even life-threatening, for both the mother and the baby. According to the Faculty of Medicine at the University of Texas, preeclampsia can cause severe complications:

For the mother: cerebral hemorrhage, coagulation disorders, seizures, liver disorders, HELLP syndrome (hemolysis with elevated liver enzymes and low platelet count).

For the baby: growth restriction, placental abruption, stillbirth.

There are also significant risks of cesarean delivery and premature birth. To avoid complications, doctors may decide to induce labor early in the case of preeclampsia. 

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