Pressure Points

Dr. Dolores Roman of Independence Blue Cross answers our questions about high blood pressure and pregnancy.

Who should be concerned about high blood pressure during pregnancy?
Dr Roman: During pregnancy, blood pressure is one of the vital signs we pay close attention to because it can lead to life-threatening complications for the mother and unborn child. Some of these complications include preeclampsia, eclampsia, stroke, the need for labor induction and placental abruption. Hypertensive disorders (high blood pressure) currently affect 5 to 10% of people during labor and delivery and up to a year after delivery, which is a 25% increase during the past two decades. 

What puts pregnant people at high risk for high blood pressure during pregnancy? DR: High blood pressure can happen to a pregnant person during pregnancy, delivery, and even up to a year after a child is born. Pregnancy-related heart problems can happen to anyone, but people may be at higher risk if they are over 40; are African American, American Indian or Alaskan native; are overweight or obese; use opioids, alcohol, or tobacco; or have existing heart disease or an existing heart condition.

Can high blood pressure impact the baby? DR: Yes! Less blood flow to the placenta (organ that connects the growing baby to the mother) can result in the fetus receiving less oxygen and fewer nutrients. Placental abruption, where the placenta separates from the inner wall of the uterus before delivery, can occur. Intrauterine growth restriction, a condition where baby does not grow to normal weight during pregnancy, can lead to low birth weight. Also premature delivery and future heart disease for the child are possible.

What are the signs and symptoms of high blood pressure? DR: A common sign of high blood pressure during pregnancy is finding protein in the pregnant person’s urine. Symptoms of high blood pressure include a headache that will not go away; changes in vision; chest pain; pain in the upper stomach area; nausea or vomiting, swelling of the face or hands, sudden weight gain; and trouble breathing. Many pregnant people have no symptoms, which is why it’s important to visit a health care team regularly during pregnancy.

How can pregnant people manage hypertension?
DR: Talk to your doctor about your risk of for high blood pressure, your medications, and any concerns you may have. Live a healthy lifestyle, including choosing healthy foods, getting regular physical activity, aiming for a healthy weight, managing stress, getting good quality sleep, and quitting smoking. Take blood pressure medications as prescribed and pay attention to the symptoms of high blood pressure during pregnancy and in the year following delivery. If symptoms develop, seek treatment from a medical provider.

If you had high blood pressure during pregnancy, are pregnant people at risk for heart disease after? DR: Yes. Hypertension during pregnancy can unfortunately affect a person’s heart health years or even decades after a child is born. People who had preeclampsia have a higher long-term risk of future heart and blood vessel problems. They should work with their doctor to monitor overall heart health and to make medication and lifestyle changes as needed.

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