Thursday, September 21, 2023

High Blood Pressure Post Partum

Things You Can Try Yourself To Reduce High Blood Pressure

Causes of postpartum hypertension – Dr. Teena S Thomas

Keeping active and doing some physical activity each day, such as walking or swimming, can help keep your blood pressure in the normal range. Eating a balanced diet and keeping your salt intake low can help to reduce blood pressure.

There isn’t enough evidence to show that dietary supplements such as magnesium, folic acid or fish oils are effective at preventing high blood pressure.

Identifying Gaps In Research

We also realized that one significant blood pressure management challenge relates to women who resist going to the hospital when referred for blood pressure control. They may avoid going because they do not feel any symptoms or they may lack transportation. The hospital may be too far away. And a lack of money may compound the problem.

This lack of awareness of pre-eclampsia danger signs in some settings points to the need for advocacy around seeking early antenatal care, regular check-ups throughout pregnancy , and close follow-up after childbirth. More research is needed to study the intersection and integration of community-based education, health promotion, peer influence, and PHC-moderated access to advanced health services.

We found little documentation on the follow-up care of women who had experienced pre-eclampsia into the extended postnatal period in LMICs. In Bangladesh and Nigeria, where we surveyed women in the extended postnatal period, one-third of women continued to have problems with high blood pressure a year after experiencing hypertension during pregnancy. We also found that women resist seeking routine postnatal care due to a range of social and normative barriers related to reaching facilities.

What Is Postpartum Hypertension

Hypertension is the medical term for high blood pressure. Your blood pressure is the measure of the force placed on your arteries as the heart pumps blood through your body. High blood pressure means the circulatory system is working harder to move your blood supply around. This can put a strain on the arteries, causing them to harden and narrow while losing their elasticity. It also puts more strain on your heart as it is working harder.

While it’s possible to experience high blood pressure at any time of your life, some people experience postpartum hypertension. This is high blood pressure experienced after giving birth. Normal blood pressure is 120/80mm Hg, while postpartum hypertension is high blood pressure of 140/90mm Hg or above.

Blood pressure tends to drop in the early stages of pregnancy before returning to normal by the third trimester. It’s common for blood pressure to fall directly after the baby is born, then rise until it reaches its peak between three and six days after delivery¹. This can be due to many factors including pain, medication, and fluid retention, and usually doesn’t last long.

Your doctor or midwife will closely monitor your blood pressure during this time. They will take blood pressure readings during your labor, immediately after youve given birth, and throughout your hospital stay. They will also take routine readings at your postnatal appointments.

What risks are associated with postpartum hypertension?

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Clinical Trial Results And Their Evaluation

The exposure group consisted of 8 women with various hypertension forms who were subject to noninvasive percutaneous electrical stimulation with AVR-051 device in addition to antihypertensives intake.

The comparison group consisted of 8 women of the same age and comorbidities with hypertension who took antihypertensive drugs, but were not subjected to AVR-051 device use .

Table 1

General characteristics of parturient women in both groups

Abbreviations: HTN hypertension, PE preeclampsia.

Table 2

How Do You Treat Postpartum Preeclampsia

High Blood Pressure Treatment: High Blood Pressure After Giving Birth ...

Postpartum preeclampsia can quickly progress to eclampsia, so its important to be treated for the condition right away. Your doctor may recommend the following medications:

  • Blood pressure medications, or antihypertensive medications, which will bring down your blood pressure.
  • Magnesium sulfate, which can help prevent seizures. Typically, women will take this for 24 hours, and continue to be monitored for other symptoms after theyve finished the treatment.

Chances are, youll be able to breastfeed while taking these medications, but you should always check with your doctor before doing so.

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How Do You Get Rid Of Postpartum Hypertension

In many cases, high blood pressure after delivery will resolve on its own within a week or so. If it doesn’t, your doctor may recommend further treatment. Treatment options include:

Watchful waiting

If your blood pressure is high but not high enough to concern your doctor, they may recommend that you continue to monitor your blood pressure over time. That might mean taking your own blood pressure readings at home with an at-home machine or coming into their office to get checked regularly.

Antihypertensive medication

These can help bring your blood pressure back into a normal range. Your doctor will determine which medication is best for you based on your condition, your age, and whether you are breastfeeding. There are many options available, and you may require a combination to achieve the best results.

Your doctor may also recommend lifestyle changes to help prevent hypertension from developing further. This might include stopping smoking, maintaining healthy body weight, and exercising regularly.

When Should I Go To The Hospital For Postpartum Preeclampsia

Watch for warning signs of postpartum preeclampsia and trust your instincts. Seek help when youre not feeling well or when something feels off.

Contact your healthcare provider right away if you have symptoms like headache, swelling in your hands and face or changes in vision. You may need immediate medical attention at the nearest emergency room if you have a seizure or become short of breath.

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What Are The Symptoms Of Postpartum Hypertension

People with hypertension often do not have any symptoms. That’s why it’s sometimes called the silent killer. Whether you are pregnant or not, you won’t be able to tell if you have high blood pressure without having it checked.

