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Increased pressure before childbirth. Childbirth and pressure Pressure on internal organs during childbirth

Pregnancy and childbirth are physiologically conditioned, natural processes, but this, unfortunately, does not guarantee their successful course. Problems can arise on the eve of delivery, during labor, or in the early days of recovery. And often high blood pressure is among the alarming symptoms. Often a similar ailment happens to women with a history of diabetes mellitus.

High blood pressure before childbirth: possible causes

The last months of the gestational period are associated with the fact that the woman's body adjusts to the upcoming process of giving birth to a baby. It is very important during this period to listen to the body in order to respond in time to alarming symptoms. Even a perfectly healthy, calm pregnancy of all previous months can turn to significant problems of the last trimester.

A pregnant woman may face such unpleasant pathologies as varicose veins, swelling, nausea, heartburn, and increased blood pressure. And the last factor is of particular danger, therefore, all possible provocateurs of hypertension must be prevented.

In a healthy woman, the average blood pressure is 120/80 mm Hg. Art., this is the norm. Some deviation of these values ​​is permissible, as in expectant mothers the range of blood pressure marks ranges from 90/60 to 140/90 mm Hg. At each appointment with a gynecologist leading a pregnancy, the patient's blood pressure is measured. And if the indicators are alarming, the doctor takes quick action.

Pressure increase provocateurs before childbirth can be:


Diabetes mellitus in itself is not a direct cause of high blood pressure, but during pregnancy it can provoke hypertension. On the recommendation of a doctor, pregnant women with diabetes mellitus should be monitored according to a special schedule, also visiting specialist doctors in a timely manner.

Danger of high blood pressure before childbirth

Increased pressure before childbirth is an extremely unfavorable factor. Often this is a signal that gestosis has developed. This is the name for late toxicosis of pregnant women, a dangerous complication of the last weeks of gestation. In a woman's body, fluid is retained, a pregnant woman has edema, an increased content of protein in the urine. The child also suffers: he lacks oxygen in the womb.

Dangerous jumps in blood pressure and possible premature placental abruption, and this is an extremely alarming situation - childbirth may be premature. Finally, gestosis is capable of provoking eclampsia, and this is already a condition with characteristic seizures, requiring mandatory resuscitation procedures. This diagnosis is a threat to the life and health of a woman and a baby.

As a rule, high blood pressure before childbirth is a reason for hospitalization. To refuse it, hoping for a spontaneous healing, is thoughtless and risky.

Pregnancy itself is a factor that does not allow the body to bounce back, so you need to monitor the woman's condition, reacting in time with the right appointments and supportive procedures.

What is the danger of high blood pressure during childbirth

If a woman in labor has high blood pressure, she cannot naturally give birth. High pressure delivery is a big risk. Therefore, doctors assess the degree of pathology, predict how the body will react to even greater stress, childbirth, and decide whether to give a woman the opportunity to give birth herself or have a cesarean. In most cases, the choice is in favor of the operation.

Childbirth with hypertension is a threat to the life of the mother and child, and during the operation, doctors can monitor the patient's condition, and thereby prevent complications.

If a woman is in the last weeks of pregnancy, and she has signs of hypertension, do not wait - go to the doctor, or go straight to the hospital.

Signs of high blood pressure:


You should not run to the first aid kit, thinking which drug would be safe and would relieve painful symptoms. Pathology can develop rapidly, therefore only specialists can be trusted, and preferably in stationary conditions.

Why does blood pressure jump after childbirth

If earlier, before pregnancy and during gestation, there was no hypertension, and after the birth of the child, pressure surges appeared, the matter may be in a neuropsychic disorder. And to be more specific - this is an overstrain, which often occurs precisely in the postpartum period.

The reasons for it are obvious: a woman is recovering physiologically and morally, but the recovery period cannot be called calm. She has a baby in her arms, which requires round-the-clock attention.

And if the young mother has not yet learned how to distribute her forces, if the regime of her life with the child in her arms has not yet returned to normal, her body is in serious stress. Fatigue, stress, overwork lead to a physical reaction of the body to such events. Disruption of self-regulation of the nervous system leads to pressure surges, headaches, and fatigue.

