Increased pressure during pregnancy: treatment and prevention
Pregnancy is a special condition of a woman when serious changes occur in her body, which cannot be fully explained. In truth, the birth of man is great wisdom. It is in the “pregnant state” that a woman changes right before her eyes, and not only because her belly grows. Remember, because only in the “interesting” position you wanted to cry because of a trifle, enjoy the sandwich with jam and cucumber, change the color of the walls in the kitchen, and stick around the whole room with wallpaper with dandelions. Of course, all these "oddities" are cute and harmless, which do not interfere with either you or your baby. But it happens worse. For example, with blood pressure. Earlier, you could not even suspect that you have it, and from the very first days you came across the fact that it is being measured, the results are recorded, and compared each time, while the doctor looks at the records and shakes his head: tall ...
Naturally, our introductory story is a bit exaggerated, but personally I really learned about my pressure during pregnancy. Fortunately, it was normal, but in the "gynecological" corridors I had heard plenty of stories about dangerous high pressure.
"Normal" high blood pressure during pregnancy
Everyone should know what his normal blood pressure is. For some, it is always rather low, for someone it is tall, but everyone feels good. For women who are preparing to become mothers, this knowledge is extremely important. Blood pressure during pregnancy is measured in the clinic for good reason, since its indicators are a kind of "determinant" of the state of a woman and her baby.
Medical standards of blood pressure during pregnancy (and in the normal state) are as follows: no less than 100/60 and no more than 140/90. However, during pregnancy, these indicators can "jump" in the range of 10-15%.
With regard to high blood pressure, it is extremely undesirable during pregnancy, because it is a formidable symptom, but not always. In the last trimester of pregnancy, high blood pressure is “normal” or justified. Judge for yourself: another circle of blood circulation appeared in your body, which means that the volume of blood that circulates inside you also increased (by 20 p. About half a liter, and by the end of pregnancy, by a whole liter!). Naturally, “because of this,” the load on your loving heart has increased: it decreases more often, because the release of blood increases. So if deviations from the norm at the end of pregnancy are small - do not worry. You only need to monitor your health and regularly measure your blood pressure.
Remember: excitement, excessive physical activity, stress, and even magnetic storms increase your pressure, so consider these circumstances when you measure it. It is better to do it early in the morning at the same time. Before measuring blood pressure, do not drink strong tea, much less coffee, otherwise the results will not be reliable.
Pregnancy pressure: norm and deviations from it
You've probably heard that the first digit means systolic, and the second - diastolic pressure, and that in a healthy person they should be 120/80? However, it is necessary to focus on your individual indicators. It is believed that the rate of pressure during pregnancy is not higher than 140/90 and not lower than 90/60.
A large enough range of values, isn't it? So, you should know your "working pressure", that which you usually have. 90/60 for not giving birth to a 20-year-old girl weighing 50 kg is absolutely normal, and the notorious 120/80 would already be considered tall indicators.
What is the danger of high blood pressure during pregnancy?
Unfortunately, a steady increase in pressure during this period is an alarming symptom. If blood pressure rises during pregnancy, doctors fear possible development. preeclampsia - a dangerous and insidious complication during pregnancy, which consists in the breakdown of the functioning of vital organs, and first of all the cardiovascular and circulatory system.
It arises from the fact that the placenta produces substances that cause micro-holes in the vessels. Through them, plasma protein and fluid from the blood into the tissue, which causes swelling, especially of the legs and hands. The worst thing is that not only the limbs swell, but also the placenta, and this already causes a lack of oxygen in the fetus.
Even if the increased pressure during pregnancy is not a sign of preeclampsia, it is still impossible to give up on it, after all, it’s not for nothing that doctors at antenatal clinics pay so much attention to controlling pressure in women who are registered while waiting for a baby. The fact is that increased blood pressure during pregnancy provokes changes in the vessels of the placenta and fetus.
