Gestational Hypertension

Covering gestational hypertension definition, symptoms, treatment and diet.



Gestational Hypertension Definition

Normally defined as blood pressure over 140/90mmHg gestational high blood pressure is also known as pregnancy-induced hypertension (PIH). Gestational high blood pressure definition in its simplest form is a significant rise in blood pressure during pregnancy occurring after 20 weeks. Even though PIH can occur as early as 20 weeks as started in the definition, it more commonly occurs beyond 24 to 28 weeks. Gestational high blood pressure occurs in five percent of pregnancies.

Pregnancy-induced hypertension typically occurs because one is pregnant. This entails that even a woman with no previous history of high blood pressure may develop the condition on account of being pregnant. Gestational hypertension is known to be more common in first pregnancies, multiple pregnancies with pre-existing hypertension, diabetes or renal disease. Doctors diagnose gestational high blood pressure by taking repeated readings at certain intervals on different days to establish the average blood pressure numbers. Advanced blood pressure equipment such as the Omron blood pressure monitor series is able to automatically calculate the average blood pressure.

Doctors can conclude that a pregnant woman has pregnancy-induced hypertension if she fulfills the following criteria;

  • The pregnant woman is past 20th week of pregnancy
  • She carries no symptoms or signs of preeclampsia
  • She had no high blood pressure before becoming pregnant
  • She has an average blood pressure reading greater than 140/90mmHg

Doctors may also test the pregnant woman's urine for the detection of protein. The presence of protein in urine is a sign of damage to kidneys which leads doctors to detecting the presence of a hypertensive condition. In terms of risk factors, daughters and sisters of women with a past of gestational high blood pressure have a heightened risk for the condition. Other risk factors will include diabetes, molar pregnancy and antiphospholipid antibody syndrome.

Gestational hypertension symptoms

There are specific normal occurrences that do not obtain in women with gestational high blood pressure. For example, blood pressure in pregnant women normally declines during the first trimester and reaches lowest point at 20 weeks gestation. Blood pressure then usually returns to ideal blood pressure levels at full term. This decline is missing in pregnancy-induced hypertension patients.

Symptoms and signs of gestational high blood pressure in women will include headache, blurred vision, abdominal pain in combination with elevated blood pressure. Other symptoms will also include retinopathy which is damage to blood vessels that supply oxygen to the retina of the eyes. The following is a summary of the symptoms of gestational high blood pressure;

  • Headache
  • Blurred vision
  • Abdominal pains
  • Retinopathy
  • Right upper-quadrant pain
  • Thrombocytopenia
  • Elevated serum creatinine
  • Swelling of the face and hands
  • Yellow discoloration of the skin and eyes

Gestational hypertension treatment and diet

Hypertension during pregnancy apparently continues to be an ongoing vexing clinical problem. Doctors and hypertension specialists note that the dilemma is further enlarged by the clear fact that today women are choosing to have their children later in life. Even though controversial and subject of much debate some doctors believe that pregnant women who show no symptoms at all and with a normally developing pregnancy and have no other concomitant medical problems should be let alone until their blood pressure exceeds 170/110mmHg.

Gestational hypertension treatment which is rather remarkable in comparison to all others is delivery. In fact the term 'gestational hypertension' is applied if blood pressure reverts to normal after delivery. Treatment of gestational high blood pressure is also a subject of much debate especially as it pertains to bed rest. There is widespread belief that bed rest is an effective treatment for pregnancy-induced hypertension. Some doctors argue that there is no conclusive evidence from all studies done to support the notion that bed rest is useful.

Regular check-ups during the period of pregnancy and after giving birth are usually done for early detection of preeclampsia and chronic hypertension. Treatment will also involve introduction of lifestyle related changes. In particular job stress has been identified to be detrimental in a PIH situation. Job stress typically involves lack of control over work pace and the timing and frequency at breaks. In fact a study showed that women exposed to high job stress were at greater risk of developing gestational high blood pressure than women with less job stress.

There is ongoing mention of the benefits of light physical exercise for high blood pressure patients. In fact for primary hypertension the link between exercise and high blood pressure is well established. However as it pertains to pregnancy-induced hypertension some doctors note that there is insufficient evidence to make a recommendation about the usefulness of exercise. The doctors also doubt the usefulness of workload reduction or stress reduction in pregnant women who are hypertensive.

Treatment of gestational high blood pressure will also include the use of pharmacological drugs. However these are taken under strict doctor observation for fear of possible induction of fetal growth retardation. Scientific research has found particular gestational hypertension treatment and diet approaches necessary. It's been noted that eating more fish reduces risk of gestational high blood pressure. Unlike sodium intake restriction in primary hypertension, a low sodium diet has shown no significant benefit in reducing high blood pressure during pregnancy. However it continues to be recommended that pregnant women eat food with no added sodium

Some supplements have been shown to be useful in preventing or reducing the risk of gestational high blood pressure. 1200 to 1500mg of calcium daily may reduce the risk of gestational high blood pressure. Taking 300mg of magnesium is also believed to prevent pregnancy-induced hypertension or reduce its severity. Zinc is also an important supplement for hypertensive pregnant women.

The following is a summary of gestational hypertension treatment and diet approaches;

  • Diet - less sodium, eating fish, fruits and veggies
  • Supplements - calcium, magnesium, zinc
  • Anti hypertensive drugs - diuretics, CCBs etc
  • Physical exercise
  • Delivery/giving birth
  • Lifestyle changes - quitting smoking, drinking, reducing stress, reducing workload

These approaches should be considered in the context of the foregoing discussion.




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