Pressure in Pregnancy
Gestational hypertension is becoming more common, but it can be successfully managed
A woman may have normal blood pressure, near or at 120/80, her entire life. But when she gets pregnant, she may see those numbers go up. What happened? Certainly the baby isn’t causing high blood pressure, right?
Andres Montes, MD, with SJ/C Physician Network – OB/GYN, says the problem is not the baby growing inside you but the placenta that delivers nutrients and oxygen and helps the baby grow.
“We know from a molecular standpoint that the placenta is sending out factors into the vascular system that remodel it and put the patient at risk for high blood pressure, or what we call gestational hypertension,” Dr. Montes says. “What we don’t know yet is why.”
What doctors do know is how to keep both mom and baby safe for the rest of the pregnancy. Managing gestational hypertension is crucial because the condition can increase the risk of preeclampsia, a serious and possibly even fatal complication of pregnancy.
“If I see that your blood pressure rises in the 20th week or later, the first thing I have to do is rule out preeclampsia,” Dr. Montes says. He will look for certain signs and symptoms, such as high levels of protein in urine. Once preeclampsia is ruled out, your diagnosis is gestational hypertension. If the high blood pressure was present before 20 weeks, that is a different diagnosis of chronic hypertension.
“With gestational hypertension, I will see you every week starting at 32 weeks,” Dr. Montes says. “We will complete ultrasounds to make sure the baby is neurologically doing well. We will make sure the placenta is working properly and that the blood flow between the baby and the placenta is going well.”
Delivery is always at 37 weeks for moms with gestational hypertension. This is necessary due to risk of preeclampsia, increased maternal morbidity and mortality, and increased risk to the fetus, including stillbirth.
“We also don’t prescribe blood pressure medication because we don’t want to mask any developing severe preeclampsia,” Dr. Montes says.
If you are being closely monitored each week, you may feel more anxious about your pregnancy. Dr. Montes hopes to alleviate those fears in his patients.
“This condition is becoming more and more common,” he says. “So I don’t want all these new moms to feel afraid. We are very adept at managing gestational hypertension so that you will have the safest pregnancy possible.”