The decrease in blood circulation between mother and child is called placental insufficiency. If the child lacks oxygen and nutrients, the intrauterine growth retardation may begin, and this is very serious.
If the pressure during pregnancy jumps regularly, and the rates are quite high (140-150 and higher), this can lead to premature placental abruption - a very dangerous complication of the normal course of pregnancy. Hypertension in the mother may well cause a threatened abortion or premature delivery. Finally, high pressure from the mother during childbirth can lead to eclampsia, a convulsive syndrome, which also does not benefit either the woman or her child.
Signs of high blood pressure during pregnancy
The most accurate way to find out your pressure is to measure it with a special device (tonometer), which is desirable for every pregnant woman to buy, and if there are problems with pressure, it is simply obligatory to buy it. In household use, it is more convenient to use an electronic tonometer, but the usual one is fine - some doctors even think that his testimony is more accurate, and it costs less.
But a woman can find out about pressure increase by her own feelings: this state can be accompanied headachessometimes very strong dizziness.
It is also characteristic:
- deterioration of health,
- noise in ears,
- nausea, vomiting,
- the appearance of "fly" before the eyes,
- the appearance of red spots on the skin of the face and chest or general redness of the skin in these areas.
But it also happens that hypertension is asymptomatic, does not bother the pregnant woman and is detected only at the next measurement of blood pressure.
Causes of high blood pressure during pregnancy
Why does the pressure increase during pregnancy? There are several common reasons for this.
- stress already mentioned above. The load on the body is so great that it does not have time to rebuild and reacts with irregular pressure,
- insufficiency of the compensatory forces of the body of a pregnant woman. The heart, which should pump blood "for two", can not cope with the increased volume of circulating blood,
- heredity. If one of your close relatives had high blood pressure, there is a possibility that you will also have to face this,
- diabetes. It does not increase blood pressure during pregnancy, but diabetes can be an adverse factor,
- smoking. Health, in any case, it does not add, and in fact the cardiovascular system nicotine affects one of the first,
- weak physical activity. A trained heart is much better at handling loads.
- overweight or obesity. Carefully keep track of how much you are typing during pregnancy, monitor this process,
- kidney problems. Oddly enough, but there is a direct relationship - often in people suffering from kidney diseases (for example, pyelonephritis, glomerulonephritis) there is increased pressure,
- violation of the hormonal activity of the thyroid gland, adrenal glands, pituitary. Often, high blood pressure during pregnancy is the result of these hormonal shakes, because at this time women experience real hormonal storms.
Decreased pressure during pregnancy
Many women are interested in how to reduce the pressure during pregnancy on their own? But just in this case, self-treatment is unacceptable. Do not take any pills from the pressure during pregnancy, do not drink any "weed" before consulting a doctor!
The doctor will conduct your examination and prescribe medication. Strictly adhere to the scheme of use of drugs and their dosage, do not stop taking drugs without permission - when it comes to increased pressure, the result is only careful adherence to all recommendations.
You may need to be hospitalized in the pathology department of a pregnant maternity hospital. There you will not only be printed, but also an individual plan of childbirth will be drawn up taking into account the increased pressure. Often, in this case, epidural anesthesia is prescribed during labor, more about this →
At the end of pregnancy, closer to childbirth, you are likely to be offered a second hospitalization to correct the pressure before the birth.
There are also pressure reducing products during pregnancy - their use, of course, will not remove the problem completely, but may serve as a preventive measure. First of all, it is beetroot and beet juice, cranberry juice - in addition to reducing pressure, it is also a source of vitamins!
A good remedy is pumpkin decoction with honey: boil 200 g of pumpkin in pieces in a small amount of water over low heat, cool, add honey. Such a salad can also help: mix raw beets, cabbage and carrots in equal proportions and fill with vegetable oil.
Do not eat coffee, chocolate, strong tea - during pregnancy they are undesirable, and even more so with high blood pressure. But karkade tea or a very weak tea with a few lemon wedges, on the contrary, will improve your condition. Still can help soothing - valerian, motherwort, or a cool shower.
