Blood pressure or blood pressure It is the pressure exerted by the blood against the wall of the arteries. This pressure is essential for the blood to circulate through the blood vessels and provide oxygen and nutrients to all the organs of the body so that they can function.
When there is a continuous increase in blood pressure figures in the arteries we are facing a case of high blood pressure, which can complicate pregnancy and constitute a risk to the health of the mother and the fetus.
High blood pressure may be present before pregnancy, although only in a small percentage of cases it develops during it. That is, pregnant women with hypertension usually have this disease before.
But it can also happen that it is due to pregnancy (gestational hypertension), since during pregnancy the circulatory system undergoes alterations. The common denominator of the heterogeneous group of hypertensive diseases of pregnancy is the increase in blood pressure equal to or greater than 140/90 mmHg. Let's see what they are types of hypertension during pregnancy.
Types of hypertension during pregnancy
There are four main types of hypertension during pregnancy:
- Preeclampsia This potentially serious disorder for both the mother and the fetus is characterized by a surge in tension caused by pregnancy and the presence of protein in the urine. It affects 15% of pregnant women, but if detected early it can be controlled and reduce their risks. It usually develops after 20 weeks of pregnancy and disappears after delivery. In the most severe cases it results in eclampsia, when hypertension is accompanied by seizures and / or coma.
- Gestational hypertension, also known as pregnancy induced hypertension or transient hypertension. This type of hypertension develops after 20 weeks of pregnancy and disappears after delivery. Although women with gestational hypertension do not have protein in their urine, some of them develop preeclampsia at a later stage of pregnancy. The chances of having preeclampsia are 50% if gestational hypertension develops before 30 weeks. If it develops after 36 weeks of gestation, hypertension in general is moderate.
- Chronic hypertension. This is what is called high blood pressure diagnosed before pregnancy or before 20 weeks of pregnancy: the mother was already hypertensive. As the name implies, this type of hypertension does not disappear after delivery. Most of the time it corresponds to essential arterial hypertension in 90% of cases that is of unknown cause and only 10% of cases is secondary to another disease such as diabetes, kidney, heart and autoimmune diseases, among others.
- Chronic hypertension with preeclampsia, a subtype of the previous section. Approximately 25 percent of women with chronic hypertension also develop preeclampsia. It occurs more frequently in multiparous women and is characterized by severe arterial hypertension and increased uric acid in the blood. This hypertensive condition is dangerous since it can present with seizures, kidney damage and liver damage, as well as thrombocytopenia (decrease in platelets).
Can pregnant women be medicated with hypertension?
The only person indicated to say if the woman can medicate (or continue medicating) and what are the most appropriate drugs in case of hypertension is the specialist who controls your pregnancy. In general, the guidelines to follow depend on the degree of hypertension that the woman suffers.
- If a woman has a slightly high blood pressure, is medicated and is trying to get pregnant or discovers that she is already, the doctor usually suspends the pharmacological treatment she is following, since there could be a risk that the drugs increase morbidity and mortality of the fetus
- In case the blood pressure is moderately high, in general you should continue taking antihypertensive drugs. However, some of the drugs that are safe for women can injure the fetus, so the specialist will review the medication, as there are certain more appropriate drugs during pregnancy. Every month, it is necessary to perform an analysis to know the renal functioning, and the growth of the fetus is monitored with ultrasound.
- The pregnant women with severe hypertension They need special care and rigorous control, including hospitalization during the second half of pregnancy. Pregnancy can greatly worsen hypertension and in the mother cause swelling of the brain, cerebral hemorrhage, renal failure, heart failure and even death. There are also serious risks for the fetus such as premature detachment of the placenta from the uterine wall (abruptio placentae: the supply of oxygen and nutrients received by the fetus is interrupted and it can die). Although the placenta does not break free, hypertension can reduce the blood supply that the placenta receives and slow fetal growth.
In any case, as we say, The specialist will indicate the appropriate treatment for each particular case, weighing risks and benefits. They probably give certain nutritional and physical guidelines to avoid complications in mild cases.
And good gestational control is always necessary to prevent the risks of hypertension during pregnancy, and as far as possible to maintain healthy habits from before achieving pregnancy so as not to suffer the disease when it is not suffered chronically.
