Chronic Hypertension
What is hypertension in pregnancy?
Hypertension or high blood pressure is diagnosed when your blood pressure is ≥ 140/90 mm Hg during pregnancy. Depending on the type of hypertension it could be associated with complications to you and your baby.
What is chronic hypertension? How is it diagnosed?
This is when the patient develops high blood pressure even before pregnancy or the hypertension episode was first diagnosed during pregnancy but before 20 weeks of pregnancy and the hypertension do not resolve 6 weeks after delivery.
Is there any anti-hypertensive medication which should not be used during pregnancy?
Some women with pre-existing hypertension are already on medication prior to pregnancy to control their high blood pressure. However, some of these medications are not suitable for pregnancy. This includes ACE-inhibitor or diuretic medications. Do not stop your medication yourself, please consult your doctor regarding your anti-hypertensive medications.
What are the possible effects of having chronic hypertension to my pregnancy?
- Increased risk of developing preeclampsia. Up to 20% of women with chronic hypertension could develop preeclampsia.
- Intrauterine growth restriction to your baby
- Preterm delivery and problems associated with preterm birth
- Placental abruption
How will I be managed during pregnancy?
- It will be better for you to see your doctor prior to getting pregnancy i.e prenatal check up
- Once pregnant your blood pressure control and medications will be reviewed by your obstetrician. Unsuitable anti-hypertensive medication will be changed.
- Sometimes hypertension may be associated with other medical condition such as diabetes or auto-immune disorders. Hence, your doctor may need to review this condition if required
- A baseline investigation may be done to check your kidneys. If you are young with a newly diagnosed chronic hypertension your doctor may want to do other investigation to rule out other secondary causes of hypertension in you.
- Throughout pregnancy your blood pressure and baby’s growth will be monitored closely to detect early possible complication associated with chronic hypertension.
- Timing of delivery. If your blood pressure if well control, there are no other complications and you are not on any medication, you may be given up till your expected date of delivery before induction of labour is done. However, if you are on medication, women tend to be delivered by 38 weeks of pregnancy.
Most women with chronic hypertension provided they have good antenatal follow up and their blood pressure is well control have a good outcome of your pregnancy.
When should I seek treatment from the doctor?
You seek treatment preferably from your obstetrician or hospital if you experience the following symptoms:
- Headache
- Nausea and vomitting
- Blurring of vision
- Pain at the upper part of your abdomen
- Vaginal bleeding
- Reduce movements of your baby
The above collection of symptoms could indicate your are having severe preeclampsia and possible complications such as placental abruption. You need to seek help from your doctor immediately.
What will happen after delivery?
Your blood pressure will be reviewed. If you had required anti-hypertensive medication, this may be continued or tapered down gradually after delivery depending on your blood pressure. A follow up appointment and check up will be arranged to ensure that your blood pressure is well controlled as complications such as eclampsia could still occur after delivery. If you are young and diagnosed with hypertension further investigation will be done after delivery to rule out other secondary causes of hypertension in you.
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