It’s important to attend your doctor’s appointments both during and after your pregnancy. This will give your doctor a chance to check your blood pressure and track those numbers over time. They’ll do this by placing a blood pressure cuff on your arm and inflating it. The cuff will feel tight on your arm, and while it may be briefly uncomfortable, it shouldn’t be painful.

If your blood pressure is high, your doctor may recommend continuing to monitor it over a period of time. They will also examine you for HELLP syndrome², a rare liver and blood-clotting disorder. Your doctor may run additional tests to determine any underlying cause of your hypertension. They may also ask you to provide a urine sample to test for protein in your urine, a sign of preeclampsia.

Around 5.7% of preeclampsia cases start in the postpartum period², so it’s important to monitor yourself for any new or unusual symptoms once your baby has been born. Watch for symptoms such as persistent headaches, stomachaches, changes in your vision, or sudden swelling in your face, hands, or feet. If you start to experience any of these symptoms, contact your doctor right away.

Chronic Hypertension Later In Life

HYPERTENSIVE CRISIS | Dangerously high blood pressure POSTPARTUM

By leveraging data from our widely scaled postpartum hypertension remote monitoring program, we were able to discover that a womans blood pressure in the first six weeks after childbirth appears to be an important indicator of whether she is likely to develop chronic hypertension six to 18 months later, said one of the studys lead authors, Eesha Dave, MD.

Researchers believe that this new information can help better identify women at risk for developing cardiovascular problems later in life. They hope that physicians could take the data recorded over a pregnancy term and use it towards preventative measures later on in life.

Women who experience high blood pressure during pregnancy should be aware that it is not only a concern for later in life but can also affect how they carry their baby to term. Recent studies have found that high blood pressure can put both the mother and baby at risk for pregnancy problems. It can also cause problems during and after delivery.

The good news is that high blood pressure during pregnancy is preventable and treatable. By speaking with a physician and getting the right treatment, both mother and baby can stay healthy.

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Bringing Essential Care To Pregnant Women

Many women around the worldespecially those in low-and-middle-income countries have limited access to quality antenatal, childbirth and postnatal care. Moreover, many clinical guidelines recommend that women with conditions such as pre-eclampsia be managed in a hospital setting. However, the focus should also be on early detection and prompt management of the condition at lower levels of a health system, such as in a primary healthcare setting. The Population Councils Ending Eclampsia project found that it was possible to scale up a primary healthcare model for detecting and managing pre-eclampsia and eclampsia.

In Bangladesh, Nigeria, and Pakistan we worked closely with the Ministry of Health to train 1,296 frontline health workers in 316 PHC facilities and at the community level. The work involved risk assessment, early detection of pre-eclampsia by accurately measuring blood pressure, testing urine, and ensuring adherence to treatment. If severe pre-eclampsia was suspected, then providers administered the first dose of magnesium sulphate and referred the women to the nearest hospital.

Postpartum Preeclampsia: Moms Are Still At Risk After Delivery

Most women with preeclampsia will deliver healthy babies and fully recover. However, some women will experience complications, several of which may be life-threatening. A womans condition can progress to severe preeclampsia, eclampsia, or HELLP syndrome quickly. Delivery, sometimes after a period of expectant management , is a necessary intervention. Once delivered, mom still needs to receive care if she is experiencing high blood pressure and related preeclampsia symptoms.

It’s important to know that delivery is not the cure for preeclampsia. Any woman can develop preeclampsia after her baby is born, whether she experienced high blood pressure during her pregnancy or not. Moms need to continue to monitor their health after delivery. Recognizing these warning signs can save your life:

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How Do We Treat It

ACOG guidelines for preeclampsia recommend IV medication treatment that begins within 30 to 60 minutes of confirmed severe, acute hypertension. The goal is to lower the patient’s blood pressure to between 140/90 and 150/100 to prevent prolonged exposure to severely high blood pressure.

During this time, the care team will frequently check your blood pressure and monitor the baby for signs of distress, such as changes in fetal activity or heart rate. The only way to “cure” preeclampsia is to deliver the baby often, patients with preeclampsia must deliver early to prevent the mother from having a potentially deadly stroke or seizure.

Emergencypostpartum hypertension may also be treated with IV therapy or oral medication. In some cases, the doctor may recommend magnesium therapy to prevent preeclampsia-induced seizures. Patients who go to their local doctor’s office with very high postpartum blood pressure should be transferred to a hospital for treatment and monitoring.

Chronic hypertension, while not usually an emergency, is a long-term health risk that must be controlled. Most patients can achieve a healthy blood pressure through a combination of medication, exercise, and diet changes. Increasing exercise and reducing sodium are two key factors in getting blood pressure to a healthier level.

Why This Is Important:

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New-onset raised blood pressure affects about one in ten pregnancies. For some women, raised blood pressure is an indication of pre-eclampsia: newly arising high blood pressure in pregnancy combined with protein leaking into the urine. After birth, womens blood pressure remains elevated for a period of time, but in most cases returns to normal over 212 weeks. During this period medication needs to be adjusted to achieve the correct blood pressure control. Research suggests that more normal blood pressure during this period is associated with improved long-term health outcomes.

