Cmo Puedo Controlar Mi Hipertensin Arterial Durante El Embarazo
Aunque no existe una cura para la hipertensión crónica, hay maneras de manejar con éxito su condición durante el embarazo. El cuidar de sí mismo es la mejor manera de cuidar de su bebé en desarrollo.A continuación se presentan algunos ejemplos:
- Consuma una dieta saludable, y especialmente limitar su consumo de sodio
- Tome sus medicamentos para la presión arterial de la manera que se supone
- Mantenga todas sus citas prenatales
- Mantenerse físicamente activo, aunque su médico le puede recetar reposo en cama si desarrolla preeclampsia
- No fumar, beber alcohol o tomar drogas ilícitas
- Controle su aumento de peso no subír demasiado
Compilado usando información de las siguientes fuentes:Harms, R. W., Johnson, R. V., & Murray, M. M. . Mayo Clinic Guide to a Healthy Pregnancy. New York: HarperCollins Publishers.Mayo Clinic Staff. . Preeclampsia. Recuperado de The American College of Obstetricians and Gynecologists. . Your Pregnancy and Childbirth: Month to Month, Fifth Edition. Washington, DC: American College of Obstetricians and Gynecologists.
What Will Happen In My Pregnancy Appointments If I Have Hypertension
Your antenatal team will be monitoring your blood pressure closely during pregnancy. If you have hypertension, you and your baby will also be closely monitored to ensure the high blood pressure is not affecting baby’s growth.
They will also be checking for the pregnancy condition, pre-eclampsia. You may be asked to provide a urine sample to test for this.
What Is High Blood Pressure
High blood pressure means that the force of the blood flowing through your blood vessels is too strong. A certain amount of pressure is necessary for blood to move around your body, but too much pressure called hypertension can cause serious problems for you and your baby during pregnancy. That’s why your healthcare provider will check your blood pressure at every prenatal visit.
About 8 percent of women in the United States have some kind of hypertension during pregnancy. Some women have high blood pressure before getting pregnant, and some develop it during pregnancy. Preeclampsia, a dangerous blood pressure disorder, can happen during pregnancy or postpartum.
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Tips For Tracking Blood Pressure During Pregnancy
There are ways to track your blood pressure between doctor visits.
You can buy a blood pressure monitor from a pharmacy or online medical goods store. Many of these devices will go on your wrist or upper arm. To check the monitors accuracy, take it to your doctors office and compare the readings on the monitor to those from your doctor.
Visit a grocery store, pharmacy, or other store that has a machine that takes blood pressure readings.
For the most accurate readings, take your blood pressure at the same time every day. Take it while seated with your legs uncrossed. Use the same arm each time.
Notify your doctor immediately if you have repeated high blood pressure readings that are four hours apart or symptoms of high blood pressure.
If you have high blood pressure during pregnancy, there can be complications.
What Are The Possible Problems With High Blood Pressure During Pregnancy
As a rule, the higher your blood pressure, the greater the risk for you and your baby.
Mild to moderate high blood pressure
If your blood pressure remains mildly to moderately raised and you do not develop pre-eclampsia, then the risk is low. Most women with high blood pressure during pregnancy just have mildly or moderately raised blood pressure. However, it is important that your blood pressure and urine should be checked regularly throughout your pregnancy and that you look out for any signs of possible pre-eclampsia.
Severe high blood pressure or pre-eclampsia
Severe high blood pressure, especially with pre-eclampsia, is serious.
The risks to you as the mother include: an increased chance of having a stroke damage to your kidneys and liver an increased risk of blood clotting problems an increased risk of severe bleeding from your placenta. Also, if you develop pre-eclampsia, there is a risk of eclampsia.
The risks to your baby include: an increased chance of poor growth an increased chance of premature birth an increased chance of stillbirth.
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The Affect Of High Blood Pressure On Pregnant Women
High blood pressure can reduce blood flow to the uterus and indirectly problems with the placenta leading to reduced or suboptimal weight gain for the baby. Sometimes, high blood pressure can lead to a special condition called pre-eclampsia or eclampsia. Pre-eclampsia is when along with high blood pressure, other organs start to get affected like kidneys, liver, and sometimes eyes. Kidneys may start leaking protein in urine, liver enzymes may increase and blood parameters like platelets may start to get affected. Women can develop swelling all over the body in this phase. Eclampsia happens, when the brain gets affected leading to seizures in pregnant women.
Preventing High Blood Pressure During Pregnancy
Common risk factors for high blood pressure, such as obesity, can be minimized through diet and exercise.
During pregnancy, its normal to gain some weight. If youre concerned, talk to your doctor about a target weight gain and ways to stay within a range thats healthy for you.
Dietary guidelines for pregnant women vary from person to person. A nutritionist can help create a meal plan thats designed for your specific height and weight.
Avoid smoking and drinking alcohol. Both are known to raise blood pressure and to cause other complications during pregnancy.
