Pregnancy Induced Hypertension (PIH) refers to high blood pressure that occurs during pregnancy.
Blood pressure is necessary for transporting blood from the heart to the entire body through a system of blood vessels, arteries and veins. It is created every time the heart squeezes (contraction) and pumps blood into the arteries. When the heart relaxes, veins return the blood. Blood pressure consists of 2 numbers, for example, 120/60. Systolic pressure, the first number, refers to the pressure in the arteries during the heart’s contraction. Diastolic pressure, the second number, refers to the pressure in the arteries when the heart relaxes in between contractions.
It is not known what causes PIH. Women at risk for developing PIH include:
First-time pregnancies
History of high blood pressure during previous pregnancy
History of chronic high blood pressure
Mother or sister(s) had a previous history of PIH
Multiple baby pregnancy (twins, triplets, etc...)
Teenage mother
35 years old and older
History of kidney disease or diabetes or certain immune disorders like lupus or blood diseases
Obesity
African American descent
PIH can limit blood flow to the placenta. If the placenta is not receiving sufficient blood, the developing baby will receive less and less oxygen and nutrients. This can result in low birth weights in the developing baby.
Symptoms may include:
Mild
High blood pressure (>140 systolic or >90 diastolic)
Protein found in urine
Retaining water (swelling) in hands and face
Rapid weight gain
Severe
Severely High blood pressure (>160 systolic, >110 diastolic)
Severe persistent Headaches
Sensitivity to bright lights, seeing spots, blurred vision, double vision
Severe tiredness, shortness of breath
Pain to abdomen in middle or on Right upper side near ribs
Increased bruising and/or bleeding
Excessive weight gain or swelling
Baby movements have slowed down
Passing small amounts of urine
What your doctor can do:
Diagnose the problem by asking about your symptoms and performing a physical exam
Monitor blood pressure, weight and urine at each prenatal visit
Order laboratory tests including urinalysis, kidney function, and blood clotting tests
Order diagnostic tests such as an ultrasound to monitor the baby’s growth and a Doppler scan to evaluate the placenta’s blood flow
Prescribed treatment based on how far along the pregnancy has progressed
Baby at Full-Term and Mild or Severe Hypertenson
- Deliver the baby as soon as possible either by natural labor or by cesarean delivery
Baby not at Full-Term and Mild Hypertension
Bed Rest - Lying on left side to keep weight of baby off of major blood vessels
Prenatal checkups - Increase visits
Diet - Decrease salt intake
Fluids - Consume 8 glasses of water per day
Baby not at Full-Term and Severe Hypertension
Previous recommendations for Mild Hypertension
Prescribed Blood Pressure medicines as needed
What you can do:
Before becoming pregnant
Have your blood pressure checked
Control blood pressure if you have high blood pressure
Follow a prescribed program of diet and exercise to lose weight if necessary
Take all prescribed blood pressure medicines
Discuss your blood pressure control plan during pregnancy with your doctor including what medications are safe to take.
When Pregnant
Keep all scheduled prenatal visits.
Learn to measure your own blood pressure. Self monitor your blood pressure if diagnosed with PIH.
Do not add salt to meals; talk to your doctor about substitutes
Limit junk foods and fried foods in your diet
Get plenty of rest
Talk to your doctor about an exercise program
Keep feet elevated several times daily
Avoid alcoholic beverages
Avoid caffeine containing beverages
Take only medications and/or supplements prescribed by your doctor
What you can expect:
Regular prenatal visits can detect PIH early
Early treatment can lead to delivery of healthy, full-term babies
In some cases, you may need to be admitted to the hospital to monitor the blood pressure and baby
Severe PIH can lead to a condition known as eclampsia. In this case the mother’s kidneys, liver, brain, heart and eyes can be damaged. Seizures may also occur.
Consult with your doctor if you are planning on becoming pregnant; if you are planning on becoming pregnant and have high blood pressure, and/or if you are at risk for developing PIH during pregnancy.
Seek immediate medical advice if you check your blood pressure and it is equal to or above 160/110 mm Hg, if you have any vision changes like double vision or see spots, if you have abdominal pain, or if you experience any vaginal bleeding.
