In the last months of pregnancy, the female body is actively preparing for labor and the birth of a long-awaited baby. During this period, a woman should monitor her health more carefully and respond to various symptoms in a timely manner. Indeed, often in the last weeks, expectant mothers are faced with unpleasant surprises that can negatively affect the birth process.
Varicose veins, pressure on internal organs, heartburn, nausea, swelling, high blood pressure - all these are difficulties that pregnant women have to face. Hypertension is especially dangerous during the period of bearing a baby, so every expectant mother needs to know what factors provoke its appearance, as well as how dangerous this condition is in the last weeks of pregnancy.
Blood pressure during pregnancy: normal and pathological
In a normal state, a person’s blood pressure should be within 120/80. During pregnancy, the concept of normal has a wider range of values - from 90/60 to 140/90.
Almost every tenth pregnant woman experiences hypertension, so this category of patients must always be under strict medical supervision. When visiting an antenatal clinic, the expectant mother must have her blood pressure measured. If the indicators are outside the normal range, then doctors urgently take measures to normalize it in order to eliminate all kinds of complications.
What factors provoke an increase in blood pressure
There can be many reasons for hypertension during pregnancy:
- stress on the female body, which does not have time to adapt to new conditions and reacts to changes with high blood pressure;
- Stressful situations are a common cause of increased blood pressure;
- genetic predisposition when there are hypertension in the family;
- insufficiency of the compensatory forces of the female body during pregnancy, when the heart should be responsible for increased blood circulation, but it cannot fully cope with the task;
- diabetes mellitus - the disease itself does not increase blood pressure during pregnancy, but can become a provoking factor;
- abuse of tobacco products (smoking). Everyone knows that there are few health benefits from a bad habit, and besides, nicotine has a negative effect on the cardiovascular system;
- weak physical activity, as a result of which the heart does not fully cope with the load;
- problems with excess weight. During the nine months of pregnancy, every woman is obliged to control her weight, because excess weight or a tendency to obesity will certainly affect blood pressure indicators;
- disturbances in the functioning of the kidneys can also provoke pressure surges;
- hormonal imbalance caused by dysfunction of the thyroid gland, pituitary gland or adrenal glands.
Who is at risk
Of course, not all pregnant women have problems with blood pressure. However, there are also patients who are especially susceptible to this condition. These include:
- women who have had miscarriages;
- pregnant women over 35 years of age;
- women who had problems with blood pressure during a previous pregnancy;
- overweight and obese pregnant women;
- patients suffering from hormonal disorders.
What signs indicate high blood pressure?
It would not hurt for every expectant mother, especially if she has problems with blood pressure, to have a tonometer in the household - a special device that measures blood pressure. It is easy to use and allows you to find out accurate indicators at any convenient time.
If it is not possible to measure blood pressure, then pregnant women should listen to their body: it will always tell you when something is going wrong. The occurrence of symptoms such as headache, ringing in the ears, attacks of nausea and even fainting indicates high blood pressure.
But there are cases when hypertension is asymptomatic and does not bother the pregnant woman, but is diagnosed only with the help of a tonometer. This is why it is so important to monitor blood pressure readings during pregnancy and regularly attend antenatal clinics.
Why is high blood pressure dangerous in the last weeks of pregnancy?
High blood pressure levels before the happiest and most long-awaited moment of pregnancy do not bode well. First of all, this condition can signal the occurrence of gestosis - late toxicosis. This is a very dangerous complication during pregnancy, which is accompanied by fluid retention in the pregnant woman’s body, edema, and increased protein content in the urine. Preeclampsia is dangerous for a child due to insufficient oxygen supply.
Even if high blood pressure is not caused by late toxicosis, then it should not be left without due attention, since with regular high blood pressure, vascular tone increases, which in turn can lead to fetoplacental insufficiency. In this case, the child will not receive enough oxygen and nutrients, which can lead to delays in intrauterine development.
In addition, if blood pressure surges are regular and the readings are above 140, then premature placental abruption is possible. Such a process may result in termination of pregnancy or premature onset of labor.
Also, hypertension in the last weeks of pregnancy can provoke eclampsia, a condition characterized by convulsive seizures, which is also dangerous for the woman and her baby.
What to do if you have high blood pressure?
As you already understand, high blood pressure during pregnancy, especially before birth, is a dangerous symptom that signals pathology and requires immediate medical intervention. Self-medication in this situation is simply unacceptable. Based on the examination results, the doctor will prescribe drug therapy. Your task is to strictly follow all medical prescriptions, observing the dosage of medications and the duration of therapy.
If the pressure rises slightly, then you can resort to alternative therapy. Antihypertensive drinks can help normalize blood pressure: cranberry juice, beet juice, pumpkin decoction, viburnum infusion, birch sap. Of course, folk remedies will not completely eliminate the problem, but they can be an excellent preventive measure.
In severe cases, the only correct solution may be hospitalization, where the patient will undergo therapy under strict medical supervision until the upcoming birth.
A pathological condition such as hypertension during pregnancy is dangerous. The risk of developing severe complications increases especially if a woman had problems with blood pressure before pregnancy, and if she is overweight. Let's consider what causes problems with blood pressure, what symptoms accompany it, what kind of treatment is indicated, and what possible risks await a woman who refuses medical help?
Causes and course
The reasons why blood pressure may increase are varied, but the most significant are:
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- heredity, in which hypertension bothers family members and is inherited;
- the woman has untreated, chronic kidney disease;
- dysfunction of the endocrine system;
- pathological hormonal imbalance;
- a mental or neurogenic disorder that can cause hypertension.
The chronic form of the disease is life-threatening for the pregnant woman and the fetus. Hypertension in most cases occurs in the pre-pregnancy period, but often the pathology develops after conception. If arterial hypertension bothered a woman before conception, then the symptoms will worsen afterwards, and if the situation is not controlled, there is a high risk of serious complications that can cost the woman and baby their lives. In severe cases of the disease, pregnancy and childbirth are contraindicated, and if a woman manages to become pregnant, premature termination is indicated. During the period of bearing a child, depending on the factors provoking the pathology, there are:
- Arterial hypertension of pregnancy, when blood pressure rises in the second trimester, but after childbirth the pathology does not bother you.
- Chronic hypertension, in which high blood pressure bothers a woman before, during, and after pregnancy.
- Preeclampsia, when during the period of bearing a child, chronic diseases and other kidney pathologies worsen, which affects the functioning of the cardiovascular system.
Symptoms of pathology
In arterial hypertension, the most dangerous symptom is a sharp increase in blood pressure. In this case, the accompanying symptoms are as follows:
- cardiopalmus;
- tinnitus;
- deterioration of visual and auditory functions;
- severe headaches;
- blood may flow from the nose;
- sleep deteriorates, signs of anxiety, irritability, and fatigue appear.
Diagnostic methods
At risk are women with possible hereditary hypertension. The course of hypertension cannot always be diagnosed in time, since many women take symptoms of deterioration in health as a sign of pregnancy. Therefore, not everyone immediately runs to the hospital and finds out what exactly is bothering them. If a pregnant woman has had problems with blood pressure in her family, it is worth regularly measuring blood pressure, and if it increases, inform the doctor.