This condition requires medical and psychological intervention. This is not always associated with postpartum depression - this pathology is extremely serious, but it does not occur so often. But the so-called baby blues is a much more common condition, and the psychosomatic manifestations of this disorder can be expressed precisely by changes in blood pressure.

In addition, after the birth of a child, pressure jumps due to:

If a pathology is found, you need to go to the doctor and in no case curtail lactation. The doctor will help you choose such drugs that are characterized by a low degree of penetration into breast milk.

Antihypertensive drugs should be taken so that the lactation period does not coincide with the moment of the maximum concentration of the drug in the blood. Therefore, a woman is recommended to take pills immediately before feeding, so that the active substances of the drugs simply do not have time to enter the bloodstream so quickly.

And if a mother decides to complete lactation, she should know: drugs that reduce lactation increase blood pressure.

High blood pressure after cesarean section

Caesarean section is a rescue operation. This is a cavity surgery, which means that a recovery period is required. Someone goes through it relatively easily, to someone the days of recovery seem painful. But you need to be prepared for the fact that the postoperative period will be, and it requires preparation, full implementation of medical recommendations.

A separate item is spinal anesthesia. Spinal anesthesia may be given so that a woman can be awake when giving birth to her baby by caesarean. The anesthesiologist makes a puncture of the dura mater in a specific part of the spine, using a special thin needle.

There is a fluid-filled area between the spinal cord and its membrane, it is this fluid called cerebrospinal fluid. When the membrane is pierced, a small amount of fluid flows out, and the intracranial pressure due to this drops sharply. This subsequently provokes headaches, and they can already be accompanied by pressure surges.

High blood pressure and postoperative endometritis

In some women, high blood pressure accompanies endometritis - this is a severe postoperative complication. Together with the air, viruses and microbes can enter the uterine cavity, which is open during the operation. And if this happened, then in the first days after cesarean the signs of endometritis will appear.

Endometritis symptoms:


High blood pressure is an optional sign of endometritis, but it may well occur in addition to the rest. To avoid this complication, antibiotics are prescribed for the young mother after the operation.

And before being discharged, the woman is observed: an examination is carried out, an ultrasound is done in order to exclude postpartum complications.

Is high blood pressure associated with hormonal disruption?

After the baby is born, the maternal organism is rebuilt. This takes quite a long time. Therefore, the menstrual cycle does not return to normal immediately, even if the woman is no longer breastfeeding. Weight gain can also be related to hormone-mediated pregnancy outcomes. But they, hormones, do not justify an addiction to sweet, starchy and fatty foods, just as they do not justify physical inactivity.

During the period of expectation of a child, the female body becomes very vulnerable, long-standing diseases become aggravated, previously unknown sensations appear, sometimes not always pleasant.

Quite often, one of the symptoms of the development of pathologies during pregnancy is high blood pressure. Therefore, during examinations, obstetricians-gynecologists control the pressure of the expectant mother every time.

Normal pressure during pregnancy, in which the heart and blood vessels perform their functions without overloading, are indicators:

  • 110-120 mm. rt. Art. for upper (heart) pressure - diastolic;
  • 70-80 mm. rt. Art. for the lower (vascular) - systolic.

For chronic hypotensive patients, these limits may be lower: 90/60 mm Hg. Art.

It is important that a woman, registering for pregnancy in a medical facility, knows the "working" values ​​of her pressure.

Indeed, often (as, for example, in hypotensive patients), high blood pressure is ascertained, based on an increase in values: more than 30 mm. rt. Art. for the upper indicator and 15 mm Hg. Art. for the lower one, it means that the blood pressure has risen beyond the permissible level.

Of course, a one-time increase in blood pressure for some reason is not a reason for the diagnosis of hypertension. But if an increased level is recorded at least twice in a row, then this is already a reason for concern.

Why does the pressure rise?

The factors contributing to the appearance of high blood pressure during pregnancy differ little from the causes of hypertensive conditions in the "non-pregnant" period:

  • (obesity);
  • bad habits (alcohol, smoking);
  • chronic diseases of internal organs, which are accompanied by increased blood pressure;
  • hereditary predisposition;
  • hypertension as an independent disease (in the absence of endocrine disorders, diseases of internal organs).

