Hypertension in Pregnancy: Treatment, Cost and Side Effects

Hypertension in pregnancy also referred to as gestational hypertension is characterized by high blood pressure during pregnancy. Blood pressure is defined by how hard blood pushes against the artery walls when your heart beats. A minimum amount of pressure is required but too much pressure is a problem. Blood pressure is measured in millimeters of mercury (mmHg). It has two numbers, the top (systolic) number denotes the pressure when heart contracts and pumps blood, and the lower (diastolic) number is the pressure felt when the heart relaxes and fills with the blood. The normal blood pressure during pregnancy will usually range between 110/70 to 120/80. However, it varies from woman to woman.

Gestational hypertension or pregnancy induced hypertension can be broadly be classified into four categories. Chronic hypertension is characterised by high blood pressure (over 140/90) which can occur before pregnancy, early in pregnancy or continue after delivery. The second type, Gestational hypertension is characterized by high blood pressure which occurs after 20 weeks in pregnancy and usually goes away after delivery. The third type is preeclampsia that is characterized by high blood pressure and excess protein in the urine (proteinuria). Other symptoms include organ damage in other parts of the body like kidney, liver and blood. The fourth type is eclampsia that is characterized by seizures in pregnant woman along with high blood pressure and proteinuria. It can lead to severe complications for the mother and the baby.

Pregnancy induced hypertension generally develop in women who are pregnant for the first time or women younger than 20 years of age or older than 40 years of age or women carrying twins or triplets or women who have had high blood pressure or kidney disease prior to getting pregnant. A woman is also at a risk of getting PIH if she has diabetes or kidney related problems. PIH usually effects 6 to 8 percent of women globally.

Gestational hypertension is cause for worry for both the mother and baby. Therefore, regular monitoring of your blood pressure is needed. Your blood pressure will be checked during the monthly appointment to your gynecologist. At each of this prenatal check-up your doctor will also check your urine samples, order blood tests and blood-clotting tests. He may also perform ultrasound scan and a Doppler scan to see your baby’s growth and measure the efficiency of blood flow to the placenta. Based on which you will be advised to take certain medications and make certain lifestyle changes because there is no definite cure for hypertension.

Your treatment will also depend on how close you are to your due date and the type of hypertension you have. One of the possible treatments for gestational hypertension or preeclampsia is to deliver your baby if it is developed and you are close to your due date. Although there are certain antihypertensives drugs, taking them might affect the fetus. However, if you have mild or chronic hypertension, your doctor will tell you to rest, lying on your left side to take the weight of the baby off your major blood vessels. He will ask you to come for regular prenatal checkups, consume less salt and drink 8 glasses of water every day.

These are some of the ways in which you can reduced the risks or complications arising due to gestational hypertension. Additionally try to stay active and eat a healthy diet. Don’t smoke or drink alcohol which can be fatal to you and your baby.

Pregnancy induced hypertension is generally diagnosed based on your blood pressure level. If your blood pressure is less than 120/80, then you have a normal pressure and there is no need for worry. However, if your blood pressure is at 120/80 but less than 140/90, then it is called prehypertension and you are at risk of developing PIH. If your blood pressure is at 140/90 but less than 160/110 then you have mild hypertension. Lastly, if your blood pressure is at 160/110 and above then you have severe hypertension and is at risk of developing preeclampsia. If you fall between 140/80 to 160/110 and above, then you are eligible for treatment.

Additional symptoms may include headaches, vision changes, intense pain or tenderness in the upper domain and nausea or vomiting.

If you are pregnant and have a normal blood pressure ranging between 110/70 to 12/60, then you do not have hypertension and is not eligible for PIH treatment.

Though there are no side effects for the treatment of pregnancy induced hypertension, it can lead to various complications. Your baby might be at an increased risk of developing intrauterine growth restriction (IGR) which is characterized by less nutrients and oxygen being delivered to the baby via the placenta. This will directly affect the growth of the fetus or low birth weight which might lead to premature birth. Premature baby might have trouble breathing, or other infections and complications. Other complications include placental abruption in which a part or the entire placenta separates from the uterine wall before the baby is born (this also results in intrauterine growth restrictions), premature birth or induced labour and preeclampsia which is characterized by injury to other organs like kidney or liver and cardiovascular diseases. Preeclampsia which develops when you already have a high blood pressure is called 'superimposed preeclampsia.'

There are no separate guidelines for pregnant women having hypertension. It follows similar pathways like that of normal delivery or normal C-section. Post-delivery you will be asked to increase your water intake as you will be breastfeeding your baby. Also try to avoid alcohol and beverages containing caffeine. Have less spicy food and low salt in your diet because it also affects your breastfeeding. Try to have foods that lead to production of breast milk like sago (sabudana) and pulses. If you are exercising, please ask your doctor about the do’s and don’ts Moreover, if you had a C-section, then it is ideal to wait at least 6 months before starting your exercising regime.

The recovery period is similar to normal pregnancies which usually range from 1 to 3 months depending on the type delivery you had. However, if you have developed preeclampsia and still delivered a baby, then your recovery period may be longer.

As there is no treatment for pregnancy induced hypertension, the pricing will generally involve doctoral consultations, medicinal charges and maternity care at hospitals which will range from Rs.500 to Rs.5,00,000.

No, the results are not permanent as high blood pressure can continue to exist even after delivery or post-pregnancy.

As there is no definite treatment for pregnancy induced hypertension (PIH), alternative treatments also do not exists.