High blood pressure in early pregnancy?

Question

I am 37, 8 weeks pregnant and slightly over weight. I have been on high blood pressure meds for 12 years. I had to cut out one of the meds I was on because it could be dangerous for the baby. My regular doctor said double up on the lebatilol and give it a week. My pressure avgs. about 140/100. I am really nervous that this could become a serious issue. My doctor doesnt seem to think it is critical. Am I being a worry wart? I am considering changing doctors. What do you think?

Answer 1

This article will be helpful for you to decide what to do, I tried to summerised it for you:

Although the primary risk of chronic hypertension in pregnancy is development of superimposed preeclampsia, no evidence suggests that pharmacological treatment of mild hypertension reduces the incidence of preeclampsia in this population.

* In normal pregnancy, women's mean arterial pressure drops 10-15 mm Hg over the first half of pregnancy. Most women with mild chronic hypertension (ie, SBP 140-160 mm Hg, DBP 90-100 mm Hg) have a similar decrease in blood pressures and may not require any medication during this period. Conversely, DBP greater than 110 mm Hg has been associated with an increased risk of placental abruption and intrauterine growth restriction. Therefore, place pregnant patients on antihypertensive therapy if the SBP is greater than 160 mm Hg or the DBP is greater than 100 mm Hg. The goal of pharmacologic treatment should be a DBP of about 80-90 mm Hg.

* Three treatment options are available in cases of mild chronic hypertension in pregnancy.

o Antihypertensive medication may be withheld or discontinued, with subsequent close observation of blood pressure. Because blood pressure drops during normal pregnancy and no data support the use of medication in patients with pressures less than 160/100 mm Hg, the authors recommend this option most often.

o If a woman is on pharmacologic treatment with an agent not recommended for use in pregnancy, she may be switched to an alternative antihypertensive agent preferred for use in pregnancy.

o If a woman is on pharmacologic treatment with an agent acceptable for use in pregnancy, she may continue her current antihypertensive therapy.

* For a woman with chronic hypertension in her first trimester, obtain the following laboratory studies: CBC, electrolytes, BUN, creatinine, liver enzymes, urine dip for protein, and a 24-hour urine collection for creatinine clearance and protein excretion. These tests serve as baseline values to be referred to later in the pregnancy if a concern regarding superimposed preeclampsia arises.

* Closely observe women with chronic hypertension in pregnancy for the development of worsening hypertension and/or the development of superimposed preeclampsia (risk is approximately 20%). Repeat laboratory investigations for preeclampsia if the patient's blood pressure increases or if she develops signs or symptoms of preeclampsia.

* Promptly hospitalize women with suspected or diagnosed preeclampsia for close observation. When diagnosed with preeclampsia, delivering the baby always is in the mother's best interest. Any delay in delivery should be due to uncertainty about the diagnosis or immaturity of the fetus. When preeclampsia develops remote from term (ie, <34-36 weeks' gestation), attempts often are made to prolong the pregnancy to allow for further fetal growth and maturation. Monitor both maternal and fetal status closely if pregnancy is prolonged. Perform fetal testing at least twice weekly, using a combination of biophysical profiles and nonstress testing supervised by an obstetrician. Facilitated delivery should occur if either maternal or fetal deterioration is noted, with the mode of delivery decided by obstetric indications.

Consultations:

* An obstetrician should follow all cases of women with chronic hypertension throughout pregnancy; refer women with moderate or severe hypertension to an experienced internist (obstetric medicine specialist), a medical subspecialist, and/or a specialist in maternal-fetal medicine (perinatologist).

* An internal medicine consultation may be useful in the care of women with chronic hypertension due to a secondary cause, women with target organ damage, and women in whom preeclampsia causes significant organ failure.

o Diagnosis of secondary hypertension during pregnancy can be difficult.

o While not absolutely contraindicated, renal captopril scans involve radioactive isotopes and usually are deferred to the postpartum period.

o Hyperaldosteronism and hypercortisolism are difficult to diagnose during pregnancy due to the high levels of progesterone and the normal increase in endogenous cortisol output.

Diet: Multiple dietary interventions have been investigated for a role in preventing preeclampsia (see Deterrence/Prevention), but none with any effect.

HOWEVER DON'T FORGET THAT AN EMERGENCY C/S MIGHT BE CARRIED OUT IF YOUR OBSTETRICIAN CONSIDERS IT NECESSARY.

Answer 2

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Answer 3

.High blood pressure can be developed anytime. What causes high blood pressure? In 90–95 percent of cases, scientists don't know what causes high blood pressure. This is essential hypertension. Fortunately, although scientists don't fully understand the causes of this disease, they've developed both non-drug and drug treatments that treat it effectively. They've also identified some factors that contribute to higher blood pressure. These are arteriosclerosis (or hardening of the arteries), thickening or hypertrophy of the artery wall, and excess contraction of the arterioles (small arteries). In the remaining cases, high blood pressure results from a recognizable underlying problem. This is called secondary hypertension. Some possible causes are a kidney abnormality, tumor of the adrenal gland or congenital defect of the aorta. When the root cause is corrected, blood pressure usually returns to normal.

Answer 4

This can be serious for both you and the baby. What is your family history of this and or miscarriage.? I had high blood pressure for a short time and it caused a stroke. Your hormones are changing and if your doctor does not consider this situation a problem, you may need a new doctor. Best wishes to you and the baby!

Answer 5

If your doctor is not worried, don't be worried. To think u already have a history of hypertension and taking anti-hypertensives. All you think about is if the baby is ok. And I hope your doctor has discussed with you that there is a high chance that you are having your baby by C section.

Answer 6

You are being a worry wart, and that is making your blood pressure go up. Chill out and go for a walk.