What is Hypertension?
Gestational hypertension is high blood pressure during pregnancy, but it is not the same as preeclampsia. It often starts in the second half of pregnancy and normally goes away after the baby is born. Gestational hypertension differs from preeclampsia because it does not involve excess protein in the urine or other signs of organ damage. However, some women with gestational hypertension eventually go on to develop preeclampsia. Gestational hypertension can be diagnosed through frequent blood pressure readings.
What are the Symptoms of Gestational Hypertension?
The main symptom of gestational hypertension is high blood pressure during pregnancy. Some women may have no other symptoms, and symptoms can also occur differently from one pregnancy to the next. General signs of high blood pressure during pregnancy include:
- Consistent headache
- Vision changes (blurring, double vision)
How is Gestational Hypertension Handled?
Most cases of gestational hypertension do not harm the mother or baby, and blood pressure returns to normal sometime after the baby is born. However, since some women with hypertension go on to develop preeclampsia, which is more serious, your blood pressure must be monitored throughout your pregnancy. Your doctor will let you know if any lifestyle changes or adjustments are needed to manage your blood pressure during your pregnancy.
What is Preeclampsia?
Preeclampsia is a sudden increase in blood pressure that occurs after 20 weeks of pregnancy. Although this high blood pressure usually goes away after birth, it is dangerous for both the mother and baby and can lead to several pregnancy complications. The condition can keep the baby from getting proper amounts of blood and oxygen from the mother. Preeclampsia can also cause the mother to have serious problems with her brain, liver, and kidneys. The most severe cases of preeclampsia can lead to seizures, which is called eclampsia. Experts believe that preeclampsia is caused by improper development of the blood vessels that send blood to the placenta during pregnancy. This condition also has genetic components, with the father’s mother often having had preeclampsia while she was pregnant. Proper identification and treatment of preeclampsia are crucial for both the mother and baby, and our specialists at NJPA are skilled and experienced in managing pregnancies where preeclampsia is present.
What are the Symptoms of Preeclampsia?
Symptoms of preeclampsia are similar to the symptoms of gestational hypertension, including swelling in your face and hands, a headache that does not go away, and pain in your upper right abdomen. However, preeclampsia differs from hypertension due to the addition of the following problems:
- Excess protein in the urine (called proteinuria)
- Signs of damage to another organ system (usually the liver and kidneys)
What are the Complications of Preeclampsia?
Preeclampsia is accompanied by various pregnancy complications, which may be more severe the earlier the preeclampsia occurs during pregnancy. Induced labor and delivery may be required. Complications that can impact a mother or baby due to the presence of preeclampsia include:
- Fetal growth restriction (low birth weight)
- Preterm delivery
- Placental abruption
- HELLP syndrome (a more severe form of preeclampsia)
- Eclampsia (preeclampsia plus seizures)
- Organ damage
- Increased risk of future cardiovascular disease
Prevention of Preeclampsia – Low Dose Aspirin for Moderate Preeclampsia Risk Factors
In accordance with current ACOG recommendations, we sometimes recommend the use of low dose aspirin (81 mg daily), initiated between 12 to 28 weeks, for the prevention of preeclampsia, if two or more moderate risk factors are present. This is based on current available evidence which suggests that low dose aspirin therapy results in a significantly decreased incidence of preeclampsia. This therapy is currently recommended when two or more of the following risk factors are present:
- Certain sociodemographic characteristics (African American race, low socioeconomic status)
- Age 35 or older
- Personal history factors (e.g. low birthweight, previous adverse pregnancy outcome, more than 10 year inter pregnancy interval)
At NJPA, your physician will let you know if this prevention method is recommended for your specific pregnancy. We encourage all pregnant women to adopt standard healthy lifestyle practices both before and during their pregnancies, including incorporating healthy diet choices and exercise into their daily routines.
How is Preeclampsia Treated in NJ?
After preeclampsia is diagnosed through blood pressure readings and tests for protein in the urine, your doctor will decide on treatment. Treatment methods will depend on the severity of the preeclampsia, how far along in your pregnancy you are, and the potential risks to you and your baby. If you are more than 37 weeks pregnant, delivery may be the best next step. Those less than 37 weeks pregnant will be closely monitored via blood and urine tests, ultrasound, and monitoring of the baby’s heart rate and growth. Symptoms of preeclampsia usually go away within six weeks of delivery.
What is Mild Preeclampsia?
Mild preeclampsia can also be dangerous, as there are no symptoms aside from increased blood pressure. Your chances of developing mild preeclampsia increase with high blood pressure before getting pregnant. At NJ Perinatal Associates, we will keep a log of your blood pressure to track whether you are at risk for mild preeclampsia. We will suggest a diet to decrease your blood pressure, as well as make other lifestyle recommendations. Exercising is extremely important, as a healthy pregnancy decreases the chances of mild preeclampsia occurring.