Self-management approaches may help to empower patients, improve blood pressure control and patient satisfaction, and reduce the burden on primary care and community care services. – Dr Alexandra Cairns, University of Oxford.

National guidance from the National Institute for Health and Care Excellence highlights that very few clinical studies have addressed the management of blood pressure after birth. Clinical care is typically to continue the blood pressure medication started during pregnancy and monitor blood pressure in the community with a focus on prevention of over-treatment.

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Pregnancy And Heart Health

In general, pregnancy puts stress on a womans heart and circulatory system, the Mayo Clinic reports.

Because blood volume goes up 30 to 50 percent to support the baby, a pregnant womans heart pumps more blood per minute and her heart rates increase.

Women who develop early-onset preeclampsia are more likely to have thickening in their hearts left ventricle one month after delivery and therefore are at the greatest risk for developing heart disease, according to American Heart Association research presented last year.

High Blood Pressure: Pregnant And Postpartum Women Face Hidden Danger

April 23, 2020 By Charlotte E. Warren& Pooja Sripad

One-third of all maternal deaths can be traced to high blood pressure in pregnancy and in the weeks after giving birth. Yet many women dont know how dangerous high blood pressure can be. And they may not realize they are at risk for many life-threatening conditions such as pre-eclampsia and eclampsia. Because high blood pressure can be asymptomatic, women with hypertension may not feel unwell or even know that their health is compromised.

This article is part of the Maternal Health Initiatives CODE BLUE series, developed in partnership with EMD Serono, a business of Merck KGaA, Darmstadt, Germany. Every year, 18 million women of reproductive age die from non-communicable diseases which poses a growing and often overlooked challenge to global maternal health. The CODE BLUE series aims to bring to light and explore these issues.

One-third of all maternal deaths can be traced to high blood pressure in pregnancy and in the weeks after giving birth. Yet many women dont know how dangerous high blood pressure can be. And they may not realize they are at risk for many life-threatening conditions such as pre-eclampsia and eclampsia. Because high blood pressure can be asymptomatic, women with hypertension may not feel unwell or even know that their health is compromised.

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How High Is Too High

The American College of Obstetricians and Gynecologists estimates that 1.5 percent of patients enter pregnancy with chronic hypertension a number that increased 67 percent from 2000 to 2009 due in part to the obesity epidemic and increased maternal age.

Having high blood pressure in pregnancy or postpartum puts you at greater risk for stroke, preterm birth, seizures, and death. Chronic hypertension increases your risk of stroke, heart attack, and death. Keeping your blood pressure in check dramatically reduces your risks.

Follow these parameters when monitoring your blood pressure:

  • Normal: A normal, healthy blood pressure reading is 120/80. Once we creep over that, the brain’s ability to regulate blood flow is impacted at varying levels, depending on the patient.
  • High: During pregnancy and the few weeks after, your blood pressure may be 140/90. This is considered high, but not severe. You and your doctor should keep an eye on your blood pressure to make sure it goes no higher.
  • Emergency: Having a blood pressure reading of 160/110 or higher is a medical emergency.

Women who had preeclampsia may still be at risk up to six weeks after delivery. Women who had high blood pressure before and during pregnancy continue to be at risk as long as their blood pressure remains high.

You Can Have Preeclampsia And Not Know It So Go To All Of Your Prenatal Care Visits Even If Youre Feeling Fine

Postpartum Hypertension | UPMC Healthbeat Podcast

What is preeclampsia?

Preeclampsia is a serious blood pressure condition that can happen after the 20th week of pregnancy or after giving birth . Its when a woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working normally. Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body. High blood pressure is when the force of blood against the walls of the blood vessels is too high. It can stress your heart and cause problems during pregnancy.

Preeclampsia is a serious health problem for women around the world. It affects 2 to 8 percent of pregnancies worldwide . In the United States, its the cause of 15 percent of premature births. Premature birth is birth that happens too early, before 37 weeks of pregnancy.

Most women with preeclampsia have healthy babies. But if not treated, it can cause severe health problems for you and your baby.

Can taking low-dose aspirin help reduce your risk for preeclampsia and premature birth?

For some women, yes. If your provider thinks youre at risk for preeclampsia, he may want you to take low-dose aspirin to help prevent it. Low-dose aspirin also is called baby aspirin or 81 mg aspirin. Talk to your provider to see if treatment with low-dose aspirin is right for you.

Are you at risk for preeclampsia?

Youre at high risk for preeclampsia If:

How is preeclampsia diagnosed?

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Hypertensive Disorders Of Pregnancy Risk Factors And Complications

While any new mother can develop high blood pressure during pregnancy, these factors can increase your risk:

  • Having preeclampsia or another hypertension disorder during a prior pregnancy
  • Giving birth to twins, triplets, or more babies
  • Being a woman of color
  • Being overweight or underweight
  • Having your first baby over age 40
  • Having a prior medical condition, such as diabetes or chronic high blood pressure

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