Since the period of bearing a child for the female body is a period of increased stress load, then, with a known predisposition, problems with pressure in the expectant mother are quite expected.

Moreover, if earlier the expectant mother had already suffered from high blood pressure (including during the previous pregnancy), then in the overwhelming majority of cases (about 80%) during the next pregnancy, high blood pressure is inevitable.

However, it also happens that a jump in intracranial pressure in a woman was first noted precisely during the current pregnancy. This could be due to:

  • ... Then hypertension is one of the symptoms of the triad of this pathology (along with proteinuria and).
  • Gestational arterial hypertension, which is not combined with other symptoms of preeclampsia. It occurs after the 20th week of pregnancy and, as a rule, self-heals after childbirth.

The insidiousness of hypertension lies in the fact that the initial stages of it may easily not be recognized.

This is especially true for expectant mothers, for whom high blood pressure is habitual.

The body has adapted to this state and is in no hurry to respond to it. Therefore, at each scheduled examination by an obstetrician-gynecologist, a woman is monitored with a tonometer.

With a mild degree of hypertension, its signs may be mild:

  • mild, dizziness;
  • rapid pulse;
  • excessive sweating;
  • bright "blush" on the cheeks;
  • anxiety.

The severity of the listed symptoms progresses with a further increase in pressure. Added to them:

  • dyspnea;
  • areas of redness on the skin all over the body;
  • "tinnitus;
  • weakness;
  • attacks of nausea, vomiting;
  • "Flies", "fog" before the eyes.

Pain in the left sternum, insomnia, excessive nervousness, which are so easy to mistake for the characteristics of a "pregnant" organism, may appear.

Perhaps this is true, but the doctor must confirm or deny the suspicions.

Dangerous consequences of high blood pressure during pregnancy

Of course, high blood pressure is a pathology and requires immediate correction.

Careful monitoring of blood pressure values, which are carried out by specialists, is caused by the likelihood of consequences dangerous for the mother and child.

  1. High blood pressure in pregnant women is a "response" to the narrowing of blood vessels, including in the uterus and placenta. This leads to obstruction of blood circulation in the "uterus-placenta-fetus" system, and, consequently, to. Prolonged hypoxia is the reason for the delay in the intrauterine development of the baby.
  2. , which also develops due to vasospasm, can cause spontaneous abortion.
  3. Due to the increased blood pressure in the bed between the uterus and the placenta, it can occur, which will lead to insufficient nutrition of the fetus, and, depending on the extent of detachment, it can cause it.
  4. Long-term hypertension can cause functional insufficiency of the vital organs of a woman, which poses a danger to the health and life of the mother and her unborn baby.
  5. Severe hypertension, as a manifestation of preeclampsia, can lead to the development of complications that are dangerous for the parent and her unborn child - preeclampsia and eclampsia.
  6. A significant spike in pressure, especially during labor, can cause retinal detachment (and subsequent blindness) or even stroke.

Do I need hospitalization?

Since hypertension is an extremely dangerous phenomenon for a pregnant woman, it is unreasonable to refuse the proposed hospitalization. In addition, it is very likely that with a favorable prognosis, the time spent in the hospital will be short.

If hypertension was listed in the woman's medical history even before registration for pregnancy, a referral for hospitalization will be issued at the very first appointment with an obstetrician-gynecologist.

In the hospital, the degree of hypertension will be determined, the risk of possible complications for the woman's health will be predicted and the methods of therapy will be selected.

At the initial detection of hypertension during pregnancy, hospitalization is also indicated to search for the causes that caused the increase in pressure.

If an increase in indicators occurred in the second trimester, it is important to exclude the development of preeclampsia or diagnose it in a timely manner.

If the degree of hypertension is mild, the pressure is stable and does not negatively affect the well-being of the expectant mother, then the next hospitalization according to the plan will follow at the beginning of the third trimester, since the likelihood of a crisis increases during this period.

At 38-39 weeks of pregnancy, the expectant mother with high blood pressure moves to the hospital until the very birth.

