Hypertension in Pregnancy: Risks and Importance of Early Detection
Hypertension in pregnancy occurs when blood pressure reaches or exceeds 140/90 mmHg, typically after the 20th week of pregnancy. Unlike chronic hypertension, this condition develops during the second half of pregnancy and usually resolves after delivery.
High blood pressure during pregnancy is often asymptomatic, making regular prenatal check-ups essential to monitor the health of both mother and fetus. Without proper management, hypertension can lead to complications for both.
Based on data from Maternal Perinatal Death Notification (MPDN), a maternal death recording system at the Ministry of Health of the Republic of Indonesia, maternal mortality increased from 4,005 in 2022 to 4,129 in 2023, with 13% of deaths linked to hypertension complications.
Causes
Several factors can increase the risk of hypertension during pregnancy, including
- Overweight or obesity
- Lack of exercise or physical activity
- Smoking
- Alcohol consumption
- First pregnancy
- Family history of hypertension
- Twin pregnancies
- Maternal age over 35 years
- Medical conditions, such as diabetes or autoimmune diseases.
What are the types of hypertension during pregnancy?
The types of high blood pressure vary depending on when it began and its symptoms.
1. Chronic hypertension
Chronic hypertension occurs before pregnancy or within the first 20 weeks of pregnancy or persists beyond 12 weeks postpartum. It often has no symptoms, making early detection challenging.
2. Gestational hypertension
This form appears after 20 weeks of pregnancy without excess protein in the urine or organ damage. In some cases, it progresses to preeclampsia.
3. Preeclampsia
Preeclampsia develops after 20 weeks (usually after 27 weeks) and involves high blood pressure alongside signs of organ damage, such as kidney or liver dysfunction. If untreated, it can lead to eclampsia, characterized by seizures and other severe complications.
Untreated preeclampsia can lead to serious—even fatal—complications for both mother and baby. Complications can include eclampsia, in which seizures occur.
What happens if a pregnant woman has high blood pressure?
High blood pressure in pregnant women can cause serious complications for both the mother and the fetus, such as
1. Reduced blood flow to the placenta
The fetus may receive less oxygen and nutrients if the placenta does not get enough blood. This can lead to slow growth (intrauterine growth restriction), low birth weight, or premature birth.
Babies born prematurely may have breathing problems, an increased risk of infection, and other complications.
2. Placental abruption
Placental abruption is a condition in which the placenta separates prematurely. This can cause severe bleeding that is life-threatening for both mother and baby.
3. Implications for other organs
Uncontrolled high blood pressure can affect the brain, eyes, heart, lungs, kidneys, liver, and other major organs. In severe cases, it can be life-threatening.
4. Premature delivery
Sometimes early delivery is necessary to prevent life-threatening complications from high blood pressure during pregnancy.
5. Future cardiovascular disease
A woman who has preeclampsia is at increased risk for developing heart and blood vessel (cardiovascular) disease later in life.
If you have high blood pressure during pregnancy, contact your doctor right away if you get sudden, persistent headaches, blurred or blurred vision, unusual swelling, or decreased urination.
How do I know if I have high blood pressure during pregnancy?
Regular blood pressure monitoring is a vital part of prenatal care. If you have a history of chronic hypertension, your doctor would evaluate the following categories for blood pressure measurement (according to JNC VIII):
- Prehypertension is a systolic pressure between 120-139 mmHg and a diastolic pressure between 80-89 mmHg. If not controlled, high blood pressure tends to get worse over time.
- Stage 1 hypertension is defined as a systolic pressure between 140-159 mmHg or a diastolic pressure between 90-99 mmHg.
- Stage 2 hypertension is more severe. The systolic pressure is exceeded or equal to 160 mmHg, or the diastolic pressure is more than or equal to 100 mmHg.
After 20 weeks of pregnancy, blood pressure greater than or equal to 140/90 mmHg without other organ damage is categorized as gestational hypertension. Blood pressure needs to be measured two or more times at least four hours apart to confirm the diagnosis.
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Hypertension, or high blood pressure during pregnancy, can cause serious complications for both you and your baby. However, this condition usually goes away after delivery.
Hypertension treatment involves regular blood pressure checks, medication, and lifestyle changes. If managed properly, it will not cause serious problems.
On the other hand, if left unmanaged, high blood pressure can lead to premature birth, placental abruption, or other serious complications.
If you have concerns about blood pressure readings or managing your blood pressure during pregnancy, visit GWS Medika Clinic, a health clinic in Jakarta.
At GWS Medika Clinic, you can also get pre-pregnancy check-ups. Early detection can prevent serious complications and maintain the health of both mother and baby.
