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High Blood Pressure and Preeclampsia

High blood pressure (hypertension) and hypertensive disorders such as preeclampsia are common complications of pregnancy. Chronic hypertension (CHTN) may be seen in 5% of pregnant women with rates varying depending on the population studied. Hypertensive disorders such as gestational hypertension, preeclampsia, and eclampsia may develop during pregnancy or shortly after delivery.

Chronic Hypertension

Chronic hypertension (CHTN) is diagnosed when there is a persistent elevation of your blood pressure which may be diagnosed prior to 20 weeks of pregnancy or may have been diagnosed prior to pregnancy.

Complications

CHTN can have significant adverse effects on your pregnancy. Some of the more common complications include development of preeclampsia or toxemia, placental separation (abruption), fetal growth delay, poor perinatal outcome, and preterm birth. Women who have had high blood pressure for a long time have end-organ damage that can worsen in pregnancy. Maternal end-organ damage may include retinal (eye) changes, an enlarged heart, and evidence of kidney damage.

Treatment

Specialists at the Texas Fetal Center will follow you and your pregnancy very closely for development of worsening complications. Doctors at the Center will work with other adult medicine subspecialists as needed, and additional testing will be performed based on your specific needs.

Some women require medications to lower blood pressure during pregnancy. Maternal-fetal medicine specialists will prescribe antihypertensive medications which are safe in pregnancy.

Preeclampsia

Preeclampsia is diagnosed when your blood pressure increases during pregnancy, but this increase occurs after 20 weeks and is associated with protein in your urine.

Causes

The causes of preeclampsia is not known but preeclampsia occurs more frequently in women with chronic high blood pressure, pregestational diabetes, vascular and connective tissue diseases, lupus, antiphospholipid antibody syndrome, kidney disease, multiple gestations, and obesity.

Complications

Complications that may occur with preeclampsia include fetal growth delay, low amniotic fluid, preterm birth, placental separation (abruption), and maternal complications such as ventricular (heart) enlargement and damage, kidney damage, and stroke.

Treatment

Maternal-fetal medicine specialists at the Texas Fetal Center will follow you and your pregnancy very closely for development of complications, and will work with other adult medicine subspecialists as needed, and additional testing will be performed based on your specific needs.

Often preterm delivery is recommended to avoid worsening of your health. In these situations, your baby will be stabilized and treated by the physicians in the neonatal intensive care nursery at Children's Memorial Hermann Hospital. The Center will develop a coordinated plan for you and your baby before, during and after delivery.

Gestational Hypertension

Gestational hypertension is diagnosed when your blood pressure increases after 20 weeks of pregnancy, but there is no significant amount of protein in your urine. Pregnancies complicated by gestational hypertension will closely monitored, and the Texas Fetal Center will develop a coordinated plan for you and your baby before, during and after delivery.

Eclampsia

With eclampsia, in addition to your blood pressure increase after 20 weeks of pregnancy and elevated urinary protein, convulsions or seizure activity can occur.

Treatment for eclampsia includes prevention of the seizures, blood pressure control, and delivery. The Texas Fetal Center will coordinate your care and the delivery of your baby. After birth, your baby will be stabilized and treated by specialists in the neonatal intensive care nursery.