Types of disease
Chronic pathology, in turn, is shared by:
- Hypertension of the primary type (GB),
- Secondary hypertension (symptomatic).
Hypertension is characterized by elevated blood pressure without any concomitant pathology of organs and organ systems.
Symptomatic arterial hypertension often develops on the background of kidney damage. The cause can also be endocrine pathology (Itsenko-Cushing syndrome, Conn, pheochromocytoma), various disorders of the cardiovascular system. Sometimes on the background of long-term use of anti-inflammatory drugs, oral hormonal contraceptives and some other substances.
High blood pressure during pregnancy is considered in terms of blood pressure during heart systole (contraction) of more than 160 mm Hg, and for diastole (relaxation) - more than 90 mm Hg. In this case, there is a threat of stroke in the parturient woman (often with hemorrhage in the brain tissue) during childbirth or in the postpartum period.
Table: Pregnancy Pressure Rate
Preeclampsia is divided into severe and moderate. With a moderate degree of severity, it is possible to prolong the pregnancy, but in a hospital setting. In severe cases, it is urgent to resolve the issue of maternal delivery.
In case of joining the symptomatology of pre-eclampsia of the convulsive syndrome, we can speak about the onset of eclampsia. The occurrence of seizures is preceded by excessive agitation or drowsiness, the appearance of fibrillar twitching of the muscles of the face, pain in the abdomen, arms and legs, and headaches.
Every pregnant woman must independently control the level of her pressure through. Semi-mechanical or mechanical tonometers come to the rescue. If the level of blood pressure is elevated, then you should contact the specialists for help. A thorough history of the patient’s complaints is being conducted, an examination is carried out.
In this case, a number of compulsory clinical and laboratory studies are carried out:
- General analysis of blood and urine,
- Biochemical blood test to determine the level of urea, creatinine, electrolyte level,
- Ultrasound of the kidneys.
An acute onset is more characteristic of symptomatic hypertension. More often fast installation at a high level of arterial pressure (diastolic blood pressure exceeds 110 mm Hg). In this case, the woman feels quite normal. Adversely this type of hypertension affects the organ systems in the body, which often leads to complications.
For the diagnosis of preeclampsia, a number of indicators are determined: hematocrit, hemoglobin, leukocytes, platelets. A peripheral blood smear, the level of fibrinogen, uric acid, creatinine, the level of AlAT, AST, albumin, bilirubin are studied.
Help and treatment
Hypertension and high blood pressure during early pregnancy require immediate treatment. Elevated levels of blood pressure adversely affect the cardiovascular system of the mother and fetal development.
Antihypertensive therapy significantly reduces the risk of maternal mortality and contributes to the bearing of the fetus in the later periods.
What to do if the tonometer shows bad numbers? Need to see a doctor for help! The specialist must designate a diagnostic test plan.
When gestational hypertension is detected, hospitalization with full clinical and laboratory examination of the patient is necessary. Immediately prescribed antihypertensive therapy.
The target values of systolic and diastolic blood pressure are 130-150 mm Hg and 80-95 mm Hg, respectively. A significant decrease in blood pressure should be avoided, as this may reduce the blood flow through the placenta and disrupt the nutrition of the fetus.
Treatment of hypertension during pregnancy should be prescribed by a doctor! Self-medication is inappropriate and often adversely affects the development of the fetus.
Angiotensin receptor antagonists and angiotensin-converting enzyme (ACE) inhibitors are strictly contraindicated for women in a position!
Pills for high blood pressure during pregnancy can only be prescribed by a doctor! In no case can not take their own drugs to bring down high blood pressure!
Table: Preparations for the rapid reduction of pressure during pregnancy
Pregnancy Pressure Rates
Normal pressure during pregnancy, in which the heart and blood vessels perform their functions without experiencing excessive load, are considered indicators:
- 110-120 mm. Hg Art. for the upper (heart) pressure - diastolic,
- 70-80 mm. Hg Art. for the lower (vascular) - systolic.