During this time, she will undergo an examination in order to clarify her condition and choose a method of delivery, preparatory procedures.

In the event of an exacerbation of a hypertensive state in a woman, referral to the hospital is mandatory. This is necessary to determine the factors that caused the exacerbation of hypertension and the appointment of appropriate treatment.

How to lower blood pressure during pregnancy

Depending on the reasons that caused arterial hypertension, the doctor chooses the tactics of further pregnancy management and methods of therapy aimed at normalizing blood pressure.

As a rule, a combination of drug and non-drug therapy is used.

Non-drug method

The non-drug method consists in limiting physical and social stress, namely:

  • refusal to participate in stressful situations.
  • creating a comfortable psychological environment.
  • exclusion of excessive physical efforts, therapeutic exercises, swimming at a calm pace are allowed.
  • Compliance with sleep, rest.

In addition, it is important to follow some nutritional principles aimed at:

  • correction of potassium-sodium metabolism (to prevent fluid retention in the body);
  • prevention of further excessive weight gain (if overweight).
  • To improve water metabolism in the body, it is necessary:
  • limit or eliminate completely the use of table salt with food, as a source of sodium, leading to fluid retention in tissues;
  • include in the diet foods rich in potassium, which reduces vascular tone and magnesium, which also has a mild diuretic property.

To prevent unnecessary weight gain, you should:

  • limit the consumption of fats to 40 g per day, giving preference to vegetable fats;
  • to minimize the presence of simple carbohydrates in the diet: sugars, refined foods, delicacies;
  • adjust the food intake in the direction of fractional nutrition.

Folk ways

Among the non-drug methods of dealing with high blood pressure, folk methods have also found their place:

  • An equal amount of rose hips, hawthorns, red viburnum, linden flowers, calendula, blueberry and heather shoots and motherwort grass, chop and mix. Separate 2 tbsp. l. , pour them with 2 cups of boiling water, darken for 15 minutes. in a water bath and insist at room temperature. Drink 100 g of the strained mixture with honey after meals 3-4 times a day. The duration of the course is 1.5 months.
  • Mix half a glass of cranberry juice with the same amount of honey. Take 1 tsp. 3 times a day. The course of treatment is 14 days.
  • Mix an equal amount of chopped valerian root, dried grass, heather shoots and viburnum flowers. Pour 2 cups boiling water over 2 tbsp. l. mixture and leave in a thermos for 2 hours. Sweeten the warm strained infusion with honey and take ¼ cup 4 times a day. The course of admission is 1-1.5 months.

Before using herbal remedies, you should get approval from the doctor who monitors the pregnancy to rule out possible contraindications.

Medication method

With a slight increase in pressure, phytopreparations that have a calming, mild sedative effect, based on motherwort, valerian, lemon balm, mint, etc., will be sufficient.

With persistent hypertension, it becomes necessary to use more serious pharmacological agents.

The most common agent, due to its availability and safety at the same time as its effectiveness, is methyldopa ("Dopegit").

The drug for pressure is approved for use from the very early stages of pregnancy. Methyldopa does not adversely affect the placental circulation, does not pose a threat to the intrauterine development of the fetus, and also does not cause adverse manifestations for a born child in the future.

The effect of the substance occurs within 2-6 hours and is manifested:

  • in a relaxing effect on the central nervous system;
  • in suppressing the activity of hormones that cause an increase in pressure;
  • in suppressing the activity of an enzyme in blood plasma (renin), which is able to affect the level of blood pressure and sodium metabolism;
  • in the removal of vascular hypertonia;
  • in general sedative effect.

With pressure in late pregnancy, when protein is detected in urine analysis and taking into account all possible risks to the fetus, β-blockers are prescribed.

As a medicine for blood pressure, pregnant women are often prescribed cardioselective β-blockers, because they have fewer side effects than non-selective ones.

In the fight against high blood pressure, the effect they have directly on cardiac activity is important:

  • the frequency and strength of heart contractions decreases;
  • the body's susceptibility to stress decreases;
  • the activity of renin decreases;
  • the conductivity in the AV node decreases to the desired level, normalizing the contractile-conducting activity of the cardiac departments;
  • the oxygen demand of the heart muscle is normalized (anti-ischemic effect);
  • the risk of cardiac arrhythmias is reduced.

