Hypertension is the most common medical problem encountered by pregnant women, complicating up to 10% of pregnancies worldwide. It may be presented as pre-existing hypertension before pregnancy, or developed for the first time in pregnancy. Accordingly, hypertensive disorders during pregnancy are classified as chronic hypertension, preeclampsia-eclampsia, preeclampsia on top of chronic hypertension and gestational hypertension. These disorders can cause low birth weight or premature delivery of the baby.
Preeclampsia may complicate chronic hypertension or gestational hypertension. It is marked by high blood pressure with a high level of protein in the urine and causes swelling in the feet, legs, and hands. It usually appears late in pregnancy although it can occur earlier. If undiagnosed, preeclampsia can lead to eclampsia, a serious condition that includes seizures that can endanger both the mother and the fetus, and in rare cases, cause death.
The only intervention that could be done in preeclampsia is delivery, regardless of the outcome of the fetal condition. Hence, preventive measures should be taken by all pregnant women to prevent the increase in blood pressure and its complications, these include:
1. Regular check-ups
Keep your antenatal appointments and visit your healthcare professional regularly throughout your pregnancy. Regular checkups ensure that your blood pressure and urine are tested. If you are already suffering from chronic hypertension before pregnancy, it’s even more important that you are monitored closely throughout your pregnancy to make sure your high blood pressure is not affecting the growth of your baby and that you don't develop preeclampsia. One of the signs of preeclampsia is an abnormal amount of protein in the urine. Pre-eclampsia can manifest long before women experience physical symptoms and women may develop the condition between antenatal visits. Because of that, home monitoring of blood pressure is also recommended as outlined by The 2013 American College of Obstetricians and Gynaecologists guidelines.
2. Take your medication
If you're taking medicine to lower your blood pressure, inform your doctor when you are trying to conceive or discover that you are pregnant. Your doctor may want to switch you to a different medicine before or as soon as you are pregnant. This is because some medicines that treat high blood pressure may not be safe to take when you're pregnant. They can potentially reduce the blood flow to the placenta and your baby. During the first half of pregnancy, a woman's blood pressure tends to fall. This means you may be able to come off your medication for a while. But this should only be done under your doctor's supervision. If you're taking medication throughout pregnancy to control your blood pressure, keep taking it during labour. Take your blood pressure medication as prescribed. Your healthcare provider will prescribe the safest medication and its appropriate dose.
3. Keep yourself active
Staying active and doing some physical activities each day, such as walking or swimming, can help maintain your blood pressure in the normal range. Consult your healthcare professional for recommended physical activities.
Physical activity is not dangerous for hypertensive pregnant women. In fact, increasing physical activity during pregnancy may reduce preeclampsia risk in oppose to sedentary activity. Unless you have other medical reason to lie down in bed, you can start slowly with light exercises and increase the intensity gradually over time. You should avoid doing fall-prone activities such as horseback riding, soccer and basketball.
4. Weight Control
It is important to monitor your weight gain throughout your pregnancy. Your healthcare professional will inform you of the range of healthy weight gain during pregnancy depending on the needs of your growing baby and the weight you were before getting pregnant. Being overweight and obese is a warning sign that can be detrimental to blood pressure. It may also cause leg cramps, diabetes, aching joints, heartburn, backaches, leg cramps, and exhaustion during pregnancy. Lifestyle modification to limit weight gain from early pregnancy onward may have the potential to reduce the incidence of the hypertensive disorder in pregnant women.
5. Maintaining a Balanced Diet
Eating a balanced diet and keeping your salt intake low can help to reduce blood pressure. A healthy balanced diet can also help you gain a healthy amount of weight. Focus on consuming lean proteins, fruits, vegetables, whole grains and low-fat dairy products. Whole grains are rich in dietary fiber and are known to reduce hypertension. During pregnancy, switch to whole grains like bread, whole wheat pasta, and brown rice. Ensure that you eat at least 8 servings of whole grains throughout the day. Refer to a nutritionist if you need additional help.
6. Know what's off-limits
Avoid smoking, alcohol, illicit drugs and caffeine. Talk to your healthcare professional before taking any over-the-counter medications. If you are on medications for any medical reasons, make sure that you seek your healthcare professional’s approval beforehand. Certain medications can lead to hypertension as a side effect. It is important to monitor and seek advice from your healthcare professional to change your medications if required.
Avoid taking caffeinated drinks or keep your consumption in a limit. Besides being harmful to you and your baby, caffeine also has a negative impact on blood pressure. It leads to a reduction of placental blood flow and may increase the risk of miscarriage, as reported by a study in the American Journal of Obstetrics and Gynecology. Hence, avoid caffeinated drinks or limit your caffeine intake to less than 200 mg per day.
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