High blood pressure during pregnancy is very common. A few related hypertensive disorders include preeclampsia, eclampsia, gestational hypertension, or chronic hypertension. All include an elevated blood pressure, but each has certain characteristics and specific treatments.

According to Dusty Dix, hypertensive disorders are the most common medical complication reported during pregnancy. Although the cause of pregnancy-induced hypertension (PIH) is unknown, the American Pregnancy Association places greater risk found with:

• First time moms
• Family history (sisters or mother) of PIH
• Twins or multiple baby pregnancy
• Over the age of 40
• Teenage women
• High blood pressure or kidney disease prior to pregnancy

There a minor differences between the various hypertensive disorders. The least severe of the bunch is gestational hypertension. Dix explained this as blood pressure elevation detected for the FIRST time after mid-pregnancy (20 weeks). What is a pressure elevation? Hypertension (whether pregnancy-induced or chronic) is defined as a systolic blood pressure (top number) greater than 140 mm Hg, or a diastolic BP (bottom number) greater than 90 mm Hg. Although, if your normal blood pressure is on the lower side, hypertension may be found at a lower blood pressure in your case.

Preeclampsia is a more specific pregnancy condition that generally occurs after 20 weeks pregnancy and is characterized by gestational hypertension + protein found in the urine. Preeclampsia ranges from mild to severe. With more severe conditions, headaches, visual problems may be present.

Eclampsia occurs when seizures activity or coma occurs with the pregnant woman (and there is no pre-existing condition to explain why). Of women experiencing eclampsia, about 1/3 develop the condition during pregnancy, 1/3 during labor, 1/3 within 72 hours post delivery (nurses keep a close eye for this condition when women have high blood pressure at delivery).

Chronic hypertension is clinically defined as having hypertension present before pregnancy or diagnosed prior to 20 weeks gestation.

There is often no or minimal complications, but some women have seen poor or reduced fetal growth. This, along with all pregnancy-induced hypertensive disorders, is due to poor perfusion of blood to the placenta due to high blood pressure. As a result, the baby will receive less oxygen and nutrients to help develop and grow in utero.

Treatment options vary for each hypertensive condition and how close the woman is to her due date. Overall, rest is encouraged and side lying (on your left side) is shown to deliver the maximum amount of blood and nutrients to the baby. Consuming less salt, drinking an adequate amount of water, and staying consistent with your prenatal checkups is essential!

For more information found in this article check out The American Pregnancy Association at: http://www.americanpregnancy.org/pregnancycomplications/pih.htm.

Additional reference:
Dix, D. (2007). Hypertensive disorders in pregnancy. In Lowdermilk & Perry (Eds.), Maternity & women’s healthcare. St. Louis, MO: Mosby.

By Claire Cipolletti
Claire is a twenty-three year old nursing student at Arizona State University. She currently lives in Tempe, AZ with her dog Bella.