Popular β-blockers prescribed for pregnant women help to relieve pressure during pregnancy, these are: atenolol, metaprotolol, labetalol, nebivolol, bisoprolol.

Currently, bisoprolol is more preferable because of its ease of use (1 tablet per day), reliable round-the-clock action, the possibility of using it in diabetics and less pronounced, in comparison with other drugs, "withdrawal syndrome".

Analogous to β-blockers in terms of effectiveness, calcium antagonists or calcium channel blockers.

But they do not affect the nervous system, but the channels in the cardiac and vascular muscles, through which calcium enters the muscle cells.

The strength of muscle contraction depends on the calcium concentration in its cells. The activation of calcium channels occurs under the influence of adrenaline, norepinephrine. The blockade of the calcium-carrying channels prevents the spasm of the muscles of the heart and blood vessels.

According to the direction of the impact of calcium antagonists, it can be conditionally divided into groups:

  • acting only on smooth vascular muscles (nifedipine, normodipine, amlodipine, etc.) and therefore are recommended for use simultaneously with β-blockers;
  • acting on the muscles and heart and blood vessels (verapamil) and therefore prohibited for use simultaneously with β-blockers.

Taking calcium antagonists during pregnancy does not exclude a possible detrimental effect on the fetus and is often accompanied by unpleasant side effects.

Therefore, they are prescribed when it is impossible to take other groups of antihypertensive drugs.

Measures to prevent high blood pressure during pregnancy

Blood pressure in a woman during pregnancy almost inevitably rises due to an increase in the volume of circulating blood with an increase in the duration of pregnancy.

Therefore, a slight increase in blood pressure in some pregnant women may be a physiological norm.

If the pressure indicators are increased already in the early stages of pregnancy, or "surges" of pressure occurred earlier, she should adjust her lifestyle and diet to prevent hypertension.

Namely:

  • do not limit the duration of sleep and rest;
  • avoid excessive physical activity, preferring feasible loads at a calm pace;
  • avoid stressful situations;
  • control weight gain during pregnancy (no more than 15 kg.);
  • adjust the diet and menu, making food intake fractional and rejecting foods that are undesirable for hypertension;
  • regularly monitor the values ​​of your blood pressure (daily, at least twice a day) both on the right and left hands.

If it happened so, at the next appointment with the doctor or with an independent measurement, mommy found that the pressure exceeded the norm, then first of all, you should stop the panic, otherwise the indicators will rise even higher.

The most reasonable thing in such a situation is not to self-medicate, but to trust qualified specialists, and then the pregnancy and the birth of the baby will go well.

Blood pressure (BP) is the pressure exerted by blood on the walls of the arteries. Its value is indicated as a fraction, in which the first digit characterizes the blood pressure at the moment of heart contraction (systole) - systolic, and the second indicates the pressure value at the moment of heart relaxation (diastole) - diastolic blood pressure. Blood pressure indicators are measured in millimeters of mercury, since initially the pressure was measured using mercury tonometers.

This parameter is one of the most important, characterizing the quality of the body's functioning. Often during pregnancy, women first encounter the problem of high blood pressure, which can be dangerous for both the expectant mother and the fetus.

High blood pressure symptoms

With an increase in blood pressure, the following may appear:

  • headache (its strength will be directly proportional to the level of blood pressure);
  • dizziness;
  • noise in ears;
  • feeling of pressure on the eyes;
  • general weakness;
  • nausea and vomiting;
  • redness of the face and chest area or the appearance of red spots on the face;
  • flashing "flies" before the eyes.

The "insidiousness" of high blood pressure during pregnancy lies in the fact that in some cases, even with high blood pressure, the patient does not feel any pathological symptoms, feels normal, and continues her usual daily activities. High blood pressure is detected by chance, at the next visit to the antenatal clinic. The absence of clinical manifestations of high blood pressure does not exclude the development of severe complications that can threaten the life of the mother and the unborn child, therefore it is very important to regularly monitor the pressure during pregnancy.