Diagnosis, first of all, consists of regularly measuring blood pressure and monitoring protein in the urine. If there are isolated cases of increased pressure, then there is nothing to worry about, since this phenomenon often occurs in pregnant women. But if the pressure rises rapidly and the woman feels unwell, this indicates the development and exacerbation of the pathology. In this case, the pregnant woman is advised to stay in the hospital, where qualified care will be provided, and, if necessary, first aid will be provided.
Treatment of hypertension
Treatment of hypertension during pregnancy should be under medical supervision. If a woman suffers from severe arterial hypertension, the doctor will advise you to stay in the hospital for a more complete examination and determine the cause of this condition. When the danger has passed, medications for hypertension are prescribed, which it is important to take strictly according to the proposed regimen; the course will last until childbirth. You should strictly follow all the doctor’s recommendations, take prescribed medications, and monitor your condition. Do not try to fix the problem yourself, this will only make the situation worse and cause dangerous consequences.
When the pathology occurs in a mild form, the doctor will advise you to reconsider your diet, adjust your daily routine, get more rest, and walk in the fresh air. It is not necessary to take pills, it is only important to monitor your well-being, and in case of rapid deterioration, urgently go to the hospital and not self-medicate. Increased blood pressure before childbirth is a fairly common situation, but if adequate measures are taken, the pathology can be controlled and complications can be avoided.
Childbirth with high blood pressure
Natural childbirth with hypertension and high blood pressure is contraindicated, because the pressure can rise critically, and this is dangerous for the life of the expectant mother and child. Therefore, before giving birth, the doctor will weigh all the risks and recommend a cesarean section. Such childbirth with hypertension is the safest, and the doctor will be able to constantly monitor the situation and prevent dangerous complications during childbirth.
If a woman with hypertension suffered from high blood pressure even before conception, and the condition was accompanied by serious consequences, she is contraindicated to become pregnant and give birth to a child, because the consequences of such an illness can be unpredictable.
Possible complications and consequences
Exacerbation of the disease can lead to extremely negative consequences for the health of the mother and child.
If arterial hypertension worsens during pregnancy, there is a high probability of developing late toxicosis, which is dangerous both for the woman herself and for the unborn child. Another extremely dangerous complication that provokes high blood pressure is hemorrhagic stroke. With hypertension, the entire body suffers, because high blood pressure leads to disruption of the blood supply to internal organs. This negatively affects the development of the fetus, and as a consequence - disruption of the formation of the cardiovascular and central nervous systems, intrauterine bleeding, placental abruption, and premature birth in the early stages.
Among all cardiovascular pathologies, high blood pressure is a fairly common type of disease. Depending on what indicators the patient most often observes on the tonometer, 3 degrees of the disease are distinguished - these are I, II, and III. At the first stage, deviations from normal indicators are not entirely critical, but, nevertheless, require increased attention. Making a diagnosis in young men entails the question of whether they enlist in the army if they have stage 1 hypertension? Let's look at this issue in more detail.
Stage 1 hypertension: what should you be wary of?
Stage 1 hypertension is characterized by only minor fluctuations from the established norm. Systolic will be between 140 and 159 mmHg. Art., and diastolic within 90-99 mm Hg. Art.
This disease appears due to many reasons, namely:
- Disturbances in the functioning of the kidneys, which retain water in the body and impair excretory function.
- Endocrine pathologies associated with changes in hormonal function, and as a result, an increase in pressure at the level of stage 1 and heart rate.
Diseases never appear “on their own” and there is always some reason for this. The risk of hypertension is associated with the following predisposing factors:
- smoking;
- alcohol and coffee abuse;
- atherosclerotic plaques;
- poor nutrition, mainly with high salt content in foods;
- chronic stress and depression;
- decreased physical activity (adinomia);
- obesity.
Do not forget about the hereditary risk of the disease. According to statistics, genetic predisposition accounts for almost half of all recorded cases of hypertension.
In case of hypertension of the 1st degree, there is no damage to the internal organs, and the manifested clinical picture will have the following symptoms:
- emerging visual impairment;
- frequent headaches;
- sleep disturbance and decreased performance;
- increased sweating;
- pain in the area of the heart muscle;
- irritability for no reason, etc.
If such signs are present and a diagnosis is made, the young man is concerned about whether he will be accepted into the army with stage 1 hypertension.
What is the diagnosis of hypertension?
The first step is to diagnose the disease. It should immediately be noted that conscripts need to be observed at a dispensary for at least 6 months. Monitoring of hypertension is based on measuring daily indicators and recording them in the medical record. The doctor measures the upper blood pressure (the moment the heart muscle contracts completely) and the lower blood pressure (when the heart is in a relaxed state).
A complete diagnosis of a young man is carried out taking into account the following examination:
- taking a urine test;
- electrocardiogram of the heart muscle;
- blood test;
- Ultrasound of internal organs (required only in some cases).
Daily monitoring of a conscript is necessary for a qualitative study, since blood pressure can be unstable and can change its values throughout the day. For example, the risk of increased blood pressure at work or during physical activity is much higher than at rest or sleep.
Is it possible to be released from service if you have high blood pressure?
The military registration and enlistment office selects conscripts according to a medical examination according to the Schedule of Diseases. Hypertension is included in Article 43, which specifies clauses on the possibility of serving, as well as exemption.
Arriving at the military registration and enlistment office, the conscript must show documents confirming the inpatient examination, as well as the results of the previous dispensary observation for at least six months. If the young man does not have such data, the doctors of the military medical commission make a decision to send the conscript for an appropriate medical examination.
It should immediately be noted that according to an extract from article 43 of the Schedule of Diseases, indicators for stage 1 hypertension have the following meanings:
- upper (systolic) – from 140 mm Hg. Art. up to 159 mm Hg. Art.;
- lower (diastolic) – from 90 mm Hg. Art. up to 99 mm Hg Art.
A conscript with this type of pathology is assigned fitness category “B” (limited fitness).
Thus, in order to receive a withdrawal from the army you need to have the following indicators:
- Blood pressure should be between 140-159/90-99 mmHg. Art.
- Be examined at a hospital to obtain documents.
There is a risk that a young man will end up in the army, since exemption from military service is not guaranteed in the absence of supporting documents on inpatient observation and the presence of normal blood pressure readings at the time of passing the military medical examination.
Roughly speaking, without a doctor’s note about the presence of stage 1 hypertension, the military registration and enlistment office can draft him into the army if his health is normal. This is due to distrust of conscripts who simply want to “refuse” from the army under the guise of having hypertension. Therefore, you should take care of this point in advance and be sure to visit a doctor if you have grade 1 high blood pressure.
After the young man has passed the examination in accordance with paragraphs “c” in Article 43, the conscript receives fitness status “B”, which does not need to be re-examined. The young man will receive a military ID and will be exempt from military service. There is no need to confirm the presence of high blood pressure, and the risk that the young man will end up in the service is completely absent. However, this applies only to peacetime. If martial law is introduced in the country, persons suffering from stage 1 or 2 hypertension will be required to serve.
