If a pregnant woman develops high blood pressure after the 20th week of pregnancy, but her urine does not show any traces of protein and she also does not experience any major symptoms of preeclampsia, then she is most likely suffering from gestational hypertension or pregnancy-induced hypertension (PIH). Gestational hypertension or PIH is that kind of hypertension that occurs only during pregnancy and disappears after delivery. If the blood pressure is greater than 140/90 Hg, then a pregnant woman is diagnosed with gestational hypertension. It is not impossible to have natural delivery with gestational hypertension. Many women have successfully delivered the baby vaginally with gestational hypertension. However, there are some risks involved and precautions that need to be taken. Read on to know all about it.
- Who Are At Risk Of Developing Gestational Hypertension?
- Signs And Symptoms Of Gestational Hypertension
- How To Treat Gestational Hypertension?
- Impact Of Gestational Hypertension On Labor And Delivery
- Precautions To Be Taken For A Vaginal Delivery With Gestational Hypertension
Who Are At Risk Of Developing Gestational Hypertension?
Gestational hypertension is generally hereditary, so if a pregnant woman has a family history of gestational hypertension, chances are she will have it too. If a woman is pregnant for the first time, chances of developing gestational hypertension is quite common. The risk of gestational hypertension is higher in women:
- Who are under 20 years or over 35 years
- Who are obese or underweight
- Who are expecting twins or more
- Woman who has a previous history of pregnancy induced hypertension
Signs And Symptoms Of Gestational Hypertension
Gestational hypertension can be found early during prenatal visits. Some signs and symptoms of Gestational hypertension are:
- 20 or more weeks pregnant with a blood pressure that is 140/90 or higher
- Blurred vision
- Breathing problems
- Decrease in urine output
- Extreme fatigue
- Rapid weight gain
- Stomach or rib pain
- Flashing lights in eyes
- Swelling
- Severe headaches
- Dizziness
- Nausea and vomiting
How To Treat Gestational Hypertension?
Treatment options depend on the severity. Mild PIH can be treated at home by taking complete bed rest and following a healthy diet. However, moderate to severe PIH need close observation and medication and hence a pregnant woman should be admitted to the hospital until her blood pressure is under control.
Impact Of Gestational Hypertension On Labor And Delivery
Gestational hypertension can result in:
- Preterm delivery: Several complications can arise towards the end of pregnancy if the pregnant woman is experiencing pregnancy induced hypertension. One such complication is the risk of preterm delivery and health problems to the preterm baby
- Postpartum hemorrhage: Gestational hypertension increases the chances of postpartum hemorrhage. PPH can bring about a serious drop in blood pressure. If not treated fast, this can lead to shock and death of pregnant woman. This happens when there is no proper blood flow in the organs of the body
- Low birth weight: Gestational hypertension can damage the blood vessels which carry blood to the placenta. As a result, the baby receives inadequate oxygen and nutrients, which can affect the development of baby. As a result, the baby can be born with low birth weight
- Placental abruption: Placental abruption is a condition in which the placenta separates from the wall of the uterus during pregnancy, labor or in the course of delivery. This is potentially a dangerous situation for both the pregnant woman (can result in serious and intense hemorrhage) and the baby (the baby will not get enough oxygen and nutrients if the placenta separates from the wall of the uterus and can lead to fetal distress)
- Preeclampsia: Sometimes, if not properly treated and managed, gestational hypertension can develop into preeclampsia, a more serious issue that can damage the brain and organs like liver and kidney of pregnant woman
As gestational hypertension can cause complication during labor and delivery or can cause critical issues (even a seizure or stroke) to the pregnant woman immediately after delivery so it is advisable to have the delivery in the hospital rather than at home.
Precautions To Be Taken For A Vaginal Delivery With Gestational Hypertension
Normal labor and vaginal delivery are preferred if the cervix is dilated and the mother and baby are healthy and strong enough to undergo a vaginal delivery. Otherwise, the doctor prefers to perform a C-section. It is possible to have high blood pressure and have a vaginal birth. Some precautions to be taken are:
- Monitoring the mother: The blood pressure of the pregnant woman will be continuously monitored throughout labor and delivery. If necessary, magnesium will given through IV to control the blood pressure
- Monitoring the baby: Baby’s heart rate will also be monitored throughout labor and delivery. This is usually done with a help of a fetal monitor, which can detect any sign of fetal distress
- Inducing the labor: To avoid further complications, if the blood pressure of the pregnant woman continues to be high, the doctor will offer to start labour artificially by inducing much before the due date
- Epidural: Epidural is given during labor and delivery. This is because the pain of labor spikes the blood pressure. Inducing an epidural will help in lowering the blood pressure
If medication is prescribed for gestational hypertension, the pregnant woman will need to continue taking it even during labour. Some pregnant women with severe high blood pressure may not respond to treatment. In such cases, the doctor may offer an assisted birth where he helps the baby to be born using instruments that are attached to the baby’s head. This speeds up the second stage of labour. Worse case, the doctor may recommend a Cesarean section if the health of the pregnant woman or her baby’s health is in danger.
