Pre-eclampsia
Blood pressure is the amount of force exerted by the blood against
the walls of the arteries. A person's blood pressure is considered high when
the readings are greater than 140 mm Hg systolic (the top number in the blood
pressure reading) or 90 mm Hg diastolic (the bottom number). In general, high
blood pressure, or hypertension, contributes to the development of coronary
heart disease, stroke, heart failure and kidney disease.
Return to top 
Although many pregnant women with high blood pressure have healthy
babies without serious problems, high blood pressure can be dangerous for both
the mother and the fetus. Women with pre-existing, or chronic, high blood pressure
are more likely to have certain complications during pregnancy than those with
normal blood pressure. However, some women develop high blood pressure while
they are pregnant (often called gestational hypertension). The effects of high
blood pressure range from mild to severe. High blood pressure can harm the
mother's kidneys and other organs, and it can cause low birth weight and early
delivery. In the most serious cases, the mother develops preeclampsia--or "toxemia
of pregnancy"--which can threaten the lives of both the mother and the fetus.
Return to top
Preeclampsia is a condition that typically starts after the 20th week
of pregnancy and is related to increased blood pressure and protein in the
mother's urine (as a result of kidney problems). Preeclampsia affects the placenta,
and it can affect the mother's kidney, liver, and brain. When preeclampsia
causes seizures, the condition is known as eclampsia--the second leading cause
of maternal death in the U.S. Preeclampsia is also a leading cause of fetal
complications, which include low birth weight, premature birth, and stillbirth.
There is no proven way to prevent preeclampsia. Most women who develop signs
of preeclampsia, however, are closely monitored to lessen or avoid related
problems. The only way to "cure" preeclampsia is to deliver the baby.
Return to top
High blood pressure problems occur in 6 percent to 8 percent of all pregnancies
in the U.S., about 70 percent of which are first-time pregnancies. In 1998,
more than 146,320 cases of preeclampsia alone were diagnosed. Although the
proportion of pregnancies with gestational hypertension and eclampsia has remained
about the same in the U.S. over the past decade, the rate of preeclampsia has
increased by nearly one-third. This increase is due in part to a rise in the
numbers of older mothers and of multiple births, where preeclampsia occurs
more frequently. For example, in 1998 birth rates among women ages 30 to 44
and the number of births to women ages 45 and older were at the highest levels
in 3 decades, according to the National Center for Health Statistics. Furthermore,
between 1980 and 1998, rates of twin births increased about 50 percent overall
and 1,000 percent among women ages 45 to 49; rates of triplet and other higher-order
multiple births jumped more than 400 percent overall, and 1,000 percent among
women in their 40s.
Return to top
- Women with chronic hypertension (high blood pressure before becoming pregnant).
- Women who developed high blood pressure or preeclampsia during a previous
pregnancy, especially if these conditions occurred early in the pregnancy.
- Women who are obese prior to pregnancy.
- Pregnant women under the age of 20 or over the age of 40.
- Women who are pregnant with more than one baby.
- Women with diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma.
Return to top
Unfortunately, there is no single test to predict or diagnose preeclampsia.
Key signs are increased blood pressure and protein in the urine (proteinuria).
Other symptoms that seem to occur with preeclampsia include persistent headaches,
blurred vision or sensitivity to light, and abdominal pain. All of these sensations
can be caused by other disorders; they can also occur in healthy pregnancies.
Regular visits with your doctor help him or her to track your blood pressure
and level of protein in your urine, to order and analyze blood tests that detect
signs of preeclampsia, and to monitor fetal development more closely.
Return to top
If you are thinking about having a baby and you have high blood pressure,
talk first to your doctor or nurse. Taking steps to control your blood pressure
before and during pregnancy--and getting regular prenatal care--go a long way
toward ensuring your well-being and your baby's health. Before becoming pregnant:
- Be sure your blood pressure is under control. Lifestyle changes such as
limiting your salt intake, participating in regular physical activity, and
losing weight if you are overweight can be helpful.
- Discuss with your doctor how hypertension might affect you and your baby
during pregnancy, and what you can do to prevent or lessen problems.
- If you take medicines for your blood pressure, ask your doctor whether
you should change the amount you take or stop taking them during pregnancy.
Experts currently recommend avoiding angiotensin-converting enzyme (ACE)
inhibitors and Angiotensin II (AII) receptor antagonists during pregnancy;
other blood pressure medications may be OK for you to use. Do not, however,
stop or change your medicines unless your doctor tells you to do so.
While you are pregnant:
- Obtain regular prenatal medical care.
- Avoid alcohol and tobacco.
- Talk to your doctor about any over-the-counter medications you are taking
or are thinking about taking.
Return to top
The effects of high blood pressure during pregnancy vary depending
on the disorder and other factors. According to the National High Blood Pressure
Education Program (NHBPEP), preeclampsia does not in general increase a woman's
risk for developing chronic hypertension or other heart-related problems. The
NHBPEP also reports that in women with normal blood pressure who develop preeclampsia
after the 20th week of their first pregnancy, short-term complications--including
increased blood pressure--usually go away within about 6 weeks after delivery.
Some women, however, may be more likely to develop high blood pressure or other
heart disease later in life. More research is needed to determine the long-term
health effects of hypertensive disorders in pregnancy and to develop better
methods for identifying, diagnosing, and treating women at risk for these conditions.
Even though high blood pressure and related disorders during pregnancy can
be serious, most women with high blood pressure and those who develop preeclampsia
have successful pregnancies. Obtaining early and regular prenatal care is the
most important thing you can do for you and your baby.
Return to top