How can you lower your blood pressure before going to the military registration and enlistment office?
So, if a young man has grade 1 high blood pressure, the risk that he will be “rejected” by the military medical board is quite high. The fact is that the military registration and enlistment office will not accept a conscript suffering from cardiovascular pathology. But what to do in a situation where exemption from the army is not required, but the young man really wants to serve?
First of all, you need to weigh all the pros and cons and decide whether this risk is really worth your health or is it better to save it? If the answer is yes, we move on. Having decided to go to the military registration and enlistment office for service, be sure to consult with your doctor about the possibility of such a decision. If high blood pressure of the 1st degree often does not bother you, and there are no complications against its background, then military service is possible, but with restrictions. However, if the course of hypertension is aggravated by other diseases, and the indicators are often unstable, such a risk can be worth a lot.
When thinking about military life, you can reduce the pressure before the medical examination in the following way:
- You need to wet your hands up to your shoulders with cold water and hold them under the stream for a while. Also moisten a towel with water and apply it to the solar plexus and thyroid gland area. The duration of the procedure is 7 minutes.
- Soak 2 small towels in apple cider vinegar and place them on the soles of your feet. You need to lie with this compress for at least 10 minutes. Thus, you can reduce the pressure to 30 units instantly.
- 2-3 weeks before going to the military registration and enlistment office, pay attention to your diet. It should be low-fat and include a sufficient amount of dairy products. You should give up strong coffee and tea, alcoholic beverages, baked goods, smoking, salty, smoked, spicy and fried foods. The amount of salt consumed should be reduced to half a teaspoon per day. Drink more fluids, especially rosehip infusion. It is very useful for cardiovascular pathologies.
- You can also get a massage. Stroking in the collar area and light rubbing. There are also strokes on the neck, but with light pressure. Stroking and rubbing in the upper part of the chest. In the back of the head, knead the pain points with your fingertips. It should be noted that contraindications to this type of massage are the presence of tumor-like neoplasms, severe forms of diabetes mellitus and hypertensive crisis. But departing from the above, the risk that a young man will think about going to the military registration and enlistment office with such diseases is small, but they are still worth noting.
With these simple methods you can reduce your blood pressure of the 1st degree and confidently go to the military registration and enlistment office for a medical examination. Military service is a test of will and spirit. If you have doubts about your health, it is better to undergo diagnostics once again to be confident in your abilities.
Why does blood pressure increase before and after childbirth?
Pregnancy and childbirth are physiologically determined, natural processes, but this, unfortunately, does not guarantee their successful course. Problems may arise on the eve of delivery, during labor, or in the first days of recovery. And often among the alarming symptoms is high blood pressure. Often this disease occurs in women with a history of diabetes.
High blood pressure before childbirth: possible causes
The last months of the gestational period are associated with the fact that the woman’s body adapts to the upcoming process of giving birth to a baby. It is very important during this period to listen to the body in order to respond to alarming symptoms in a timely manner. Even an absolutely healthy, calm pregnancy of all previous months can cause significant problems in the last trimester.
A pregnant woman may encounter such unpleasant pathologies as varicose veins, swelling, nausea, heartburn, and increased blood pressure. And the last factor is especially dangerous, so all possible provocateurs of hypertension must be warned.
In a healthy woman, the average blood pressure is 120/80 mmHg. Art., this is the norm. Some deviation of these values is acceptable; for expectant mothers, the range of blood pressure marks ranges from 90/60 to 140/90 mmHg. At each appointment with a gynecologist during pregnancy, the patient’s blood pressure is measured. And if the indicators are alarming, the doctor takes immediate action.
Provocateurs for increased blood pressure before childbirth can be:
Diabetes mellitus itself is not a direct cause of high blood pressure, but during pregnancy it can cause hypertension. On the recommendation of a doctor, pregnant women with diabetes should be monitored on a special schedule, also visiting specialist doctors in a timely manner.
The dangers of high blood pressure before childbirth
Increased blood pressure before childbirth is an extremely unfavorable factor. Often this is a signal that gestosis has developed. This is the name for late toxicosis of pregnancy, a dangerous complication of the last weeks of gestation. The woman’s body retains fluid, the pregnant woman experiences swelling and increased protein content in the urine. The child also suffers: he lacks oxygen in the womb.
Jumps in blood pressure and possible premature abruption of the placenta are dangerous, and this is an extremely alarming situation - childbirth can be premature. Finally, gestosis can provoke eclampsia, and this is a condition with characteristic convulsive seizures that requires mandatory resuscitation procedures. This diagnosis is a threat to the life and health of the woman and baby.
Pregnancy itself is a factor that prevents the body from returning to normal, so you need to monitor the woman’s condition, responding in time with the right prescriptions and supportive procedures.
Why is high blood pressure dangerous during childbirth?
If a woman in labor has high blood pressure, she cannot give birth naturally. Giving birth with high blood pressure is a big risk. Therefore, doctors assess the degree of pathology, predict how the body will react to even greater stress, childbirth, and decide whether to give the woman the opportunity to give birth herself or have a cesarean section. In most cases, the choice is in favor of surgery.
Childbirth with hypertension is a threat to the life of mother and child, and during surgery, doctors can monitor the patient’s condition and thereby prevent complications.
If a woman is in the last weeks of pregnancy and has signs of hypertension, do not wait - go to the doctor, or straight to the hospital.
Signs of high blood pressure:
Why does blood pressure jump after childbirth?
If earlier, before pregnancy and during gestation, there was no hypertension, but after the birth of the child pressure surges appeared, the matter may be a neuropsychiatric disorder. And to be more specific, this is overexertion, which often occurs during the postpartum period.
The reasons for it are obvious: the woman is recovering physiologically and morally, but the recovery period cannot be called calm. She has a baby in her arms who requires round-the-clock attention.
And if a young mother has not yet learned to distribute her strength, if her life pattern with a child in her arms has not yet returned to normal, her body is under serious stress. Fatigue, stress, overwork lead to a physical reaction of the body to such events. Failure of self-regulation of the nervous system leads to pressure surges, headaches, and fatigue.
This condition requires medical and psychological intervention. This is not always associated with postpartum depression - this pathology is extremely serious, but it does not occur so often. But the so-called baby blues is a much more common condition, and the psychosomatic manifestations of this disorder can be expressed precisely by changes in blood pressure.
In addition, after the birth of a child, blood pressure increases due to:
- Hormonal imbalance (vasospasm under the influence of hormones);
- Recurrent chronic diseases;
- Side effects of medications taken by the mother.
If pathology is detected, you need to go to the doctor and under no circumstances stop lactation. The doctor will help you choose medications that are characterized by a low level of passage into breast milk.
Antihypertensive drugs should be taken so that the lactation period does not coincide in time with the moment of maximum concentration of the drug in the blood. Therefore, it is recommended for a woman to take the pills immediately before feeding, so that the active ingredients of the drugs simply do not have time to enter the bloodstream so quickly.
