Chronic hypertension during pregnancy can increase risks for both mother and fetus, including heart problems, kidney and liver issues, bleeding disorders, and premature birth. Preeclampsia, characterized by high blood pressure and kidney dysfunction, can also lead to complications and may require delivery of the baby. Adequate prenatal care and medication can help manage chronic hypertension.
Chronic hypertension refers to hypertension that is diagnosed in women before pregnancy or before the 20th week of pregnancy. Some doctors also use the phrase to describe high blood pressure that first arises during late pregnancy but persists for several weeks after delivery. High blood pressure is defined as a blood pressure range that exceeds 120 millimeters of mercury at its highest level or 90 millimeters of mercury at its lowest level. Chronic hypertension can increase the risks of pregnancy for both the three percent of mothers who suffer from it and for their fetuses. Careful medical monitoring and adequate prenatal care, however, allow most mothers with chronic hypertension to deliver safely.
During pregnancy, blood volume increases by 40 to 50 percent. Cardiac output increases by about the same amount. This, along with other factors, can lead to congestive heart failure. Heart problems complicate one to two percent of pregnancies in women without a known history of heart abnormalities.
Other health complications that accompany chronic high blood pressure include kidney failure, liver problems, bleeding disorders, and brain hemorrhages. Abruptio placenta, a particularly life-threatening condition, refers to an early separation of the placenta from the wall of the uterus, leading to excessive bleeding and shock. Signs of placental abruption also include abdominal pain and stiffness. Interruption of blood flow through the placenta to the baby can cause fetal distress.
Maternal hypertension also carries risks to the developing baby, including premature birth and stillbirth. Retarded fetal growth with low birth weight results from inadequate blood flow to the placenta, a condition called intrauterine growth retardation. Clinical studies reveal that lowering maternal blood pressure with medication and the daily administration of low-dose aspirin significantly increases the growth rate in children of mothers with chronic hypertension. Low-dose aspirin improves uterine and placental blood flow.
Sometimes confused with chronic hypertension, preeclampsia is a medical condition characterized by increased blood pressure and kidney dysfunction, indicated by increased protein in the mother’s urine. Preeclampsia begins after the 20th week of gestation. Hypertension-Elevated Liver Enzymes-Low Platelets (HELLP) syndrome may accompany preeclampsia. HELLP syndrome can indicate damage to the maternal liver, kidneys, and brain. Doctors infuse magnesium citrate to prevent seizures, the leading cause of death in pregnant women. Doctors treat mothers with preeclampsia by delivering the baby.
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