How to measure pressure?

Currently, there are automatic electronic blood pressure monitors on sale that make it easy to measure pressure by pressing one button. Their use does not require any special skills. From the moment of pregnancy, it is advisable to purchase a tonometer and measure the pressure at least 2 times a day. But it is necessary to take into account the fact that electronic blood pressure monitors may not be accurate enough, and in order to find out what pressure you have at the moment, it is recommended to measure three times and calculate the average value between the readings.

Indicators of arterial pressure during pregnancy depend on many factors: the total volume of circulating blood, vascular tone, heart function (for example, heart rate), quality characteristics of blood (viscosity, etc.), as well as the level and activity of a number of hormones and biologically active substances produced by the kidneys and the adrenal glands, the thyroid gland, etc. In addition, a number of external conditions have a great influence on blood pressure: the level of physical activity, psychoemotional stress, the value of atmospheric pressure.

Considering that changes occur in the body of the expectant mother regarding the amount of circulating blood, the work of the heart, changes in hormonal levels, even with a physiologically proceeding pregnancy, blood pressure changes depending on its duration.

In the first and second trimesters, blood pressure, as a rule, decreases (systolic - by 10-15 mm Hg, diastolic - by 5-15 mm Hg), which is due to the action of the main hormone of pregnancy - progesterone. It has a relaxing effect on blood vessels, which is a prerequisite for the favorable growth and development of the fetus. As the gestation period increases, the load on the cardiovascular system increases, as the volume of circulating blood increases (by about 40% of the initial: in the body of the expectant mother circulates 2-2.5% more blood than before pregnancy), the heart rate increases (on average by 15-20 beats per minute), the production of placental hormones increases, the body weight increases significantly (by the end of pregnancy - normally by 10-12 kg). This leads to a slight increase in the level of arterial pressure during pregnancy, and it becomes the same as it was before pregnancy.

With the development of complications of pregnancy, the level of blood pressure can increase significantly, which poses a potential threat to the woman and the unborn child. Therefore, from the moment of registration in the antenatal clinic, careful monitoring of the value and dynamics (change) of blood pressure is carried out.

Is the pressure normal?

It is believed that the average blood pressure, which can be considered optimal (that is, necessary for the life support of the body with a minimum risk of developing cardiovascular complications), is the level of systolic blood pressure 110–120? Mm Hg. Art., and diastolic - 70–80? mm Hg. Art. The borderline values ​​are 130? /? 85 –139? /? 89? Mm Hg. Art. If the value blood pressure is 140? /? 90 and above, then this condition is regarded as arterial hypertension (pathologically high blood pressure).

It should be noted that among young women there are often those for whom the usual blood pressure before pregnancy is 90? /? 60-100? /? 70 mm Hg. Art. In these cases, it is more correct to focus not on the absolute values ​​of blood pressure, but on the increase in indicators: if the values ​​of systolic pressure during pregnancy increased by 30 mm Hg. Art., and diastolic - by 15? mm Hg. Art., then the expectant mother has high blood pressure.

To determine a reliable blood pressure level, the doctor observes a number of fairly simple, but important conditions, since expectant mothers quite often have a "white coat" syndrome: if a woman has been sitting in line for a doctor's appointment for a long time, being under stress from an unfamiliar environment, in tension while waiting for the test result, it is possible to obtain increased values ​​of the measured pressure. BP is measured for all pregnant women at each visit to the doctor. The doctor measures the pressure on both arms while the woman is sitting, with the cuff of the tonometer (pressure measuring device) at the same level as the patient's heart. Measurement of blood pressure is performed using a tonometer, which can be manual (when the doctor listens to heart sounds in the region of the brachial artery in the elbow bend) and automatic, when the device independently registers the blood pressure level using electronics. Hand-held blood pressure monitors allow you to more accurately measure the level of pressure, but they require special skill. The positive point of electronic blood pressure monitors is ease of use, but they can give an error in measurements.

The patient must exclude physical activity an hour before visiting the doctor, before registering blood pressure, sit in a calm atmosphere for 5-10 minutes. During the measurement, one should relax, lean back in a chair or chair, do not cross the legs (this hinders venous outflow, and blood pressure values ​​may be overestimated). To obtain a reliable result, the doctor takes measurements several times, since the first measurement, as a rule, is overestimated.

