It was Elaine’s first pregnancy. She was ecstatic about her growing baby. Yet, she had never felt worse in her life. Prior to pregnancy, Elaine exercised, ate well and proactively maintained a healthy lifestyle. So, doctors dismissed her complaints when she reported feeling like she was dying.
However, her headaches, tiredness and nausea continued to intensify. Finally, two days before her c-section, she was diagnosed with preeclampsia, only to experience an eclamptic seizure and excessive bleeding during labor.
Pregnancy-related hypertension is a leading cause of complications and death during pregnancy in America. Physicians need to be aware and proactive in educating their pregnant patients so that we can prevent complications for both mom and baby.
With one in 17 pregnant women suffering from elevated blood pressure during pregnancy, medical professionals must recognize symptoms, reinforce patient education and respond to high blood pressure findings during pregnancy.
Gestational hypertension is elevated blood pressure during pregnancy that does not present with symptoms. If your pregnant patient presents with blood pressure greater than 140/90 without symptoms or protein in the urine, she likely suffers from gestational hypertension.
Typically, this blood pressure disorder dissipates within 12 weeks after delivery without harm to the mom or baby. However, gestational hypertension increases the mom’s risk of developing chronic hypertension and preeclampsia.
Preeclampsia is elevated blood pressure readings (>140/90) AND accompanying symptoms. This pregnancy-related disorder typically presents itself during the last trimester. The cause is unknown, but the condition can be devastating if left untreated. Other than elevated blood pressure, the mom-to-be may experience some or all of the following side effects:
Occasionally, symptoms can become apparent or persist after delivery. This rare occurrence is rightly named postpartum preeclampsia.
HELLP is a rare but severe condition that results in significant anemia, liver inflammation and decreased platelet counts. The acronym HELLP stands for:
HELLP causes similar manifestations as preeclampsia. However, with HELLP, hypertension and proteinuria may or may not be present. The most common side effects are the following:
Eclampsia, the most life-threatening, pregnancy-related hypertension disorder, causes significant blood pressure elevation and organ damage. The side effects are the same as preeclampsia with the addition of new-onset seizures or coma.
Screening aims to recognize conditions before they become symptomatic. Preeclampsia screening utilizes simple blood pressure monitoring and urinalysis tests. Since medical professionals commonly use these tools, healthcare providers can easily dismiss the signs of preeclampsia.
Understanding which patients are at risk of pregnancy-related high blood pressure helps providers recognize and respond. Women characterized by the following are at risk of developing preeclampsia:
Since your patient understands her body the best, enlisting her help for symptom recognition is vital. Busy moms often dismiss symptoms because they do not know what things are essential to report.
Healthcare providers should educate their pregnant patients on the following remarkable findings:
Assure your patient that preeclampsia is easily diagnosed with a blood pressure check and a urinalysis. If the patient’s blood pressure exceeds 140/90, more tests will be necessary to determine proteinuria.
Pregnant women want to know the implications of high blood pressure during pregnancy. Doctors need to assure mothers that with early recognition and treatment, many of the following complications never result:
Preeclampsia can be safely treated with proper monitoring and early intervention. OB/GYN doctors typically induce women diagnosed with preeclampsia at 37 weeks or greater. If the patient is not yet 37 weeks gestation, closely monitoring the mom’s blood pressure and heart rate while assessing fetal development boosts positive outcomes.
Often, doctors prescribe medications to manage blood pressure and prevent seizures. Steroid injections during the antepartum period stimulate fetal lung development for early deliveries.
Elaine is not the only preeclamptic woman whose symptoms were dismissed. As the body changes due to pregnancy, healthcare professionals can unknowingly discount complaints. Vigilant prenatal monitoring and prompt interventions promote positive outcomes during pregnancy.
“Pregnancy and High Blood Pressure.” NIH: National Heart, Lung, and Blood Institute, 2022, High Blood Pressure – Pregnancy and High Blood Pressure | NHLBI, NIH.
“High Blood Pressure in Pregnancy.” NIH: National Library of Medicine, 2019, High Blood Pressure in Pregnancy | Preeclampsia | MedlinePlus
“Screening for High Blood Pressure Disorders During Pregnancy.” JAMA Network ®, 2023, Screening for High Blood Pressure Disorders During Pregnancy | Guidelines | JAMA | JAMA Network.
“HELLP Syndrome | Disease at a Glance.” NIH: National Center of Advancing Translational Science, 2023, HELLP syndrome – About the Disease – Genetic and Rare Diseases Information Center.
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