High blood pressure after caesarean section
Caesarean section is a rescue operation. This is a cavity surgery, which means a recovery period is required. Some people get through it relatively easily, while others find the recovery days excruciating. But you need to be prepared for the fact that there will be a postoperative period, and it requires preparation and full compliance with medical recommendations.
A separate item is spinal anesthesia. To ensure that a woman is conscious during the birth of her baby by Caesarean section, she may be given a spinal anesthetic. The anesthesiologist makes a puncture of the dura mater in a certain part of the spine, using a special thin needle.
Between the spinal cord and its membrane there is a fluid-filled zone, this fluid is called cerebrospinal fluid. When the membrane is punctured, a small amount of fluid leaks out, and intracranial pressure drops sharply because of this. This subsequently provokes headaches, and they can already be accompanied by pressure surges.
High blood pressure and postoperative endometritis
In some women, high blood pressure accompanies endometritis - this is a severe postoperative complication. Along with air, viruses and microbes can enter the uterine cavity, which is open during surgery. And if this happens, then in the first days after cesarean section, signs of endometritis will appear.
Symptoms of endometritis:
High blood pressure is an optional sign of endometritis, but it may well occur in addition to the others. To avoid this complication, antibiotics are prescribed to the young mother after the operation.
And before discharge, the woman is monitored: she is examined, an ultrasound is performed to exclude postpartum complications.
Is high blood pressure associated with hormonal imbalance?
After the birth of a child, the mother's body is rebuilt. This takes quite a long time. Therefore, the menstrual cycle does not return to normal immediately, even if the woman is no longer breastfeeding. Weight gain can also be a hormonal consequence of pregnancy. But they, hormones, do not justify addiction to sweets, flour and fatty foods, just as they do not justify physical inactivity.
But hormonal changes do not always go smoothly. Be sure to consult an endocrinologist if:
- Weight increases unmotivated;
- Signs of virilization are observed - hair grows according to the male type;
- The cycle is irregular, spotting is observed between periods;
- Neurotic symptoms appeared - headache, drowsiness, fatigue;
- High/low blood pressure is noted.
Whatever causes the increase in pressure, it cannot be ignored. You must first go to a therapist, he can send you to a cardiologist, neurologist, endocrinologist. After undergoing the examination, the patient will be prescribed competent and safe treatment, which will not become an obstacle to prolonging the lactation period.
The video shows high blood pressure and pregnancy.
Let's consider what causes problems with blood pressure, what symptoms accompany it, what kind of treatment is indicated, and what possible risks await a woman who refuses medical help?
Causes and course
The reasons why blood pressure may increase are varied, but the most significant are:
- heredity, in which hypertension bothers family members and is inherited;
- the woman has untreated, chronic kidney disease;
- dysfunction of the endocrine system;
- pathological hormonal imbalance;
- a mental or neurogenic disorder that can cause hypertension.
The chronic form of the disease is life-threatening for the pregnant woman and the fetus.
Hypertension in most cases occurs in the pre-pregnancy period, but often the pathology develops after conception. If arterial hypertension bothered a woman before conception, then the symptoms will worsen afterwards, and if the situation is not controlled, there is a high risk of serious complications that can cost the woman and baby their lives. In severe cases of the disease, pregnancy and childbirth are contraindicated, and if a woman manages to become pregnant, premature termination is indicated. During the period of bearing a child, depending on the factors provoking the pathology, there are:
- Arterial hypertension of pregnancy, when blood pressure rises in the second trimester, but after childbirth the pathology does not bother you.
- Chronic hypertension, in which high blood pressure bothers a woman before, during, and after pregnancy.
- Preeclampsia, when during the period of bearing a child, chronic diseases and other kidney pathologies worsen, which affects the functioning of the cardiovascular system.
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Symptoms of pathology
In arterial hypertension, the most dangerous symptom is a sharp increase in blood pressure. In this case, the accompanying symptoms are as follows:
- cardiopalmus;
- tinnitus;
- deterioration of visual and auditory functions;
- severe headaches;
- blood may flow from the nose;
- sleep deteriorates, signs of anxiety, irritability, and fatigue appear.
Return to contents
Diagnostic methods
The course of hypertension cannot always be diagnosed in time, since many women take symptoms of deterioration in health as a sign of pregnancy. Therefore, not everyone immediately runs to the hospital and finds out what exactly is bothering them. If a pregnant woman has had problems with blood pressure in her family, it is worth regularly measuring blood pressure, and if it increases, inform the doctor.
Diagnosis, first of all, consists of regularly measuring blood pressure and monitoring protein in the urine. If there are isolated cases of increased pressure, then there is nothing to worry about, since this phenomenon often occurs in pregnant women. But if the pressure rises rapidly and the woman feels unwell, this indicates the development and exacerbation of the pathology. In this case, the pregnant woman is advised to stay in the hospital, where qualified care will be provided, and, if necessary, first aid will be provided.
Treatment of hypertension
If a woman suffers from severe arterial hypertension, the doctor will advise you to stay in the hospital for a more complete examination and determine the cause of this condition. When the danger has passed, medications for hypertension are prescribed, which it is important to take strictly according to the proposed regimen; the course will last until childbirth. You should strictly follow all the doctor’s recommendations, take prescribed medications, and monitor your condition. Do not try to fix the problem yourself, this will only make the situation worse and cause dangerous consequences.
When the pathology occurs in a mild form, the doctor will advise you to reconsider your diet, adjust your daily routine, get more rest, and walk in the fresh air. It is not necessary to take pills, it is only important to monitor your well-being, and in case of rapid deterioration, urgently go to the hospital and not self-medicate. Increased blood pressure before childbirth is a fairly common situation, but if adequate measures are taken, the pathology can be controlled and complications can be avoided.
Childbirth with high blood pressure
Natural childbirth with hypertension and high blood pressure is contraindicated, because the pressure can rise critically, and this is dangerous for the life of the expectant mother and child. Therefore, before giving birth, the doctor will weigh all the risks and recommend a cesarean section. Such childbirth with hypertension is the safest, and the doctor will be able to constantly monitor the situation and prevent dangerous complications during childbirth.
If a woman with hypertension suffered from high blood pressure even before conception, and the condition was accompanied by serious consequences, she is contraindicated to become pregnant and give birth to a child, because the consequences of such an illness can be unpredictable.
Possible complications and consequences
If arterial hypertension worsens during pregnancy, there is a high probability of developing late toxicosis, which is dangerous both for the woman herself and for the unborn child. Another extremely dangerous complication that provokes high blood pressure is hemorrhagic stroke. With hypertension, the entire body suffers, because high blood pressure leads to disruption of the blood supply to internal organs. This negatively affects the development of the fetus, and as a consequence - disruption of the formation of the cardiovascular and central nervous systems, intrauterine bleeding, placental abruption, and premature birth in the early stages.
When should you sound the alarm and go to the hospital?
