High Blood Pressure (Hypertension) and Preeclampsia

High blood pressure, also known as hypertension, occurs when the force of blood flowing through your arteries is too high. Untreated, it can lead to heart attacks, strokes, heart failure, kidney disease and other serious health threats.

It can also lead to complications during pregnancy. Women with high blood pressure face high-risk pregnancies that require close monitoring to protect the health of mother and baby.

If you are planning a pregnancy and have high blood pressure, talk to your healthcare provider about your risks. Some women develop high blood pressure during pregnancy, a condition known as gestational hypertension.

Potential Pregnancy Complications

High blood pressure during pregnancy increases the risk of complications that include:

• Fetal growth problems
• Preterm delivery
• Low birth weight
• Cesarean delivery (C-section)
• Placental abruption, when the placenta detaches from the uterus before delivery, causing vaginal bleeding
• Preeclampsia, a potentially life-threatening complication

What is Preeclampsia?

Preeclampsia is a condition that typically occurs after 20 weeks of pregnancy and includes high-blood pressure along with signs of damage to the woman’s organs, including the brain, liver and kidneys. It is a common cause of premature births.

Untreated, preeclampsia can quickly worsen and pose serious risks to mother and baby, including:  

• Seizures caused by eclampsia, a potentially fatal condition that requires immediate treatment of the mother and delivery of the baby
• HELLP syndrome, a rare, dangerous complication that can lead to liver failure and death

Preeclampsia can also occur after childbirth.

What are the Symptoms of Preeclampsia?

Signs and symptoms of preeclampsia include:

• High blood pressure
• Protein in the mother’s urine
• Problems with organ function
• Severe headache
• Vision changes
• Low platelet count
• Elevated liver enzymes
• Pain in the upper abdomen
• Difficulty breathing
• Swelling of face or hands

In some cases women may not know they have high blood pressure or other signs of preeclampsia, making regular prenatal care essential for early detection.

Are You at Risk of Preeclampsia?

Factors that increase your risk of developing preeclampsia during pregnancy include:

• Chronic (pre-existing) hypertension
• History of high blood pressure or preeclampsia during pregnancy, or a family history
• Obesity
• Age younger than 20 or older than 40
• Pregnant with more than one baby (multiple gestation)
• First pregnancy, or first pregnancy with a new partner
• History of diabetes, kidney disease, lupus, blood clots, rheumatoid arthritis or scleroderma
• In vitro fertilization (IVF)
• Interval of time between pregnancies (less than 18 months or more than 4 to 5 years)

Treating Pregnancies with Hypertension Disorders

Your treatment during pregnancy will depend on the severity of your high blood pressure disorder and the health of you and your unborn baby. In general, your prenatal care may include:

• Frequent prenatal visits
• Close monitoring of your blood pressure
• Adjustments to your blood pressure medications, as needed
• Regular maternal blood and urine testing to check for signs of preeclampsia or worsening of symptoms
• Regular fetal heart rate monitoring
• Fetal ultrasounds to track your baby’s growth
• Delivery at 37 weeks or later, unless you or your baby are at risk before then
• Close postpartum monitoring

In severe cases of hypertension or preeclampsia, treatment may include:

• Hospitalization for continuous monitoring
• Medications to lower dangerously high blood pressure
• Anticonvulsant medications to prevent seizures
• Corticosteroids to speed up the baby’s lung development
• Induced labor and premature delivery

The Benefits of Specialized Care

At Texas Children’s Pavilion for Women, we are experienced in evaluating and managing these high-risk pregnancies, with expertise across the full range of high blood pressure disorders, from mild hypertension to severe preeclampsia.

We offer:

• Preconception risk assessment and counseling
• Prenatal evaluation and a recommended plan of care tailored to your needs
• Advanced ultrasound and fetal imaging technologies for early detection of complications
• A multidisciplinary medical and surgical team experienced in managing these high-risk pregnancies and deliveries
• Delivery at our state-of-the-art facility with 24/7 access to critical support resources, including blood products and transfusion services, if needed
• A contingency plan for emergency delivery with 24/7 hospitalist coverage
• Immediate access to neonatologists and critical care services at Texas Children’s Hospital for babies who need extra care and monitoring, including the Texas Children’s Fetal Center™ and the Texas Children’s Newborn Center, home to Texas Children’s level IV neonatal intensive care unit (NICU)
• Close collaboration with your current healthcare providers