For chronic hypotension, these limits may be lower: 90/60 mm Hg. Art.
Indeed, often (as in hypotonic patients, for example), an elevated pressure is ascertained, based on an increase in values: more than 30 mm. Hg Art. for the upper index and 15 mmHg. Art. for the lower one, it means that the arterial pressure has risen beyond the limits of the permissible level.
Of course, a one-time increase in pressure for some reason is not a reason for the diagnosis of "hypertension." But if the elevated level is recorded at least twice in a row, then this is cause for concern.
Why does the pressure increase?
Factors contributing to the appearance of high blood pressure during pregnancy differ little from the causes of hypertensive conditions in the “non-pregnant” period:
- overweight (obesity),
- bad habits (alcohol, smoking),
- chronic diseases of internal organs, which are accompanied by increased blood pressure,
- genetic predisposition
- hypertension, as an independent disease (in the absence of endocrine disorders, diseases of internal organs).
Since the period of carrying a child for the female body is a period of increased stress load, with a deliberate predisposition, problems with pressure in the expectant mother are quite expected.
Moreover, if earlier the future mom had already suffered from high blood pressure (including during a previous pregnancy), then in the overwhelming majority of cases (about 80%), the next pregnancy would have high pressure inevitably.
However, it also happens that a jump in intracranial pressure in a woman was first noted during the current pregnancy. The reason for this may be:
- Developing preeclampsia. Then hypertension is one of the symptoms of the triad of this pathology (along with proteinuria and edema).
- Gestational hypertension, which is not combined with other symptoms of gestosis. It occurs after the 20th week of pregnancy and, as a rule, is self-healing after childbirth.
Dangerous effects of high blood pressure during pregnancy
Of course, high pressure is a pathology and requires immediate correction.
Careful monitoring of blood pressure values, which are conducted by specialists, is caused by the likelihood of dangerous consequences for the mother and child.
- Increased pressure in pregnant women is a “response” to narrowing of the blood vessels, including in the uterus and in the placenta. This leads to impaired blood circulation in the "uterus-placenta-fetus" system, and, consequently, to fetal hypoxia. Prolonged hypoxia is the cause of intrauterine growth retardation.
- Placental insufficiency, which also develops due to vascular spasm, can cause spontaneous abortion.
- Due to increased blood pressure in the channel between the uterus and the placenta, detachment of part of the placenta can occur, which will lead to insufficient nutrition of the fetus, and, depending on the extent of the detachment, can cause premature termination of pregnancy.
- Prolonged hypertension can cause functional insufficiency of the vital organs of a woman, which carries a risk to the health and life of mommy and her future baby.
- Severe hypertension, as a manifestation of preeclampsia, can lead to the development of complications that are dangerous for the parent and her unborn child - preeclampsia and eclampsia.
- A significant surge in pressure, especially during childbirth, can cause retinal detachment (and subsequent blindness) or even a stroke.
Do you need hospitalization?
Since hypertension for a pregnant woman is an extremely dangerous phenomenon, it is unwise to refuse the proposed hospitalization. In addition, it is very likely that with a favorable prognosis, the period spent in the hospital will be small.
The hospital will determine the degree of hypertension, predict the risk of possible complications for the health of the woman and select the methods of therapy.
At the initial detection of hypertension during pregnancy, hospitalization is also shown to search for the causes of the increased pressure.
If the degree of hypertension is mild, the pressure is stable and does not adversely affect the well-being of the future mother, then the next hospitalization according to the plan will follow at the beginning of the third trimester, since during this period the likelihood of a crisis increases.
At 38-39 weeks of pregnancy, the expectant mother with high pressure moves to the hospital until the birth.
During this time, she will be examined, in order to clarify her condition and the choice of mode of delivery, preparatory procedures.
