Hypertension Poses Pregnancy Risks

Hypertension, or high blood pressure, is a serious health issue for anyone who suffers from it.

In the case of a pregnant woman however, the potential risks affect not only her but her unborn child.

Lennart Alvarez-Mahoney is pregnant with her third child and struggling with hypertension.

“The hardest part about being pregnant are the complications that I myself continue to have, mostly my blood pressure,” she said.

Among the possible problems a mother-to-be can experience: having the placenta spontaneously detach from the uterus, giving birth to a baby that’s smaller than normal, or a potentially deadly complication known as preeclampsia (explained below), which can precipitate organ damage and seizures.

It’s long been known that a class of drugs used to treat hypertension, known as A.C.E. inhibitors, are dangerous to pregnant women in their second or third trimester because they raise the risk of birth defects.

But preliminary results from a new study suggest that all pregnant women, even women simply in their childbearing years who may be thinking of having a baby, might be better off avoiding such drugs (which go by various names including Zestril, Prinivil, Accupril, Monopril, and Lotensin).

The U.S. F.D.A., in learning of the New England Journal of Medicine’s study, advised women to reconsider taking A.C.E. inhibitors before or during pregnancy.

Though an F.D.A. spokesperson, M.D. Sandra Kweder, insisted the findings aren’t something to panic about yet since they’re preliminary, she said women should change their prescription from A.C.E. inhibitors as soon as they become pregnant.

What Is Blood Pressure?

It’s the measure of blood pressure against the walls of your blood vessels and it’s expressed with two numbers:

  • The systolic pressure (the top number) is the number that represents the force when the heart contracts and pushes blood into the vessels. If yours is 120/70, that means your systolic pressure is 120 mm Hg.
  • The diastolic pressure (the bottom number) is the number that represents the pressure exerted when your heart is relaxed.

Your blood pressure changes throughout the day and there are a number of factors that can have an effect on it, including pregnancy, emotions and medication.

What Is High Blood Pressure?

It’s also referred to as hypertension and the Heart and Stroke Foundation says it’s blood pressure that is consistently over 140 mm Hg systolic pressure, or greater than or equal to 90 mm Hg diastolic pressure.

Chronic high blood pressure in pregnancy is defined as persistent blood pressure greater than 140/90 prior to pregnancy or prior to the twentieth week of gestation.

Your doctor may decided to treat your blood pressure even if it’s lower if you have several risk factors for heart disease or stroke.

What Causes Hypertension?

According to the Heart and Stroke Foundation of Canada, identified, underlying medical problems, like kidney disease or hormonal problems, are the cause of about 10 percent of hypertension cases, which are referred to as secondary hypertension.

People with high blood pressure with no easily identifiable symptoms suffer from primary essential hypertension.

Some of the main risk factors include:

  • Smoking
  • Obesity
  • Diabetes Mellitus
  • High cholesterol
  • Family history of cardiovascular disease
  • Salt intake
  • Alcohol intake
  • Stress

How Can I Prevent It?

  • Maintain a healthy body weight
  • Eat a balanced diet, low in fat and salt and contains plenty of fruits and vegetables
  • Cut down on your alcohol intake
  • Get active
  • Reduce stress

Why Is High Blood Pressure In Pregnancy A Concern?

Pregnancy entails lots of changes in a woman’s cardiovascular system. For a pregnant woman who has hypertension, hormones related to pregnancy help in relaxing blood vessel walls but that generally isn’t enough to account for the increased fluid. That leads to a higher resting blood pressure and not much tolerance for stress.

Consistently high blood pressure can damage smaller blood vessls that transport blood to and from cells, possibly affecting tissues in the heart, lungs, brain, and the uterus.

According to experts, a pregnancy’s successful outcome is related to how severe a woman’s hypertension is before pregnancy. The more severe, the greater the chances of developing preeclampsia, a potentially life-threatening condition explained below.

Other risks associated with hypertension and pregnancy include the risk for seizures and strokes in mothers, the possibility of having the placenta spontaneously detach from the uterus, and the chance the baby will be smaller than normal.

What Is Preeclampsia?

Also referred to as toxemia, preeclampsia can occur when high blood pressure is accompanied by a high level of protein in the urine. Women with preeclampsia can also experience swelling in the feet, legs and hands.

Preeclampsia usually appears during the second half of pregnancy, generally in the latter part of the second or in the third trimesters, although it can occur earlier. Preeclampsia and other hypertension-related disorders are one of the top causes of maternal and infant illness and death.

How Can I Protect My Baby And Myself?

Seek early, comprehensive prenatal care from a medical professional.

Maintain a doctor-prescribed medication regimen to control blood pressure. Alternatives to ACE inhibitors include diuretics and medications such as Aldomet, labetalol, and Procardia.

Make sure you’re routinely assessed by your doctor for signs of preeclampsia.

Begin a log of fetal movement starting sometime between twenty-four and twenty-eight weeks of pregnancy two to three times daily. After a meal, lie down, and count the number of times your baby moves in an hour. He or she should move at least six times an hour. If it’s less than six times in the hour, contact your care provider.

Courtesy Heart and Stroke Foundation of Canada, Canadian Hypertension Society, and WebMD.

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