Gestational Hypertension is the most common hypertensive disorder in pregnancy. It affects about 6% – 15% of pregnant woman. Gestational hypertension is defined as finding of blood pressure more than 140/90 mmHg on at least two occasions at least 6 hours apart after 20 weeks of pregnancy. Hypertension differs from preeclampsia by absence of protein in the urine. The gestational hypertension is different from chronic hypertension. In chronic hypertension women has high blood pressure before the start of pregnancy.
Symptoms of Gestational Hypertension :
Main symptom is presence of High Blood pressure after 20 weeks of pregnancy. About 15-25% of women with gestational hypertension develop clinical syndrome of preeclampsia, this includes:
Blurring of vision
Sudden weight gain
Pain in upper right side of your abdomen
Women with mild gestational hypertension (BP <160/100) are managed as outpatients. They are instructed to get their BP records at home and record BP readings.
Management of Mild Gestational Hypertension:
Home blood pressure records
Check for proteinuria
Strict daily movement closely
Avoid strenuous physical activity
Avoid standing for long periods
No specific dietary advise
Weekly visits to doctor
If blood pressure is >160/100 patient is admitted to hospital to complete her evaluation and start medical treatment.
Doctor’s Visit – At each visit with doctor your blood pressure and urine is checked. Apart from blood pressure, we get blood investigations to check your renal and liver functions. Ultrasound is also done to check your baby’s growth and doppler to check the blood flow to fetus .Main object is to detect and prevent preeclampsia and its life threatening complications (HELLP Syndrome and Eclampsia).
Drug Therapy – Drug treatment options are limited .Methyl dopa and Labetalol are commonly used to treat the high blood pressure in pregnancy. If gestational hypertension is mild with no other complications, induction of labor is planned at 38-39 weeks of gestation. Sometimes Caeserian section is planned if cervix is unfavourable. There is an increased risk of prematurity with gestational HTN because sometimes delivery is planned early to save the life of mother and baby. An appropriate plan for labor and delivery is very important including deliveryin a hospital with provision for advanced life support of newborns.