Can pregnancy also cause blood pressure to rise and be diagnosed as “hypertension”? Yes! This type of hypertension is called “gestational hypertension”.
What are the specific types, what are the risks to the pregnant woman and the fetus, and how to treat and correct them after detection? Even pregnant mothers who are not affected should know.
Is there any difference in the hypertension detected in different weeks of pregnancy? Of course there is, with 20 weeks of pregnancy as the limit.
1. Hypertension diagnosed before pregnancy or newly discovered before 20 weeks of pregnancy: mainly includes chronic hypertension, white coat hypertension and occult hypertension.
– Chronic hypertension: refers to hypertension diagnosed before pregnancy or diagnosed before 20 weeks of pregnancy (<20 weeks), usually diagnosed at the time of the first register visit in early pregnancy.
– White coat hypertension: refers to elevated office blood pressure (≥140/90 mmHg), but normal blood pressure at home or work.
– Occult hypertension: a special type of hypertension, which is difficult to recognize clinically, characterized by normal blood pressure in the office, but elevated blood pressure at other times.
2. Hypertension occurring after 20 weeks of gestation (≥20 weeks): including transient gestational hypertension and gestational hypertension.
– Transient gestational hypertension: usually found at the time of office examination, but subsequent repeated measurements of blood pressure are normal.
– Gestational hypertension: is elevated blood pressure after 20 weeks of gestation (≥20 weeks), but without proteinuria, impairment of organ function or fetal growth restriction, and generally has a better prognosis.
However, it is important to note that about 25% of gestational hypertension will develop into preeclampsia, and the earlier the gestational week, the higher the percentage of gestational hypertension that will develop into preeclampsia.
What are the risks to the pregnant woman and the fetus if gestational hypertension is detected during pregnancy?
Hypertension during pregnancy is a major cause of perinatal mortality in mothers and infants, and poses a serious risk to the health and safety of the pregnant woman and her baby.
For those pregnant women with gestational hypertension, they need to bear a heavy physical burden, and they themselves have serious conditions such as vascular embolism and atherosclerosis caused by hypertension, accompanied by typical hypertensive symptoms such as headache, nausea, convulsions, abnormal kidney function, edema, myocardial ischemia, and ischemia of brain tissue.
As the fetus grows in the womb, it will take away more and more of the mother’s blood oxygen, increasing the burden on the mother.
In case of endothelial damage or acute atherosclerosis of the placental vessels, the placental function will be reduced and fetal oxygen absorption will be hindered, resulting in fetal growth retardation, weight loss, distress, asphyxia, low amniotic fluid, even neurological damage, placental vessel rupture, fetal death and other critical situations, leading to placental abruption and serious threats to the lives of mothers and infants.
Therefore, it is more recommended for pregnant women to actively prevent the occurrence of gestational hypertension after pregnancy.
What should be done after being diagnosed with gestational hypertension?
The treatment of gestational hypertension aims to prevent the occurrence of severe pre-eclampsia and eclampsia, reduce the rate of maternal and infant morbidity and mortality, and improve pregnancy outcomes.
The main treatment options include rest, sedation, monitoring of the mother and fetus, antihypertensive therapy as appropriate, and individualized treatment plans for different periods of the disease.
Fetal heart monitoring
Pregnant women with preeclampsia should be monitored closely and the pregnancy should be terminated if necessary.
As for pregnant women with chronic hypertension combined with pregnancy, the main focus is to lower the blood pressure, first choose oral antihypertensive drugs, commonly used drugs include labetalol and nifedipine. If the effect of oral antihypertensive drugs is not good, you should choose to sedative uradil hydrochloride injection, while giving antispasmodic treatment, generally using magnesium sulfate for treatment, magnesium sulfate has the effect of relieving vascular spasm.
In cases of concurrent preeclampsia, termination of pregnancy is the most effective treatment along with antihypertensive therapy.
References
[1] Niu Huifang. The risk of hypertensive disorders in pregnancy to mother and child [J]. Marriage and Health,2021(17):89.
[2]Chen Yuanxin. Effective prevention of hypertension during pregnancy[J]. Chinese and Foreign Health Digest,2013(29):149-150.
[3]Yang LJ. Treatment of hypertension in pregnancy[J]. Health Care Guide,2020(24):267-268.