In the case of exacerbation of the hypertensive state of a woman, treatment in a hospital is obligatory. This is necessary to determine the factors that caused the exacerbation of hypertension and the appointment of appropriate treatment.
How to reduce the pressure during pregnancy
Depending on the causes of hypertension, the doctor chooses the tactics for further management of pregnancy and therapies aimed at normalizing pressure.
As a rule, use a combination of drug and non-drug therapy.
Non-drug method is to limit the physical and social-household load, namely:
- refusal to participate in stressful situations.
- creation of a comfortable psychological environment.
- elimination of excessive physical effort, therapeutic exercises are allowed, swimming at a calm pace.
- Compliance with sleep, rest.
In addition, it is important to follow some nutritional guidelines aimed at:
- correction of potassium-sodium metabolism (to prevent fluid retention in the body),
- prevention of further excessive weight gain (if it is excessive).
- To improve water metabolism in the body:
- limit or eliminate completely the use of table salt with food, as a source of sodium, leading to fluid retention in tissues,
- include in the diet foods rich in potassium, which reduces vascular tone and magnesium, which also has a slight diuretic effect.
To prevent excessive weight gain should:
- limit fat intake to 40 g per day, giving preference to vegetable fats,
- minimize the presence in the diet of simple carbohydrates: sugars, refined products, treats,
- adjust the mode of eating in the direction of fractional power.
Popular methods have found their place among non-drug methods of dealing with high pressure:
- An equal number of rose hips, hawthorn, red viburnum, linden flowers, calendula, blueberry and heather shoots and motherwort grass are chopped and mixed. Separate 2 tbsp. l , pour 2 cups of boiling water over them, then 15 minutes. in a water bath and insist at room temperature. Drink 100 g. Strained mixture with honey after meals 3-4 times a day. Course duration - 1.5 months.
- Half a cup of cranberry juice mixed with the same amount of honey. Take 1 tsp. 3 times a day. The course of treatment is 14 days.
- Equal amounts of chopped valerian root, dried herbs, shoots of heather and viburnum flowers are mixed. Pour 2 cups boiling water 2 tbsp. l mix and insist in a thermos for 2 hours. Sweeten the warm filtered infusion with honey and take ¼ cup 4 times a day. The course of taking 1-1.5 months.
Before using herbal remedies, you should get approval from a doctor who is observing a pregnancy in order to rule out possible contraindications.
In addition to the non-drug techniques recommended for lowering blood pressure, the doctor will prescribe medication.
With persistent hypertension comes the need for more serious pharmacological agents.
The most common remedy for its availability and safety, along with its effectiveness, is methyldopa (“Dopegit”).
The drug pressure is approved for use from the earliest gestational age. Methyldopa does not have a negative impact on the placental circulation, does not pose a threat to fetal intrauterine development, and does not cause adverse manifestations for a born child in the long term.
The action of the substance occurs within 2-6 hours and manifests itself:
- in a relaxing effect for the central nervous system,
- in suppressing the activity of hormones causing an increase in pressure,
- in suppressing the activity of plasma enzyme (renin), which is able to influence blood pressure and sodium metabolism,
- in the removal of vascular hypertonia,
- in general sedative effect.
With the pressure on late pregnancy when detecting protein in the urine analysis and taking into account all the possible risks to the fetus, β-blockers are prescribed.
The action of tablets is based on the blockade of receptors that are sensitive to the action of "stress hormones" adrenaline and norepinephrine. Taking β-blockers has an antihypertensive effect on the woman’s body, and also reduces the frequency of proteinuria.
Cardioselective β-adrenergic blockers are often prescribed for pregnant women as a pressure medication. they have fewer side effects than non-selective ones.