For hypertension in pregnant women, specific treatment is prescribed, in which you should take the recommended medications and monitor your blood pressure. But there are times when you cannot help yourself at home, so you should always be prepared, and in case of a sharp deterioration, immediately call an ambulance. The following symptoms should alert the pregnant woman and her loved ones:
- unbearable headache and severe pressure in the temples;
- dizziness;
- increased heart rate;
- swelling of the face, upper and lower extremities;
- blurred vision, spots and spots before the eyes, photosensitivity;
- pain and cramps in the abdomen;
- nausea, profuse belching and heartburn.
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Prevention and prognosis
To ensure that the disease does not worsen and the situation is under control, it is worth knowing about preventive measures that will help avoid many complications. If a woman has hypertension, then even before conception it is worth finding out the cause of the pathology and undergoing a course of treatment. If you have kidney problems, it is important to properly treat the chronic disease and make sure that you can get rid of it. Before getting pregnant, you should bring your weight back to normal, and if it is excessive, you can consult a doctor and choose a nutrition plan that would help you reduce body weight without harming your health and immunity. It is useful to do light exercise, walk more in the fresh air, and eat healthy, light foods.
If the pathology begins to develop after conception, you should regularly monitor your blood pressure, take medications prescribed by your doctor, follow a daily routine, and exclude heavy meals and foods containing sugar, dyes and preservatives from your diet. Consume salt in moderation, drink enough water, and avoid black tea and coffee. If your health worsens, it is not recommended to try to cope with the problem yourself and self-medicate. If a woman feels that she is getting worse, she should immediately call an ambulance, then the chances of successful recovery and completion of the pregnancy are much higher.
Childbirth with hypertension
Classification of hypertensive disorders in pregnant women
Contraindications to childbirth in women with arterial hypertension
There are a number of circumstances in which late pregnancy termination is used:
Therapy. When is inpatient treatment required?
Increase in blood pressure from baseline by 30 mm Hg. and more;
Manifestation of pathologies from the central nervous system;
Outpatient treatment does not bring the desired effect.
Non-drug treatment for high blood pressure
Meal regimen;
Adequate control of risk factors;
No salt diet or restriction in salt consumption to 5 g/day;
If you gain excessive weight, avoid cholesterol-containing foods.
Drug treatment of hypertension in pregnant women
Basic medications for the treatment of hypertension:
2nd line: Atenolol, Metoprolol;
Nifedipine, Amlodipine, Verapamil, Felodipine (prescribed in cases where the possible benefits may outweigh the risks);
3rd line: Methyldop+ 2nd line drug.
For preventive measures and treatment, different combinations of the listed drugs are used in minimal dosages.
Complications of gestation. How to treat hypertension on different lines?
Regulating the functioning of the central nervous system;
For diffusion-transfusion therapy;
To improve uteroplacental blood flow;
Does blood pressure increase before childbirth? Risks for the mother and baby
Bleeding (as a result of DIC syndrome);
The third stage of labor differs from the previous ones in that as a result of an immediate drop in intra-abdominal pressure and relief of pressure on the aorta, blood is redistributed. This affects the reduction of blood pressure during childbirth.
Interruption of pregnancy;
Childbirth using cesarean section;
Preparation for possible massive coagulopathic bleeding during delivery with hypertension;
Continuation of drug treatment for 2-3 days after delivery;
Preventive measures to avoid thrombotic and inflammatory complications in the postpartum period.
Timing and methods of delivery for hypertension
Indications for premature delivery:
Deterioration of the fetus' condition;
Complications such as retinal detachment, stroke, heart attack.
If you have high blood pressure, do you do quesotherapy?
but I didn’t lie down with my son, they tried to put me to bed, but there was work, there was a family, as a result there was a sharp rise in blood pressure, an emergency caesarean section, my son was in intensive care, and I was on a drip with failing kidneys.
therefore, if the gynecologist says go to the hospital, then go to bed, they say cesarean means cesarean.
I gave birth myself, so don’t worry, they can do cesoration as a last resort.
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Pregnancy and childbirth are one of the most important periods in a woman’s life. If the child is desired, then motherhood brings incomparable joy. And, of course, I want the pregnancy to be easy and the baby to be born healthy. But hypertension can greatly complicate the fulfillment of this dream. Pregnancy with hypertension is a “special case”. If a woman has already been diagnosed with arterial hypertension before pregnancy, this will certainly create problems for doctors and for the expectant mother.
In what cases can women with high blood pressure become pregnant and bear a child, and when is this strictly contraindicated? Let's try to figure it out together.
Risks during pregnancy at various stages of hypertension
If you have hypertension, whether you can carry and give birth to a healthy child depends very much on the stage (severity) of the disease. If you have the third (severe) stage of hypertension, that is, your blood pressure goes off scale beyond 180/110 mm. rt. Art., then pregnancy is absolutely contraindicated. It is impossible not only to give birth, but to become pregnant in general, because with severe hypertension, abortion is also a deadly event.
If the doctor has diagnosed stage 2 hypertension (moderate, blood pressure/mm Hg), then it is, in principle, possible to become pregnant and give birth to a healthy child. But, unfortunately, this is only relevant for those women who did not have complications with the heart or kidneys, as well as hypertensive crises, before pregnancy. Well, the first (mild) stage of hypertension is not a contraindication for bearing and giving birth to a child. In the case of confirmed hypertension in a pregnant woman, the issue of continuing pregnancy should be decided on the first visit to a therapist or cardiologist.
Of course, high blood pressure of any severity can pose a threat to the course of pregnancy. Therefore, after pregnancy, a woman should immediately contact not only a gynecologist, but also a cardiologist, and then be regularly checked by both of these specialists.
Cardiologists conduct the following examinations of pregnant women with hypertension: regular measurement of blood pressure (this can be done at home yourself), an electrocardiogram. Also, once every two weeks you need to take a urine test to determine the presence of protein in it - this is an indicator of kidney function. When monitoring the health of the expectant mother, doctors do not forget to check the fetus. He has regular ultrasounds to monitor his growth and development.
The cardiologist will give the woman recommendations on how she should change her lifestyle to reduce the likelihood of pregnancy complications. These include: physical education, diet for hypertension, giving up bad habits, psychological climate in the family and at work.
If you were taking antihypertensive (lowering blood pressure) medications before pregnancy, you should definitely tell your doctor about this. The doctor will determine which of your medications are safe for the fetus, and which ones need to be replaced or completely discontinued so as not to have a harmful effect on the health of the unborn child.
Complications of pregnancy with hypertension
It often happens that in the early stages of pregnancy in women with hypertension, blood pressure decreases naturally. In this situation, you can reduce your intake of medications for hypertension or even stop taking them altogether. Although the opposite can also happen: pregnancy increases a woman’s stress level, especially if she has never given birth. And this, in turn, can provoke “jumps” in blood pressure.
Unfortunately, in 60% of cases, a complication of pregnancy in women with hypertension is late toxicosis, and it is usually severe. Symptoms of this phenomenon: headaches, nausea, blurred vision. The worst thing is if hypertension in a pregnant woman leads to cerebral hemorrhage or retinal detachment.
