High blood pressure = Hypertension

When you are pregnant, you are at risk of developing high blood pressure and organ damage, known as pre-eclampsia. In this article, we review and describe what preeclampsia is.

In Sweden, high blood pressure (hypertension) during pregnancy occurs in about eight percent of all pregnancies. Of this eight percent, two percent are chronically hypertensive, about three percent have pure gestational hypertension and the remaining three percent have preeclampsia, but this varies between studies. It is important to monitor blood pressure during pregnancy as it remains an important factor in the well-being (and survival) of the pregnant woman and the fetus during pregnancy. In Sweden, we have well-developed maternal health care and obstetric care, but high blood pressure as a pregnant woman in developing countries is still a major and difficult problem. The WHO classifies it as a global health problem.

So what is pregnancy-related high blood pressure, or pregnancy-related hypertension as the medical profession calls it?

Pregnancy hypertension means a blood pressure exceeding 140/90 mm Hg after week 20 of pregnancy, in a previously healthy pregnant woman with no history of hypertension. To be diagnosed as having high blood pressure in pregnancy, it must be measured at least twice, and the pregnant woman must have rested beforehand.

What is pre-eclampsia?

This is when the pregnant woman has high blood pressure and organ damage. Often, those who get pre-eclampsia leak protein in their urine, indicating that the kidneys are affected. Normally, molecules as large as protein do not leak through the kidneys. Protein in the urine is checked at the antenatal clinic by having you pee on a urine dipstick. The number of people affected depends on the research you read, but varies roughly between 3-5%. The vast majority get a mild form.

The cause of pre-eclampsia is not fully understood, but we know that if you have had a pregnancy without pre-eclampsia during that pregnancy, your risk of developing it is significantly reduced. Scientists believe that, among other things, the formation of the placenta and its vascular growth in the uterus is important for the development of pre-eclampsia.

Who is running higher risk to develop pre-eclampsia?

Yes, among other things:

- Heredity
- First-time mothers
- Previous pregnancy with pre-eclampsia
- Underlying diseases such as diabetes, but also renal, vascular or systemic diseases.
- Too much blood fats
- African ethnicity
- obesity
- Pregnancy after egg donation
- Chromosomal abnormalities in the fetus
- Twin pregnancy

If you develop pre-eclampsia, your blood pressure, urine and any other tests will be checked more frequently. This is usually done through specialist maternity services. The only way to 'cure' pre-eclampsia is to deliver the baby, so there is an increased risk of premature birth.

Want to read more pregnancy-related content? Click here here!