According to peer-reviewed medical website uptodate.com, about 5 percent of pregnancies are affected by high blood pressure, which can be divided into four main categories: preeclampsia, chronic hypertension, preeclampsia superimposed on chronic hypertension and gestational hypertension.
A woman is considered preeclamptic if she suffers from high blood pressure, typically diagnosed with readings of 140/90 or higher, and has protein in her urine. This condition only develops during pregnancy, and the only real treatment is delivering the baby.
Chronic hypertension occurs when a woman has high blood pressure before pregnancy. Women who already suffer from high blood pressure are more likely to have preeclampsia.
Gestational hypertension is high blood pressure diagnosed after 20 weeks of pregnancy without the presence of protein with no previous history of high blood pressure. This condition can be treated with medication but, like preeclampsia, the only way to completely alleviate the condition is delivery of the baby.
During the course of a pregnancy, gestational hypertension can become preeclampsia, and some women may develop chronic hypertension after delivery.
Winchester-based OB/GYN Dr. Jeffrey Chamberlain said hypertension is something commonly dealt with at his practice. Although there is no known cause for gestational hypertension or preeclampsia, risk factors include extreme maternal age (women under 20 or over 40), diabetes, obesity, a family history of preeclampsia or multiple gestation.
“The main thing is picking up on it as quickly as possible,” Chamberlain said.
Pregnant women are routinely screened for protein in their urine at obstetric visits, and Chamberlain said it is important to keep regular appointments and follow physician advice.
Warning signs for preeclampsia include vision changes, nausea and vomiting, difficulty breathing, decreased urine production and difficulty breathing.
Hypertension in all forms during pregnancy can lead to an increased risk of induced labor, which also carries an increased risk of a Caesarean delivery.
Preeclampsia and chronic hypertension differ because while chronic hypertension can be affected by lifestyle factors, “preeclampsia is something you can’t modify your behaviors to keep yourself from getting,” Chamberlain said.
Women with a diagnosis of chronic hypertension should talk to a doctor before trying to become pregnant because some hypertension medications can cause serious birth defects. Adopting healthy lifestyle behaviors, including maintaining a healthy weight and exercising.
If high blood pressure is suspected, Chamberlain said doctors will check blood pressure again, check urine for protein and may order a 24-hour urine collection, to monitor both urine output and to check for protein.
In some cases, preterm delivery may be necessary.
“It’s basically to protect the mom,” Chamberlain said.
Typically, high blood pressure and protein in the urine go away shortly after delivery.
Women with concerns about preeclampsia or hypertension should talk to their heath care providers for information regarding their specific situations.
More information can be obtained at www.mayoclinic.com/health/preeclampsia/DS00583 or www.americanpregnancy.org.