If a pregnant woman has hypertension, she should be carefully monitored by a cardiologist and obstetrician-gynecologist. This will reduce the likelihood of complications. Specialists will take timely measures if blood pressure begins to rise. A hypertensive crisis or the appearance of signs of late toxicosis is an indication to immediately refer a woman for inpatient treatment in a medical facility.
Even if the pregnancy is progressing normally, a patient with hypertension should be in the maternity ward 2-3 weeks before the predicted due date. The fact is that with hypertension, labor is often complicated both on the part of the mother and on the part of the baby. In the first case, during childbirth, special therapy is carried out to reduce the woman’s blood pressure, and in the second, constant monitoring of the child’s condition. In some cases, doctors decide to perform a caesarean section, sometimes they are forced to induce labor prematurely.
How to carry and give birth to a healthy baby if you have hypertension
Despite everything said above, it should be repeated once again that hypertension at the initial stage is not a contraindication for pregnancy. It’s just that in this situation, the expectant mother should even more carefully follow the recommendations regarding leading a healthy lifestyle. This includes: nutritious nutrition with natural foods with moderate calorie content, walks and other physical activity in the fresh air, a calm and joyful psychological environment at home and at work.
See also: treatment of hypertension - specialized medical site.
Visit doctors regularly, get tested and undergo examinations that are prescribed to you.
Giving up salt may initially cause some inconvenience, but, nevertheless, it must be eliminated from the diet as much as possible. After some time, you will learn to enjoy the natural taste of foods, which was previously “clogged” by salt.
We hope that the healthy habits you develop during pregnancy will stay with you after birth. After all, the health of a pregnant woman and her unborn child depends, first of all, on herself.
Childbirth with high blood pressure
I was thinking about something.
I'm going to the hospital on Monday due to constant high blood pressure.
ideally for me the norm is always 110 to 90
and for several days now it has been 130 to 90, and then it was even higher, and pain in the abdomen, both the entire abdomen and the lower part hurt, very much.
The gynecologist said to go to the maternity hospital, because... Possibly gestosis, although there is no edema, and it seems hidden too. only my blood pressure and my health are bad
I’ll go to bed, what will they do with me? how to treat?
How long will I stay there?
If the same pressure continues, will it be the EU or the Constitutional Court?
and will they be stimulated if so?
I just don't know anything at all
On Sunday I will be exactly 38 weeks. and I go to bed on Monday
yes I would love to, but they told me to wait until Monday
because my maternity hospital opens only on Monday
and the other one to which I was sent was refused because there were no places
How long did it take for her to give birth? for what period? reached 40 weeks? or did the doctors operate before?
I gave birth myself with a blood pressure of 180/100, I don’t know what it will cost me (
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Our pregnancy calendar reveals to you the features of all stages of pregnancy - an extremely important, exciting and new period of your life.
We will tell you what will happen to your future baby and you in each of the forty weeks.
Many babies are extremely excitable: they do not sleep, constantly scream and worry for no apparent reason. This condition of the child indicates that, perhaps, we are talking about increased intracranial pressure. High intracranial pressure in infants is a symptom that can indicate many diseases.
Causes and symptoms
In the ventricles of the brain and in the cavity of the spinal cord, as well as in the space between the bone marrow and the brain, there is a special liquid - cerebrospinal fluid. It has a certain pressure. In a healthy person, cerebrospinal fluid is constantly renewed and circulates, but if for any reason the fluid stagnates, it provokes an increase in intracranial pressure.
Intracranial pressure in newborns increases for the following reasons:
- Hypoxia as a result of complicated pregnancy (childbirth): increased intracranial pressure occurs due to the fact that the brain compensates for the oxygen deficiency due to the accumulation of cerebrospinal fluid. In most cases, the pressure indicator normalizes on its own.
- Hemorrhage into the cranial cavity, accompanied by the appearance of a hematoma: due to injury, the outflow of cerebrospinal fluid is disrupted. Its stagnation in the area where the hematoma appears provokes an increase in intracranial pressure. Hemorrhage often causes hydrocephalic syndrome.
- A tumor in the brain: because of it, the circulation of cerebrospinal fluid is disrupted and it stagnates.
- A genetic abnormality accompanied by poor absorption of fluid into the blood. Excess fluid in the body contributes to disruption of the outflow of cerebrospinal fluid.
Pathology is characterized by specific signs. External symptoms of increased intracranial pressure in infants include:
- strabismus;
- accelerated increase in head circumference;
- prominent forehead and fontanel;
- visualization of subcutaneous plexuses of large vessels;
- slow pace of child development.
The baby also develops the following signs:
- lethargy;
- excessive sensitivity and irritability;
- sleep disturbance;
- frequent and profuse regurgitation;
- the gaze is often directed downwards;
- tilting the head to one side or back;
- insufficient weight gain.
If parents observe some of the listed symptoms, it is necessary to immediately show the child to a doctor. Timely diagnosis and use of therapy will normalize intracranial pressure and minimize its negative impact on the further development of the child.
Diagnostics
If increased intracranial pressure is suspected in an infant, the following medical tests are indicated:
- Examination of the child by a neurologist: the doctor evaluates external signs of pathology and refers the patient to further diagnostic procedures.
- Examination of the child by an ophthalmologist: a specialist checks the fundus of the eye. When intracranial pressure increases, the optic nerve swells in a child.
- Ultrasound examination of the brain: carried out no earlier than 3 days after the birth of the subject. The essence of the method is to study the structures of the brain.
- Magnetic resonance imaging: the most reliable method. Children under 5 years of age are performed under general anesthesia.
- Puncture: a needle is inserted into the spinal canal and a certain amount of cerebrospinal fluid is taken to study its pressure.
Treatment
Self-treatment of increased intracranial pressure in infants is unacceptable, since incorrect selection of therapy can provoke serious complications. Treatment of newborn children is carried out under the strict supervision of doctors. Therapy is aimed not only at normalizing intracranial pressure, but also at eliminating the symptoms of this pathology.
If the pathology occurs against the background of hypoxia, the doctor in most cases recommends making adjustments to the baby’s lifestyle: putting him to the breast more often, walking in the fresh air, and maintaining a sleep schedule. But in some cases, infants require drug treatment. The doctor prescribes to the child:
- Diuretics (diuretics): taking them helps remove excess fluid from the body. These medications include Furosemide and Veroshpiron. They are prescribed for a short time, since long-term use of diuretics threatens potassium leaching.
- Sedatives: Newborns are often prescribed a medicine with citral, which is prepared by pharmacists according to a doctor’s prescription. This mild sedative helps reduce intracranial pressure and normalize sleep.
- Vitamin complexes: B vitamins.
- Nootropic drugs: improve metabolism in the brain. Such drugs include Pantogam, Cerebrill, Piracetam.
Physiotherapy, in particular massage, is also indicated for children with increased intracranial pressure. It is performed by a massage therapist who works with infants.
