Gestational Hypertension and You: What You Need to Know

What is gestational hypertension?
If you develop high blood pressure after 20 weeks of pregnancy but don't have protein in your urine, you'll be diagnosed with gestational hypertension, sometimes called pregnancy-induced hypertension. High blood pressure is generally defined as a reading of 140/90 or higher, even if only one of the numbers is elevated. It doesn't usually cause any noticeable symptoms unless it's really high.

How can gestational hypertension affect my health and my baby's?
It depends on how far along you are in pregnancy when you develop gestational hypertension and how high your blood pressure gets. The more severe your hypertension and the earlier in pregnancy it appears, the greater your risk for problems. The good news is that most women who get gestational hypertension have only a mild form of the condition and don't develop it until near term (37 weeks or later). If you're in this category, you still have a somewhat higher risk of being induced or having a c-section, but other than that, you and your baby are likely to do as well as you would if you had normal blood pressure.

However, about 1 in 4 women with gestational hypertension go on to develop preeclampsia during pregnancy or labor, or soon after giving birth, and the chances raise to 1 in 2 if you develop hypertension before 30 weeks. Gestational hypertension also puts you at increased risk for a number of other pregnancy complications, including intrauterine growth restriction, preterm birth, placental abruption, and stillbirth. Because of these risks, your caregiver will monitor you and your baby carefully.

How is gestational hypertension managed?
Because high blood pressure can affect blood flow to the placenta, if you're diagnosed with gestational hypertension, your caregiver will order an ultrasound to be sure that your baby has been growing well and to see if you have a normal amount of amniotic fluid. Your caregiver may also order a set of blood tests and ask you to collect urine for 24 hours to check for protein (this is a more sensitive test than the urine dip done at each prenatal visit). These lab tests will help her determine whether you have preeclampsia and allow her to gauge any later changes in your condition. Beyond these initial measures, how your caregiver will manage your condition depends on how high your blood pressure is, how your baby's doing, and how far along you are in your pregnancy.

Will my blood pressure return to normal after delivery?
After you give birth, your blood pressure will be closely monitored and your caregiver will be watching you for signs of worsening hypertension and preeclampsia. Most likely, your blood pressure will return to a normal level within a week after you have your baby.

In some women, though, it remains elevated. If your blood pressure is still high three months after you give birth, you'll be diagnosed with chronic hypertension. That means you probably had chronic hypertension all along and just didn't know it. Pregnancy usually causes your blood pressure to go down at the end of the first trimester and throughout much of the second trimester, so it can temporarily hide chronic hypertension. If you didn't have your blood pressure taken before conception and your first prenatal visit wasn't until late in the first trimester or so, your hypertension may not have become evident until later in your pregnancy.

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