Prenatal visits with the Gynecologist/Obstetrician during pregnancy are a mandate and should not be missed. Routine physical examinations always include checking of blood pressure of the soon to be mother at each visit. Maintaining a healthy blood pressure all throughout pregnancy is emphasized by health experts. A healthy blood pressure ascertains safe delivery and healthy baby.
Blood pressure is monitored to determine hypertension in pregnancy. This will be confirmed if systolic BP ≥ 140 mm Hg and a diastolic BP ≥ 90 mm Hg upon two separate measurements which are taken at least 4–6 hours apart.
Hypertension in pregnancy is clinically classified separately depending upon its stage of development in the body.
Chronic Hypertension – Blood pressure is greater than or equal to 140/90 mm Hg prior to pregnancy or before the 20th week of gestation.
Gestational Hypertension – Hypertension that is observed for the first time after 20 weeks of pregnancy and there is absence of proteinuria.
Preeclampsia/Eclampsia – Hypertension and proteinuria of ≥ 300 mg/24 hours after 20 weeks gestation.
Hypertension complicates pregnancy and puts risk to the developing baby. It is vital that all pregnant women with diagnosed chronic hypertension do not miss any prenatal visit as these will include an evaluation for secondary causes of hypertension, medication adjustments along with counseling regarding the risk involved with developing of preeclampsia. Advances in chronic kidney disease. 2013.
Hypertension in pregnancy decreases the blood flow to the placenta. If the placenta does not receive sufficient blood the baby will receive less oxygen and reduced nourishment. This can result in slow growth (intrauterine growth restriction), low birth weight or premature birth.
With the recent rise in neuro development disorders in children, medical experts believe that hypertension in women during pregnancy may be a possible causative factor.
A study conducted in California, USA clearly indicates that maternal metabolic conditions including diabetes, hypertension and obesity is associated with neuro development problems in children resulting in autism spectrum disorder, developmental delays, or impairments in specific domains of development. This is possibly due to lack of oxygen supply to the fetus caused because of hypertension and associated preeclampsia. American Academy of Pediatrics, April 2012
Autism in children is manifested by impaired social interactions, communication differences and restricted or repetitive behavioral patterns. One birth in 1000 may result in autistic child. Obesity before pregnancy can cause hypertension during pregnancy and research indicates that children born to mothers with obesity prior to pregnancies may be at increased risk of cognitive problems and symptoms of attention deficit hyperactivity disorder in childhood, eating disorders in adolescence and psychotic disorders in adulthood. International Association for the Study of Obesity, 2011
Acknowledging that maintain a good track record of healthy blood pressure prior to conception as well as throughout pregnancy will ascertain absolute development of the baby and avoid complications with neuro development and delayed learning or cognitive disabilities. Prenatal appointments with Gynecologist and/or Obstetrician are a priority and necessary management of hypertension with medications, diet and exercise is recommended to maintain a healthy blood pressure for safety of both mother as well as child.