If pathology occurs due to a brain tumor, the child is indicated for surgical treatment. If intracranial pressure is significantly increased, as a result of which the child has developed hydrocephalic syndrome, the decision will be made in favor of surgical intervention. Ventriculo-peritoneal shunting is often performed. The operation is carried out by implanting a system of silicone catheters, thanks to which cerebrospinal fluid from the lateral ventricle is discharged into the abdominal cavity. The fluid is absorbed by the intestinal loops. Such treatment is considered effective.
Treatment and relief of symptoms of intracranial hypertension using traditional medicine is contraindicated for infants.
A child who has been diagnosed with increased intracranial pressure, even after recovery, should be regularly monitored by a neurologist.
Why does blood pressure increase before and after childbirth?
Pregnancy and childbirth are physiologically determined, natural processes, but this, unfortunately, does not guarantee their successful course. Problems may arise on the eve of delivery, during labor, or in the first days of recovery. And often among the alarming symptoms is high blood pressure. Often this disease occurs in women with a history of diabetes.
High blood pressure before childbirth: possible causes
The last months of the gestational period are associated with the fact that the woman’s body adapts to the upcoming process of giving birth to a baby. It is very important during this period to listen to the body in order to respond to alarming symptoms in a timely manner. Even an absolutely healthy, calm pregnancy of all previous months can cause significant problems in the last trimester.
A pregnant woman may encounter such unpleasant pathologies as varicose veins, swelling, nausea, heartburn, and increased blood pressure. And the last factor is especially dangerous, so all possible provocateurs of hypertension must be warned.
In a healthy woman, the average blood pressure is 120/80 mmHg. Art., this is the norm. Some deviation of these values is acceptable; for expectant mothers, the range of blood pressure marks ranges from 90/60 to 140/90 mmHg. At each appointment with a gynecologist during pregnancy, the patient’s blood pressure is measured. And if the indicators are alarming, the doctor takes immediate action.
Provocateurs for increased blood pressure before childbirth can be:
Diabetes mellitus itself is not a direct cause of high blood pressure, but during pregnancy it can cause hypertension. On the recommendation of a doctor, pregnant women with diabetes should be monitored on a special schedule, also visiting specialist doctors in a timely manner.
The dangers of high blood pressure before childbirth
Increased blood pressure before childbirth is an extremely unfavorable factor. Often this is a signal that gestosis has developed. This is the name for late toxicosis of pregnancy, a dangerous complication of the last weeks of gestation. The woman’s body retains fluid, the pregnant woman experiences swelling and increased protein content in the urine. The child also suffers: he lacks oxygen in the womb.
Jumps in blood pressure and possible premature abruption of the placenta are dangerous, and this is an extremely alarming situation - childbirth can be premature. Finally, gestosis can provoke eclampsia, and this is a condition with characteristic convulsive seizures that requires mandatory resuscitation procedures. This diagnosis is a threat to the life and health of the woman and baby.
Pregnancy itself is a factor that prevents the body from returning to normal, so you need to monitor the woman’s condition, responding in time with the right prescriptions and supportive procedures.
Why is high blood pressure dangerous during childbirth?
If a woman in labor has high blood pressure, she cannot give birth naturally. Giving birth with high blood pressure is a big risk. Therefore, doctors assess the degree of pathology, predict how the body will react to even greater stress, childbirth, and decide whether to give the woman the opportunity to give birth herself or have a cesarean section. In most cases, the choice is in favor of surgery.
Childbirth with hypertension is a threat to the life of mother and child, and during surgery, doctors can monitor the patient’s condition and thereby prevent complications.
If a woman is in the last weeks of pregnancy and has signs of hypertension, do not wait - go to the doctor, or straight to the hospital.
Signs of high blood pressure:
Why does blood pressure jump after childbirth?
If earlier, before pregnancy and during gestation, there was no hypertension, but after the birth of the child pressure surges appeared, the matter may be a neuropsychiatric disorder. And to be more specific, this is overexertion, which often occurs during the postpartum period.
The reasons for it are obvious: the woman is recovering physiologically and morally, but the recovery period cannot be called calm. She has a baby in her arms who requires round-the-clock attention.
And if a young mother has not yet learned to distribute her strength, if her life pattern with a child in her arms has not yet returned to normal, her body is under serious stress. Fatigue, stress, overwork lead to a physical reaction of the body to such events. Failure of self-regulation of the nervous system leads to pressure surges, headaches, and fatigue.
This condition requires medical and psychological intervention. This is not always associated with postpartum depression - this pathology is extremely serious, but it does not occur so often. But the so-called baby blues is a much more common condition, and the psychosomatic manifestations of this disorder can be expressed precisely by changes in blood pressure.
In addition, after the birth of a child, blood pressure increases due to:
- Hormonal imbalance (vasospasm under the influence of hormones);
- Recurrent chronic diseases;
- Side effects of medications taken by the mother.
If pathology is detected, you need to go to the doctor and under no circumstances stop lactation. The doctor will help you choose medications that are characterized by a low level of passage into breast milk.
Antihypertensive drugs should be taken so that the lactation period does not coincide in time with the moment of maximum concentration of the drug in the blood. Therefore, it is recommended for a woman to take the pills immediately before feeding, so that the active ingredients of the drugs simply do not have time to enter the bloodstream so quickly.
High blood pressure after caesarean section
Caesarean section is a rescue operation. This is a cavity surgery, which means a recovery period is required. Some people get through it relatively easily, while others find the recovery days excruciating. But you need to be prepared for the fact that there will be a postoperative period, and it requires preparation and full compliance with medical recommendations.
A separate item is spinal anesthesia. To ensure that a woman is conscious during the birth of her baby by Caesarean section, she may be given a spinal anesthetic. The anesthesiologist makes a puncture of the dura mater in a certain part of the spine, using a special thin needle.
Between the spinal cord and its membrane there is a fluid-filled zone, this fluid is called cerebrospinal fluid. When the membrane is punctured, a small amount of fluid leaks out, and intracranial pressure drops sharply because of this. This subsequently provokes headaches, and they can already be accompanied by pressure surges.
High blood pressure and postoperative endometritis
In some women, high blood pressure accompanies endometritis - this is a severe postoperative complication. Along with air, viruses and microbes can enter the uterine cavity, which is open during surgery. And if this happens, then in the first days after cesarean section, signs of endometritis will appear.
Symptoms of endometritis:
High blood pressure is an optional sign of endometritis, but it may well occur in addition to the others. To avoid this complication, antibiotics are prescribed to the young mother after the operation.
And before discharge, the woman is monitored: she is examined, an ultrasound is performed to exclude postpartum complications.
Is high blood pressure associated with hormonal imbalance?
After the birth of a child, the mother's body is rebuilt. This takes quite a long time. Therefore, the menstrual cycle does not return to normal immediately, even if the woman is no longer breastfeeding. Weight gain can also be a hormonal consequence of pregnancy. But they, hormones, do not justify addiction to sweets, flour and fatty foods, just as they do not justify physical inactivity.
