What is it?
Sometimes called pregnancy induced hypertension (PIH), pre-eclampsia, or gestational hypertension, high blood pressure in pregnancy is a complication that occurs in approximately 8% of pregnant women. Usually it is detected some time after the 20th week of pregnancy and it goes away soon after the baby is born. Sometimes there are no noticeable symptoms. A blood pressure reading above 140/90 is considered high, but any significant rise from the woman’s early pregnancy readings could also be high for her.

Why is it a problem?
Sometimes the PIH is mild, with only a slight elevation of blood pressure and the mother and baby will likely be healthy. When it is more severe, other conditions can develop which can place the mother and baby at risk. The mother may have organ damage (eyes, kidneys, liver, brain), swelling of hands and face and even seizures. The baby may not get enough blood, which is rich in oxygen and nutrients, through the placenta and may be at risk of premature delivery related problems. It is important that it is diagnosed early and controlled.

Who gets it?
Doctors do not know why some women get PIH, but the risk seems to be greater in the following groups of women:

• Those with a personal or family history of high blood pressure
• Those who are pregnant for the first time
• Those who are over age 40 or under age 20
• Those who are carrying more than one baby
• Those who have medical conditions such as diabetes or kidney disease

What can I do?
The earlier it is detected, the better the outcome, because the health care provider can monitor the patient closely and give her medications if needed. Therefore, early and regular prenatal care is essential. Take medications and vitamins as they are prescribed. According to the March of Dimes, there is some evidence that taking vitamins (especially vitamins C, E, and folic acid) can reduce the risk of developing PIH. Communication with your health care provider is important. Notify him or her of any medications you are taking, if you have a history of high blood pressure or kidney disease or if you develop symptoms including:

• Sudden weight gain of more than about 1 pound a day
• Swelling of the face and hands
• Severe or constant headaches
• Blurred vision or spots in front of the eyes
• Pain in the upper right part of the abdomen

Many times PIH can be controlled, but the only real cure is having the baby. Sometimes PIH becomes serious enough to require bed rest or an early delivery. Medication is sometimes given in the hospital during labor to prevent seizures or to lower blood pressure. Working with your health care provider (doctor or certified nurse midwife) will help improve your chances of having a healthy baby.

Resources:
March of Dimes Birth Defects Foundation. www.marchofdimes.com

American College of Obstetricians and Gynecologists Patient Education booklet, “High Blood Pressure During Pregnancy,” ISSN 1074-4601