Blood pressure and pregnancy

Hypertension or high blood pressure is one of the more serious complications that can affect a pregnancy.

A small percentage of pregnant women who have raised blood pressure will have it as a pre-existing condition and may be on medication even before conception. This is chronic hypertension, also known as "essential hypertension".

There is a small group of women who may have pre-existing hypertension because of a known underlying disease, usually of the kidneys. In such women, the hypertension is, strictly speaking, not a pregnancy complication. Rather, it is a concomitant condition that will need to be monitored and controlled during the course of the pregnancy. This is because pre-existing hypertension has a potential for worsening or being complicated by turning into pre-eclampsia.

So, what is pre-eclampsia and how does it differ from straight-forward hypertension? This is answered in this section.

The majority of women who develop pre-eclampsia have no identifiable underlying cause.

Pre-eclampsia is also known as "pregnancy induced hypertension" (PIH) and also by the older term "pre-eclamptic toxemia" (PET).

In North America, it was also known as "EPH gestosis" in the past. All these terms mean exactly the same thing.

Pre-eclampsia is an exclusively pregnancy disease. It does not occur at any other time in a woman’s life, nor, for that reason, does it affect those of the male gender persuasion

Pre-eclampsia is significant because, if poorly managed, it may lead to loss of the baby. More serious still, both the mother's and the baby's lives could be in danger. Pre-eclampsia cannot be cured while the woman is still pregnant. All the measures that are taken are meant to control the condition, to allow the fetus to grow to a viable stage. This is why preterm delivery and cesarean section are common and predictable consequences of this pre-eclampsia.

On the other hand, if pre-eclampsia is well controlled, as is sometimes the case, the pregnancy will be allowed to go to term and, with a bit of luck, there will be a spontaneous labor and normal delivery. However, no woman with this condition should convince herself that this is what is aimed for. It should be seen as a bonus if it is achieved.

In this section, we set out to remove all those cobwebs which make pre-eclampsia and other hypertensive conditions in pregnancy mysterious.

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