But hormonal changes do not always go smoothly. Be sure to consult an endocrinologist if:
- Weight increases unmotivated;
- Signs of virilization are observed - hair grows according to the male type;
- The cycle is irregular, spotting is observed between periods;
- Neurotic symptoms appeared - headache, drowsiness, fatigue;
- High/low blood pressure is noted.
Whatever causes the increase in pressure, it cannot be ignored. You must first go to a therapist, he can send you to a cardiologist, neurologist, endocrinologist. After undergoing the examination, the patient will be prescribed competent and safe treatment, which will not become an obstacle to prolonging the lactation period.
The video shows high blood pressure and pregnancy.
High blood pressure during pregnancy
During pregnancy, increased blood pressure occurs in every tenth woman. In every twentieth patient, hypertension causes a dangerous condition - preeclampsia.
High blood pressure in pregnant women may be associated with the following conditions:
- hypertension in pregnancy;
- chronic hypertension.
Arterial hypertension occurring during pregnancy
Arterial hypertension in pregnant women is also called gestational hypertension. In this condition, systolic pressure rises to more than 140 mmHg. Art., and diastolic - above 90 mm Hg. Art. It occurs mainly after the 20th week of pregnancy and goes away after childbirth. It can be isolated or combined with edema and the appearance of protein in the urine. High blood pressure during pregnancy often occurs in young women, pregnant for the first time, and previously healthy. In more severe cases, increased pressure is combined with proteinuria and serves as a sign of preeclampsia or eclampsia.
Development mechanism
It has been proven that the tendency to increase blood pressure during pregnancy is genetically programmed. In particular, the structure of the gene responsible for the synthesis of angiotensinogen and angiotensin-converting enzyme changes. These substances actively maintain blood pressure levels. Such genetic changes do not affect the risk of developing hypertension itself. They can only appear during pregnancy.
In patients with high blood pressure during pregnancy, due to genetic mutations, the activity of the renin-angiotensin-aldosterone system, which maintains the constancy of vascular tone and water-salt metabolism, is impaired. It is known that during pregnancy the amount of sodium in the body increases significantly. These ions retain water, increasing the volume of circulating blood, which is necessary for blood supply to the fetus. Sodium is excreted in large quantities through the kidneys and is partially absorbed back into the blood. If the renin-angiotensin-aldosterone system is impaired, the reabsorption (reabsorption) of sodium slows down, it is excreted in the urine, followed by fluid, resulting in a decrease in the volume of circulating blood. Hypovolemia (decreased blood volume) leads to the development of gestosis, pathology of the placenta, and even premature birth.
When the volume of circulating blood decreases below a critical value, a reflex spasm of the vessels of peripheral tissues occurs. This reaction is designed to reduce the volume of the vascular bed, bringing it into line with the reduced blood volume. A manifestation of this condition is increased blood pressure in a pregnant woman.
Vascular spasm leads to damage to their inner lining (endothelium). Platelets begin to “stick” to these defects, microthrombi form, microcirculation is disrupted, and a large amount of biologically active substances are released, including those with toxic effects. As a result, damage to the kidneys, brain, liver, and uterus may develop. The earliest sign of organ damage is proteinuria, that is, the appearance of protein in the urine. In the future, swelling may occur and preeclampsia develops.
One of the important factors for increasing blood pressure in pregnant women is endothelial dysfunction: improper functioning of the inner lining of blood vessels, which releases substances that cause vasospasm.
After childbirth, a woman’s hormonal levels are restored, and the volume of the vascular bed naturally decreases, coming into line with the volume of blood.
The venous return of blood to the heart is normalized, and cardiac output is restored. As a result, blood pressure levels normalize.
Risk factors
Arterial hypertension in pregnant women most often occurs in the following situations:
- first pregnancy and childbirth;
- hypertension in close relatives;
- diabetes;
- multiple pregnancy;
- polyhydramnios;
- hydatidiform mole;
- kidney disease in women.
Symptoms
Rapid weight gain, especially in combination with edema, should alert a woman, as this poses a threat to her health.
In addition to increased blood pressure, a woman may experience the following symptoms:
- rapid weight gain;
- swelling in the legs;
- headache;
- visual impairment;
- pain in the upper third of the abdomen.
If such symptoms appear, you should immediately consult a doctor.
Treatment
Before starting treatment, a pregnant woman should undergo 24-hour blood pressure monitoring. This method helps to obtain valuable information about the level of pressure at different times of the day and determine the average pressure. Taking into account the obtained indicators, treatment tactics are developed, and subsequently delivery.
The therapy is designed to improve blood circulation, including venous circulation.
Its main directions:
- lying position on the left side;
- moderate physical activity;
- taking venotonic drugs after consulting a doctor;
- inadmissibility of sharp restriction of liquid and table salt;
- timely delivery, mostly conservative.
A woman should wisely reduce her intake of refined carbohydrates and animal protein. Pain, anxiety, stress, and unpleasant expectations should be avoided. All these emotions have been proven to increase blood pressure.
Medicines to lower blood pressure and diuretics are prescribed by the doctor only when necessary. The most commonly used are beta blockers or methyldopa.
Chronic hypertension during pregnancy
If a woman suffered from hypertension before pregnancy, then throughout pregnancy she is advised to constantly take antihypertensive drugs that are safe for the fetus and control blood pressure.
This condition refers to increased blood pressure caused by chronic diseases that arose before pregnancy. Most often, chronic hypertension is due to the following reasons:
- hypertonic disease;
- chronic kidney disease;
- metabolic disorders.
Hypertension can be observed before pregnancy, or may first appear only in the first trimester. After childbirth, hypertension may persist or even worsen. Pregnancy is contraindicated in case of high blood pressure (above 200/115 mm Hg), damage to the blood vessels of the brain, kidneys, heart, and retina.
When these two conditions are combined, the fetus suffers. The risk of developing preeclampsia, placental insufficiency and fetal growth retardation increases. The likelihood of placental abruption increases several times. The mother’s body also suffers: brain vessels are affected and encephalopathy develops. Even cerebrovascular accident may occur.
Pregnancy management
Before 12 weeks, a pregnant woman with hypertension must be hospitalized to assess the possibility of continuing the pregnancy. If pregnancy is not contraindicated, the next hospital treatment is carried out at 28–32 weeks, when the woman’s cardiovascular system is subject to the greatest load.
Hypertension during pregnancy is treated primarily with beta blockers and calcium antagonists with the addition of potassium-sparing diuretics. At 37–38 weeks, planned hospitalization is carried out to prepare for childbirth.
Management of childbirth
Delivery of hypertension during pregnancy is often carried out through the vaginal birth canal using epidural anesthesia. They try to shorten the second stage of labor by performing an episiotomy, using vacuum extraction of the fetus or obstetric forceps. If necessary, oxytocin, but not methylergometrine, is used to prevent bleeding in the third period. The latter drug is contraindicated as it causes vasospasm and increased blood pressure.
If antihypertensive therapy is ineffective, as well as in cases of severe complications (cerebrovascular accident in a woman, placental abruption, etc.), a cesarean section is performed.
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