How to get pregnant if you suffer from hypertension

Here is everything you need to know about how to control hypertension during pregnancy.

There are a lot of precautions you need to take once you get pregnant. But if you have a pre-existing condition then you need to be more cautious than ever. These days it is common for women to fall prey to lifestyle diseases like diabetes or hypertension even in their 30s. As many women plan a late pregnancy these problems might just come to the fore during the conception phase. Since hypertension is known to be a silent killer a woman might not know she is suffering from the same till late. Getting pregnant with hypertension isn t impossible but you definitely need to keep certain things in mind before planning one. Here is more information on how to plan a pregnancy with a heart problem.

Here we would discuss how to plan a pregnancy if you are suffering from hypertension and what precautions you need to follow during the course of nine months:

Conception

Hypertension is defined as a condition when your blood pressure is 140/90 mm Hg or more. However, this reading doesn t affect one s fertility or ability to conceive, in general. A woman who might be suffering from hypertension and is on medication to control the blood pressure can conceive if there is no impending medical condition that interferes with conception. Here are seven tips to conceive a baby faster.

Pregnancy

If a woman is hypertensive and is on medication to control blood pressure, she needs to talk to her cardiologist and gynaecologist to get it titrated during pregnancy, as some drugs taken to control hypertension can cause complications. However, it is essential to follow the advice given by the doctor to have fewer complications during pregnancy. Chronic hypertension during pregnancy can have adverse side-effects like premature delivery, fetal growth restriction, fetal death, placental abruption and caesarean delivery. It also depends on the severity of the condition. Chronic hypertension is when a woman is on hypertension medications pre-pregnancy or develops it within the first 20 weeks of pregnancy.

Women with mild hypertension like 140/90 mm Hg have a 20 percent risk of suffering from preeclampsia during pregnancy, women with severe hypertension like 160/110 mm Hg have a risk of suffering from preeclampsia by 50 percent and those with target organ damage or secondary hypertension has a 75 percent chances.

Medications

It is essential to have the prescribed medications during pregnancy to keep the blood pressure in check. The first-line of medication to treat hypertension during pregnancy is to take prescribed alpha and beta blockers. Long-acting formulations of nifedipine (a calcium channel blocker) can be used as an additional second-line agent if blood pressure is not adequately controlled with help of the beta blockers. However, don t self-medicate even if you have been taking medications prior to your conception. Consult the doctor before you take pills during pregnancy.

Some blood pressure medications can lead to premature delivery and intrauterine growth in the fetus others can also lead to fetal anomalies like cardiac malformations and problems of the central nervous system.

Complications

Uncontrolled hypertension during pregnancy can cause problems for both the mother and baby. It could lead to preeclampsia which might restrict growth in the fetus and lead to heart problems in the mother later.

Managing hypertension

In most cases, hypertension can be managed with medications and lifestyle changes like controlling the weight, limiting salt intake and doing light exercises. Apart from that having a folic acid daily is essential.

Labour and delivery

In most cases, a vaginal birth can be planned even with hypertension. However, a fetal monitoring is done to keep track of the growth and development of the baby. If fetal distress is seen due to hypertension an emergency caesarean is planned. Most often after the delivery, the blood pressure comes back to normal of the pre-pregnancy state. However, if the numbers are not in control your doctor might put you on medications to get the numbers in check.

With inputs from Dr Beena Jaysingh, Motherhood Hospitals, Bengaluru

Reference:

Carson, M. P., & Chen, K. K. (2014). Hypertension in a woman planning a pregnancy. Canadian Medical Association Journal, 186(2), 129-130.

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