Hypertension in pregnancy: how to keep it under control

In pregnancy it is important to evaluate the maximum and minimum pressure values in order not to risk complications.

During pregnancy it is important to keep your blood pressure under control: values out of the norm can be an alarm bell. A recent study indicates how it is possible to identify the expectant mothers most at risk and what treatments to prescribe to avoid complications.

Nicola Persico, Head of the Fetal Medicine and Surgery Service, Maggiore Policlinico Hospital in Milan, explains: “After the fifth month of pregnancy, care must be taken if a woman has a woman’s blood pressure to exceed the reference values (140 mmHg for the maximum, 90 mmHg for the minimum). The future mother can risk a preclampsia, or gestosis, a situation that can have serious effects on both the woman and the unborn child”.

We speak of gestosis (which occurs in 2-3% of pregnant women) when the increase in blood pressure detected after the 20th week of gestation is accompanied by proteinuria, ie the presence of proteins in the urine.

If, on the other hand, the increase in pressure occurs in the absence of proteinuria and other signs of systemic involvement, then we speak of gestational hypertension, which affects 3-4% of pregnant women.

In other words, the presence of protein in the urine is the alarm bell that signals a more complex situation, as the liver and kidneys are also compromised.

In any case, if there is a significant increase in blood pressure it is important to promptly start a drug therapy with the aim of keeping the pressure within the safe limits.

The risk of developing gestosis increases with maternal age, weight, a history of gestosis in the family or in previous pregnancies and in case of twin pregnancies.

The importance of early diagnosis

The causes of gestosis are not yet well known, but it is known that in the pressure change there is also a problem of incorrect interaction between the placenta and the maternal uterus.

The most severe, but fortunately less frequent, form of gestosis occurs before the 37th week. There is also a gestosis that can arise immediately before or immediately after childbirth. If the situation requires it, it is necessary to deliver the baby right away and remove the placenta from the uterus.

Persico continues: “The first rule is therefore to keep the pressure under control. This is a very simple operation. Just use the appliance at home, or go to the pharmacy. If the blood pressure values exceed the normal ones, then it is good to contact your doctor».

It is in fact important not to underestimate a blood pressure rise in order to be able to identify pregnancies at risk of gestosis as soon as possible. A very recent study, in which Italy also took part with the Maggiore Policlinico Hospital in Milan, indicated a possible way.

“The research, which was published in the New England Journal of Medicine, showed that, starting from the 12th week, it is possible to perform a screening test that takes into account various factors: the woman’s medical history, the age of the expectant mother, weight, previous pregnancies and cases of gestosis in the family. During a control ultrasound, along with other parameters, the flow of blood to the uterus and placenta is measured. A calculation that takes into account all these values indicates whether the woman is at risk.”

What measures to take in these cases?

“The study has shown that effective prevention can be done by prescribing a 150 mg aspirin starting from the 12th week: this treatment manages to promote a better interaction between the placenta and the blood vessels of the uterus. In fact, the study reports more than 60% less frequency of gestosis in women who took aspirin compared to the placebo group.

Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.

The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.

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