High Blood Pressure in Pregnancy: Consider the Risks
Consequences exist for mother and baby
As a physician who practices maternalfetal medicine, I was pleased to learn that Willis-Knighton and the American Heart Association have partnered to focus on reducing hypertension, or high blood pressure, in pregnant women. This is an important initiative because hypertension is a condition that can lead to serious consequences for both mother and baby.
Simply put, high blood pressure in pregnancy can lead to abnormal blood flow to the placenta (the baby’s afterbirth), leading to a number of complications, not only for the mom but for the baby. High blood pressure can increase the risk of having a lower birth weight baby or even premature separation of the placenta from the uterus in a condition called placental abruption. Poorly controlled high blood pressure can lead to rare complications like stroke, which is not something people typically think of as a problem for younger people.
Preeclampsia is a condition when high blood pressure develops after 20 weeks of pregnancy in women who have previously had normal blood pressure. Preeclampsia is one of the leading causes of maternal and perinatal death in the United States, and it’s one of the most common conditions related to high blood pressure that I treat. Preeclampsia can have unwanted effects on multiple internal organs like the kidneys, specialized blood cells called platelets, and even the liver. Research suggests that pregnant women with preeclampsia have a higher risk of developing cardiovascular disease later in life.
It’s not unusual for me to get a call from an obstetrician about a pregnant woman, generally in her 20s or 30s, whose blood pressure is elevated from her early baseline blood pressure readings with a baby that measures small on ultrasound. I’ll perform an exam and a series of diagnostic tests to determine the cause. If preeclampsia is diagnosed, there’s only one cure, which is the baby’s delivery. While delivery of the patient seems like a straightforward proposition, the baby’s gestation age must be considered. When possible, we try to maximize the gestational age before delivery occurs. However, sometimes early delivery of the pregnancy is unavoidable, especially when the health of the mother or the baby is in significant jeopardy. Why? Babies born early – especially those before 37 weeks of pregnancy – are more likely to experience health problems than babies that remain in the uterus until term. Babies need time to develop before they come into the world. For babies born prematurely, for instance, in the late second or early third trimester, problems like breathing and feeding issues can be severe.
It is critical that a pregnant woman get established with an obstetrician as soon as she knows she is pregnant. Early prenatal care is associated with improved pregnancy outcomes, including pregnancies with preexisting high blood pressure. If you have any chronic medical issues and are considering pregnancy talk to your obstetrician about a preconception planning appointment. Preconception counseling allows you and your physician to map out a strategy to improve your underlying medical issues before you move forward with growing your family. Our practice and many obstetrical practices offer this service. That is a great way to give your baby a healthy start in life.
Christian Briery, MD, FACOG, is a maternal-fetal medicine specialist with Regional Perinatal Group at Willis-Knighton South & the Center for Women’s Health.