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Telemedicine in Prenatal Care: Hypertensive Disorders During Pregnancy

May 23, 2022

High blood pressure (hypertension) has negative effects on persons living with the condition if left untreated or poorly managed. However, having high blood pressure during pregnancy can pose a higher risk for complications for both mother and baby. Hence, it is and should be taken seriously if diagnosed.

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What is high blood pressure (hypertension)?

Blood pressure is the force of blood pushing against the walls of the blood vessel. The heart pumps blood into the arteries-blood vessels that carry the blood from the heart to all the parts of the body. A person is said to have high blood pressure, also called hypertension, when the pressure in the arteries is above the normal range.

According to the American College of Cardiology (ACC) and the American Heart Association (AHA), the ranges of blood pressure and what they indicate are as follows: 

Normal: < 120/80 mm Hg

Elevated: 120 to 129/< 80 mm Hg)

Stage 1 hypertension: 130 to 139/80 to 89 mm Hg

Stage 2 hypertension: ≥ 140/90 mm Hg

Hypertensive disorders in pregnancy 

Hypertensive disorders refer to the several different types of high blood pressure during pregnancy. These types vary in severity and impact on the body. The forms of high blood pressure during pregnancy include:

Chronic hypertension

High blood pressure which is present before pregnancy or before 20 weeks gestation. 

Chronic hypertension with superimposed preeclampsia

Preeclampsia, which develops in someone who has chronic hypertension (high blood pressure before pregnancy).

Gestational hypertension

High blood pressure that first develops and is diagnosed during pregnancy, typically after 20 weeks of gestation. In this type, there are no other signs or symptoms of preeclampsia present. 

Preeclampsia

A serious condition only found in the latter half of pregnancy with the following signs and symptoms:

  • High blood pressure
  • Proteinuria (protein in the urine)
  • Edema (generalized swelling) in the mother.

It can progress into eclampsia and cause seizures.

Risk factors of high blood pressure (hypertension) in pregnancy?

The following risk factors can increase a woman's risk of developing high blood pressure (hypertension) during pregnancy:

  • Age (<20 or >40)
  • Pre-pregnancy history of high blood pressure
  • History of gestational hypertension or preeclampsia in previous pregnancies
  • Family history of gestational hypertension
  • Has diabetes or gestational diabetes
  • Overweight or obesity
  • Immune system disorders, such as lupus
  • Kidney disease
  • Multiple pregnancies (twins, triplets, etc.)
  • Race (African American)
  • IVF treatment (in vitro fertilization)

Complications of high blood pressure

High blood pressure (hypertension) during pregnancy can affect both mother and child in serious ways. 

In the baby, it can lead to poor placental development, affecting the supply of oxygen and nutrients to the baby in the womb. This can result in:

  • Slow growth (intrauterine growth restriction)
  • Premature birth
  • Low birth weight
  • Stillbirth

In the mother, it can result in:

  • Placental abruption
  • Eclampsia (seizures)
  • Kidney failure
  • Blood clotting problems
  • Liver problems
  • Stroke
  • Left ventricular failure
  • HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count)
  • Preterm labor and delivery
  • A cesarean delivery

Treatment of high blood pressure in pregnancy

Treatment of high blood pressure depends on the severity, cause, and time of onset. Generally, women with hypertensive disorders will need close monitoring. This could include more prenatal visits, ultrasounds and other tests, and intense fetal monitoring.

To prevent complications, women with any type of high blood pressure in pregnancy are expected to:

  • Adhere strictly to their prescribed blood pressure medication regimen
  • Attend all of their prenatal visits
  • Eat a healthy low-sodium diet
  • Have regular exercise and physical activity as prescribed by their healthcare providers
  • Have an early delivery if necessary

How can we help you?

As a telemedicine platform, My Virtual Physician is available to help guide you through your pregnancy and answer any questions that may arise. We also help with electronically sending orders for tests and examinations while you wait for an appointment with a local OB doctor.

We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare and Blue Cross. 

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