Salt is important during pregnancy and its usually not necessary to limit salt intake, even for women with high blood pressure. Restricting salt too much is harmful for pregnant women and can impact fetal growth and development.
Pregnancy causes hormone shifts as well as psychological and physical changes. This can bring on stress, which can make high blood pressure harder to manage. Try stress reduction techniques such as yoga and meditation.
Some traditional blood pressure medications can cause problems in pregnant women.
These medications for lowering blood pressure are typically not recommended during pregnancy:
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What Is The Treatment For High Blood Pressure Of Pregnancy
If your doctor or midwife finds that your blood pressure is high during your pregnancy, they will usually check to see if you have any protein in your urine and ask you if you have any symptoms of pre-eclampsia. If your blood pressure remains high, or if you have any signs of pre-eclampsia, you will usually be seen by a specialist . The specialist has to take into account such things as:
How severe is your high blood pressure ?
Is there pre-eclampsia and, if so, how severe is it?
How far on is your pregnancy?
What are the risks to you, the mother, and your baby? This will depend on the severity of your high blood pressure and whether or not pre-eclampsia is present.
If high blood pressure remains mild and pre-eclampsia does not develop
There is usually little risk. Regular checks of your blood pressure and your urine for protein, as well as checks to see how your pregnancy is progressing, may be all that is needed until the natural time of birth. Checks may include blood tests and an ultrasound scan to look at how your baby is growing and to check the blood flow from the placenta to the baby. You may be followed up by a specialist . You may need medicines to control your blood pressure during your pregnancy.
If high blood pressure becomes severe, or if pre-eclampsia develops
If you have severe pre-eclampsia, the medicine magnesium sulfate may be given via a drip around the time that your baby is delivered. This may reduce your chance of developing eclampsia.
What Is Considered Low Blood Pressure During Pregnancy
While there isnt a definitive number that is too low, there are symptoms that are associated with low blood pressure:
As a woman progresses in her pregnancy, her blood pressure may change or return to pre-pregnancy levels. There are a few possible reasons for this.
The amount of blood in a womans body increases. According to the journal Circulation , a womans blood volume increases by as much as 45 percent during pregnancy. This is extra blood that the heart must pump throughout the body.
The left ventricle becomes thicker and larger. This temporary effect allows the heart to work harder to support the increased blood volume.
The kidneys release increased amounts of vasopressin, a hormone that leads to increased water retention.
In most cases, high blood pressure during pregnancy will decrease after the baby is delivered. In cases where blood pressure remains elevated, your doctor may prescribe medication to get it back to normal.
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When High Blood Pressure Occurs
Blood pressure thats too high for too long can damage your blood vessels and your heart, and increase your risk of having a stroke.
For this reason, its important to understand what high blood pressure is. It usually develops over time.
It can happen because of unhealthy lifestyle choices, such as not getting enough regular physical activity. Being overweight or obese also plays a role.
What Is High Blood Pressure In Pregnancy
High blood pressure in pregnancy is defined as a systolic blood pressure of 140 mmHg or more, OR a diastolic blood pressure of 90 mmHg or more on 2 or more occasions, which are not associated with proteinuria.
High blood pressure is also referred to as gestational hypertension when it occurs in early pregnancy.
Preeclampsiais a disease that causes high blood pressure in the brain and heart during pregnancy. If left untreated, it can cause a number of problems including kidney failure, cognitive delays, hearing loss, andmuscle damage.
Although most cases of high blood pressure are due to the stress of the pregnant condition, some are caused by renal disease, hormonal abnormalities, endocrine diseases, or medications that may be taken by the mother or baby.
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Expert Advice About High Blood Pressure And Pregnancy
Among many ways to improve the odds of a healthy pregnancy, one of the most important is keeping blood pressure in check.
High blood pressure, or hypertension, is a major cause of pregnancy problems, including preterm delivery and low birthweight. It also increases risks for heart disease, stroke and death.
The U.S. still has unacceptably high rates of maternal mortality due to circulation problems, said Dr. Nisha Parikh, a clinical cardiologist and associate professor of medicine at the University of California, San Francisco. Empowering women to get healthy before conception is an important tool to prevent and treat high blood pressure.
A good starting point, she said, is for women to know their numbers. These include blood pressure readings, cholesterol and blood sugar levels, and body mass index, which help assess current heart health and signal any medical problems. Sometimes women with no history of high blood pressure will develop it during pregnancy. High blood pressure may have no symptoms so women may not realize they have it. Thats one reason why regular checkups with a health care professional throughout pregnancy are essential.
Parikh said some women can lower their high blood pressure with lifestyle changes such as better nutrition and more physical activity. Others may need to frequently monitor their blood pressure and take medications.
What Are The Types Of High Blood Pressure In Pregnancy
High blood pressure can develop before, during, and after pregnancy for several reasons. The types of high blood pressure that relate to pregnancy and their causes include:
- Chronic hypertension: This hypertension is present before you become pregnant or before you reach 20 weeks of pregnancy. Health conditions like diabetes and sleep apnea may cause chronic high blood pressure.