In the fight against high blood pressure, the effect they have directly on heart activity is important:
- reduced heart rate and strength,
- decreases the body's susceptibility to stress,
- renin activity decreases,
- conduction in the AV node decreases to the required level, normalizing the contractile-conducting activity of the cardiac departments,
- the oxygen requirement of the heart muscle is normalized (anti-ischemic effect),
- reduced risk of cardiac arrhythmias.
Currently, bisoprolol is more preferable because of its ease of use (1 tablet per day), reliable round-the-clock action, the possibility of being used in diabetics and less pronounced, in comparison with other drugs, “withdrawal syndrome”.
Similar to β-blockers in the effectiveness of calcium antagonists or calcium channel blockers.
But they do not affect the nervous system, but the channels in the heart and vascular muscles through which calcium enters the muscle cells.
The strength of muscle contraction depends on the calcium concentration in its cells. Activation of calcium channels occurs under the influence of adrenaline, norepinephrine. The blockade of calcium-conducting channels prevents the spasm of the muscles of the heart and blood vessels.
According to the direction of exposure to calcium antagonists can be divided into groups:
- acting only on smooth vascular muscles (nifedipine, normodipine, amlodipine, etc.) and therefore recommended for use simultaneously with β-blockers,
- acting on the muscles and the heart and blood vessels (verapamil) and therefore prohibited to use simultaneously with β-blockers.
Taking calcium antagonists during pregnancy does not exclude a possible detrimental effect on the fetus and is often accompanied by unpleasant side effects.
Therefore, they are prescribed in the case when the reception of other groups of antihypertensive drugs is impossible.
Measures for the prevention of increased pressure during pregnancy
Blood pressure in a woman during pregnancy almost inevitably increases due to an increase in the volume of circulating blood with an increase in the duration of pregnancy.
Therefore, a slight increase in blood pressure in some pregnant women may be the physiological norm.
- do not limit the duration of sleep and rest,
- avoid excessive physical activity, giving preference to feasible loads in a quiet pace,
- avoid stressful situations
- control weight gain during pregnancy (not more than 15 kg.),
- adjust the diet and menu, making the food fractional and abandoning unwanted hypertension foods,
- regularly monitor the values of your blood pressure (daily, at least twice a day) and on the right and left hands.
If it happened so, at the next reception at the doctor or at independent measurement, mommy discovered that the pressure exceeded the norm, then first of all it is necessary to stop the panic, otherwise the indicators will rise even higher.
The most reasonable thing in this situation is not to self-medicate, but to trust in qualified specialists and then the pregnancy and birth of the baby will pass safely.
Early Pregnancy Pressure
Both a decrease and an increase in blood pressure are dangerous in the early stages of pregnancy. Anxious for the future mother figures on the tonometer - from 140/90, especially if they are observed regularly. Increased pressure during pregnancy in the early stages indicates the presence of gestational or chronic arterial hypertension:
- Gestational hypertension. Increased blood pressure causes pregnancy. Early pathology leads to narrowing of the blood vessels, which reduces the consumption of necessary nutrients by the fetus.
- Chronic hypertension. Deviations are caused by pathological processes that develop in a woman's body. The most common causes of complications are endocrine disorders or kidney disease.
High blood pressure during late pregnancy
When there is a constant increase in pressure during pregnancy, then the woman has a high risk of developing gestosis. A dangerous disease can develop at any time, but most often begins in the third trimester. Gestosis leads to disruption of the blood flow, the vascular system and important organs. Pregnant women with chronic stress, infections or intoxications are at risk.
Increased pressure during pregnancy in the later periods may develop against the background of heredity. If female relatives suffered from hypertension, then a pregnant woman has a high probability of encountering this pathology. What to do if it is not possible to reduce pressure by yourself at a late term? It is imperative to contact your doctor, who will refer you for an examination under observation in a hospital.
Symptoms of high blood pressure
With an increase in blood pressure may appear:
- headache (its strength will be directly proportional to the level of blood pressure),
- noise in ears,
- feeling of pressure on the eyes
- general weakness
- nausea and vomiting,
- redness of the face and chest area or the appearance of red spots on the face,
- flashing "fly" before my eyes.
