A healthy living blog from Marshfield Clinic Health System

Hypertension: 4 things to know during pregnancy

High blood pressure in pregnancy is common, and is one of the leading causes of maternal mortality worldwide, said Dr. Alison Bauer, maternal fetal medicine provider with Marshfield Clinic Health System.

Although common, high blood pressure should be monitored and assessed during pregnancy.

Although common, you can start to prevent hypertension before you get pregnant or help identify hypertension during your pregnancy to keep you and baby safe.

Risks for hypertension

Because high blood pressure is common in pregnancy, a few factors can put you at risk for pre-eclampsia.

Pre-eclampsia, which affects up to 8% of pregnancies, is high blood pressure and protein in the urine that occur in the second half of pregnancy. Risk factors include it being your first pregnancy, twins, chronic hypertension, diabetes, lupus, obesity, age over 35 years, kidney disease, infertility treatments, and having pre-eclampsia before.

“If a woman has high blood pressure or pre-eclampsia, they are at increased risk for pre-eclampsia in a future pregnancy, but not all women will have it again,” Bauer said.

Women at risk for pre-eclampsia may be recommended by their provider to take aspirin during pregnancy to reduce the risk. All pregnant women should have regular blood pressure screening and be monitored for symptoms.

Signs and symptoms

During your prenatal appointments, your provider will take samples of your urine to test the protein levels as well as take your blood pressure. Other signs of pre-eclampsia include headache, spots missing from vision, pain in the right upper quadrant, chest pain or difficulty breathing.

Call your women’s health provider if you have any of these symptoms during your pregnancy.

“If pre-eclampsia develops, this is sometimes a reason women need to stay in the hospital or for preterm delivery,” Bauer said.

How to reduce your risk

Prior to getting pregnant, Bauer recommends eating a healthy diet and exercising if you have extra weight to help prevent hypertension during pregnancy. She also said it’s important to control any chronic medical conditions like diabetes or high blood pressure before pregnancy.

“Once pregnant, aspirin can reduce the risk of early or severe pre-eclampsia,” Bauer said. “Though for many women, there are no ways to reduce risk and our primary goal is to identify and treat pre-eclampsia early.”

Beyond prenatal appointments, you can monitor your blood pressure at home and take medications as prescribed.

Talk to your provider

Keeping you and your baby safe is No. 1 priority for your provider and care team. Induction of labor is often recommended with hypertension during pregnancy. Bauer said once pre-eclampsia develops, it will worsen. She recommends close monitoring and possible delivery prior to worsening illness.

“We often will weigh the risks of prematurity with the benefits of avoiding serious maternal illness to optimize timing of delivery,” she said.

Talk to your women’s health provider to discuss your options and do what is best for you and your baby.

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