- Gestational hypertension: This is high blood pressure only during pregnancy and without heart or kidney issues. With gestational hypertension, there is no elevated protein present in the urine. The condition typically resolves when you give birth. However, gestational hypertension can develop into chronic hypertension.
- Preeclampsia: This is sudden high blood pressure after 20 weeks of pregnancy, in addition to protein in the urine. Preeclampsia can occur if you previously had normal blood pressure or a history of chronic hypertension. You can also develop postpartum preeclampsia.
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Will My Pregnancy Be Classified As High
One indicator of a high-risk pregnancy includes certain chronic medical problems, such as high blood pressure. Therefore, since you already have hypertension and have become pregnant, your pregnancy is automatically classified as high risk.
High-risk pregnancies typically need expert advice and the care of a healthcare specialist. You will most likely see a perinatologist- an obstetrician who specializes in the care of high-risk pregnancies. Perinatologists give expert care to women who have pre-existing medical conditions, as well as women who develop complications during pregnancy.
In addition, you may be referred to a perinatal care center, before delivery, to lessen the likelihood your baby may become ill. Usually, these centers work together with obstetricians and a newborn intensive care unit to provide the best care for you and your baby.
Things To Know About High Blood Pressure And Pregnancy
High blood pressure also called hypertension in pregnancy may not be a common condition, but it can be a concerning one.
Women are considered to have chronic hypertension in pregnancy if they had a preexisting hypertensive condition before getting pregnant or developed high blood pressure within the first 20 weeks of pregnancy. This type of hypertension should not be confused with gestational hypertension, which is high blood pressure identified after 20 weeks of pregnancy paired with normal blood pressure before pregnancy.
For women with chronic hypertension who are pregnant or planning to become pregnant, there are a few things to know.
Know the risksWhile many women with chronic hypertension do well in pregnancy, it is important to know the risks associated with the condition. New research shows mortality rates have increased for pregnant women with chronic hypertension, especially among Black women. Obesity and advanced age contribute to even greater risk of hypertension-related maternal deaths.
Women who are pregnant and have chronic hypertension are also at increased risk for possible pregnancy complications, including:
It’s important for women to know the risks of chronic hypertension to help prepare for additional surveillance before and after pregnancy, as well as to modify lifestyle choices prior to conception, says Dr. Sara Junya, a board-certified obstetrician-gynecologist with Sharp Rees-Stealy Medical Group.
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Medical Management Of Severe Hypertension Severe Pre
If a woman in a critical care setting who has severe hypertension or severe pre-eclampsia has or previously had an eclamptic fit, give intravenous magnesium sulfate.
Consider giving intravenous magnesium sulfate to women with severe pre-eclampsia who are in a critical care setting if birth is planned within 24 hours.
Consider the need for magnesium sulfate treatment, if 1 or more of the following features of severe pre-eclampsia is present:
- ongoing or recurring severe headaches
- visual scotomata
- epigastric pain
- oliguria and severe hypertension
- progressive deterioration in laboratory blood tests .
Use the Collaborative Eclampsia Trial regimen for administration of magnesium sulfate:
- A loading dose of 4 g should be given intravenously over 5 to 15 minutes, followed by an infusion of 1 g/hour maintained for 24 hours. If the woman has had an eclamptic fit, the infusion should be continued for 24 hours after the last fit.
- Recurrent fits should be treated with a further dose of 24 g given intravenously over 5 to 15 minutes.
Do not use diazepam, phenytoin or other anticonvulsants as an alternative to magnesium sulfate in women with eclampsia.
Corticosteroids for fetal lung maturation
If early birth is considered likely within 7 days in women with pre-eclampsia, offer a course of antenatal corticosteroids in line with the NICE guideline on preterm labour and birth.
Corticosteroids to manage HELLP syndrome
What Should I Do If I Have High Blood Pressure Before During Or After Pregnancy
- Make a plan for pregnancy and talk with your doctor or health care team about the following:
- Any health problems you have or had and any medicines you are taking. If you are planning to become pregnant, talk to your doctor.7 Your doctor or health care team can help you find medicines that are safe to take during pregnancy.
- Ways to keep a healthy weight through healthy eating and regular physical activity.1,7
- Get early and regular prenatal careexternal icon. Go to every appointment with your doctor or health care professional.
- Talk to your doctor about any medicines you take and which ones are safe. Do not stop or start taking any type of medicine, including over-the-counter medicines, without first talking with your doctor.7
- Keep track of your blood pressure at home with a home blood pressure monitorexternal icon. Contact your doctor if your blood pressure is higher than usual or if you have symptoms of preeclampsia. Talk to your doctor or insurance company about getting a home monitor.
- Continue to choose healthy foods and keep a healthy weight.8
- Pay attention to how you feel after you give birth. If you had high blood pressure during pregnancy, you have a higher risk for stroke and other problems after delivery. Tell your doctor or call 9-1-1 right away if you have symptoms of preeclampsia after delivery. You might need emergency medical care.9,10
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