The “insidiousness” of high blood pressure during pregnancy is that in some cases, even with high blood pressure figures, the patient does not feel any pathological symptoms, feels normal, continues normal daily activities. High blood pressure is detected by chance, at the next appearance in the antenatal clinic. The absence of clinical manifestations of high blood pressure does not preclude the development of severe complications that can threaten the life of the mother and the unborn child, so it is very important to regularly monitor the pressure during pregnancy.
Increased pressure in pregnant women
Increased pressure in pregnant is an alarming symptom, as it can lead to serious complications:
If in the body's vessels pregnant increases blood pressure, this leads to similar changes in the mother – placenta – fetus blood circulation system. As a result, the vessels of the uterus and placenta narrow, and consequently, the intensity of blood flow decreases and less oxygen and nutrients are supplied to the fetus. These violations cause placental insufficiency (complications when the normal functioning of the placenta is impaired and the delivery of oxygen and nutrients to the fetus is reduced) and intrauterine growth retardation (with a full-term gestation, a low birth-weight baby is born). Also, the consequence of placental insufficiency is the threat of abortion.
Persistent long-term increase in arterial pregnancy pressure can cause severe disturbances in the work of the vital organs of a pregnant woman, leading to acute renal or heart failure, dangerous to the life of the mother and fetus.
Arterial hypertension in pregnant can lead to premature detachment of the placenta by increasing the pressure in the space between the uterus wall and the placenta (normally, the placenta occurs after the birth of the fetus). Premature detachment of the placenta leads to bleeding (in severe cases, with a rather large blood loss). Since the partially separated placenta cannot perform its function of ensuring the vital activity of the fetus, acute hypoxia (oxygen starvation) develops, which represents a real threat to the health and life of the unborn child.
A significant increase in blood pressure can lead to the development of severe conditions - preeclampsia and eclampsia. These conditions are the consequences of preeclampsia - complications of pregnancy, manifested by increased blood pressure, the presence of protein in the urine and edema. Preeclampsia is a condition accompanied by high blood pressure (200? /? 120 mmHg and above), headache, flickering "flies" before the eyes, nausea and vomiting, pain in the epigastric region above the navel. Eclampsia is an attack of cramps in the muscles of the whole body, accompanied by loss of consciousness, and cessation of breathing.
One of the terrible complications of hypertension is bleeding in the brain. The risk of this complication is significantly increased in the laboring period of labor, therefore, in order to avoid such severe consequences, at high blood pressure numbers, delivery is carried out by cesarean section.
High blood pressure can cause complications such as retinal detachment or retinal hemorrhage, which can lead to partial or complete loss of vision.
What is hypertension during pregnancy?
Causes leading to increased arterial pressure in pregnant womenare diverse. Diseases accompanied by an increase in blood pressure can be divided into two groups.
Group 1 - arterial hypertension that existed before pregnancy. It can be caused by:
- hypertensive disease - so called high blood pressure, the exact causes of which remain unknown until now, while the woman has no diseases that could cause an increase in blood pressure (endocrine pathology, long-term current diseases of internal organs),
- chronic diseases of the internal organs, accompanied by high blood pressure, such as kidney disease (chronic pyelonephritis, glomerulonephritis, polycystic kidney disease, congenital anomalies of kidney development), diseases of the adrenal glands, thyroid gland, diabetes, pathology of the central nervous system.
As a rule, in the presence of chronic hypertension, an elevated level of pressure is noted from the early stages of pregnancy.
Group 2 - hypertension that developed during this pregnancy. This group includes gestosis and gestational arterial hypertension (a condition where a stable and elevated blood pressure is recorded during pregnancy, not accompanied by clinical signs of preeclampsia and self-sustaining after childbirth).
Gestosis - A serious complication that develops in the second half of pregnancy (after 20 weeks), characterized by damage to vital organs. In case of severe course or lack of adequate treatment, it represents a danger to the life of the pregnant woman and the fetus. As noted above, preeclampsia is manifested by a triad of symptoms: edema, the appearance of protein in the urine and an increase in blood pressure. It should be noted that for the diagnosis of preeclampsia is sufficient the presence of two of these symptoms.
In rare cases (as a rule, in the absence of observation and treatment of preeclampsia), dangerous complications such as preeclampsia and eclampsia can develop.
The danger of preeclampsia is that it can begin with minimal clinical manifestations and develop rapidly, which dictates the need for careful monitoring of pregnant women with high blood pressure.
Risk factors for increasing blood pressure during pregnancy are:
- multiple pregnancy,
- the presence of arterial hypertension in close relatives,
- длительно текущие заболевания внутренних органов (например, почек),
- повышение АД в течение предыдущих беременностей,
- first pregnancy, as well as the age of primiparous less than 18 or more than 30 years.
Prevention of pressure increase
To avoid high blood pressure pregnancy pressure, you need to follow a few simple rules:
- It is necessary to ensure a normal duration of sleep - at night at least 8–9 hours. An afternoon break of 1–2 hours is desirable.
- It is necessary to avoid emotional and physical overloads, if they are possible at work, it is necessary to temporarily reduce the load (switch to easier work).
- Moderate physical activity (walking in the fresh air, visiting the pool, gymnastics for pregnant women, etc.) helps to improve the blood supply to the brain and internal organs, and has a beneficial effect on the emotional and physical condition of the future mother.
- A reasonable approach to the organization of food during pregnancy is necessary: in order to prevent an increase in blood pressure, it is necessary to exclude strong tea, coffee, alcohol in any quantity. It is necessary to abandon spicy, spicy, fried foods, canned and smoked meats. A daily intake of no more than 1.5 liters of liquid and no more than 5 g (1 teaspoon) of salt is important to help maintain an optimal level of pressure.
- It is necessary to control the increase in body weight (for the entire pregnancy, it should not be more than 10–12? Kg, and with an initial weight deficit - more than 15? Kg).
- An important point is to control the level of blood pressure in both hands at least 2 times a day (morning and evening). Pressure on both hands should be measured because the registration of different blood pressure values (differing by 5–10 mm Hg) indicates a violation of the regulation of vascular tone and is one of the earliest signs of the development of preeclampsia.
When to go to the hospital
If hypertension is diagnosed before pregnancy, I trimester (for up to 12 weeks) hospitalization in the cardiology department is necessary. The hospital will clarify the severity of the disease, decide on the possibility of carrying a pregnancy and select drugs that are allowed for prolonged use during pregnancy. In hypertension, planned hospitalization is carried out, in addition to the first trimester, at 28-32 weeks (the period for the greatest increase in circulating blood volume) and 1-2 weeks before delivery. Unscheduled hospitalization is indicated in the development of pregnancy complications or in the worsening of the course of hypertension.
When raising blood pressurewhich is first noted in the second half of pregnancy, hospital stay is required for further examination, diagnosis and timely detection of preeclampsia.
Future mothers with diseases of the cardiovascular system are sent to the pathology department at 28–32 weeks of pregnancy. This period is considered critical, since at this time the greatest increase in the volume of circulating blood occurs and the deterioration of the state of the pregnant woman is most often noted. Hospitalization helps to avoid complications.
Before delivery (for a period of 38–39 weeks), antenatal hospitalization is shown to select the optimal method of delivery and preparation for childbirth.
In case of worsening of the future mother's condition (increase in blood pressure against the background of the treatment, headache, signs of circulatory failure, etc.), urgent hospitalization is carried out regardless of the gestational age.
High blood pressure values recorded at any gestational age (even if the woman is in good condition and without clinical symptoms) require hospitalization for examination, identifying the causes of high blood pressure and selecting adequate treatment.