Since the “white coat” syndrome cannot be ruled out, the doctor takes the pressure measurement again 10-15 minutes after the meeting with the patient, since the anxiety of the pregnant woman is significantly reduced after a calm conversation with the doctor.

To establish an accurate diagnosis, it is desirable that each woman knows her usual (as doctors say, a worker) level of blood pressure, which took place before pregnancy.

As already mentioned, it is impossible to establish a diagnosis of arterial hypertension (pathological increase in pressure) based on only one measurement of blood pressure. To do this, the doctor carries out a second measurement, the diagnosis is made when registering a stably elevated blood pressure level at least 2 times in a row. For an accurate diagnosis, the doctor may prescribe daily monitoring of the blood pressure level. It is performed using a device attached to the patient's body. In this study, the pressure is automatically recorded for 24 hours at the normal pace of life for the patient. During the measurement, a woman keeps a diary, in which, by the clock, notes the type of activity, sleep duration, meal time, etc. With daily blood pressure monitoring, side effects of external factors (white coat syndrome, stress, etc.) are excluded, therefore, with a high degree of certainty, the presence of arterial hypertension is diagnosed or excluded.


High blood pressure in pregnant women

High blood pressure in a pregnant woman is an alarming symptom, as it can lead to serious complications:

If in the vessels of the body the pregnant woman's blood pressure rises, this leads to similar changes in the mother-placenta-fetus circulatory system. As a result, the vessels of the uterus and placenta are narrowed, and therefore, the intensity of blood flow decreases and less oxygen and nutrients are supplied to the fetus. These disorders cause fetoplacental insufficiency (complications when the normal functioning of the placenta is disrupted and the delivery of oxygen and nutrients to the fetus is reduced) and intrauterine growth retardation (at full-term pregnancy, a child with a low body weight is born). Also, a consequence of placental insufficiency is the threat of termination of pregnancy.

Persistent long-term increase in arterial pressure during pregnancy can cause severe disturbances in the functioning of the vital organs of a pregnant woman, leading to acute renal or heart failure, dangerous for the life of the mother and the fetus.

Arterial hypertension in a pregnant woman can lead to premature placental abruption due to increased pressure in the space between the wall of the uterus and the placenta (normally, placental separation occurs after the birth of the fetus). Premature placental abruption leads to bleeding (in severe cases, with a fairly large blood loss). Since the partially separated placenta cannot perform its function to ensure the life of the fetus, acute hypoxia (oxygen starvation) develops, which poses a real threat to the health and life of the unborn child.

A significant increase in blood pressure can lead to the development of severe conditions - preeclampsia and eclampsia. These conditions are the consequences of preeclampsia - complications of pregnancy, manifested by increased blood pressure, the presence of protein in the urine and edema. Preeclampsia is a condition accompanied by high blood pressure (200? /? 120 mm Hg and higher), headache, flashing "flies" before the eyes, nausea and vomiting, pain in the epigastric region located above the navel. Eclampsia is an attack of muscle cramps in the whole body, accompanied by loss of consciousness, respiratory arrest.

One of the most serious complications of arterial hypertension is cerebral hemorrhage. The risk of this complication increases significantly during the laboring period of labor, therefore, in order to avoid such severe consequences, with high blood pressure, delivery is carried out by caesarean section.

High blood pressure can cause complications such as retinal detachment or retinal hemorrhage, which can lead to partial or complete loss of vision.

What is hypertension in pregnancy

The reasons leading to an increase in arterial pressure in pregnant women, are diverse. Diseases accompanied by an increase in blood pressure can be roughly divided into two groups.

Group 1 - arterial hypertension that existed before pregnancy. It can be caused by:

  • hypertension - this is how high blood pressure is called, the exact causes of which remain unknown to this day; at the same time, the woman does not have diseases that could cause an increase in blood pressure (endocrine pathology, long-term current diseases of the internal organs);
  • chronic diseases of internal organs, accompanied by high blood pressure, such as kidney disease (chronic pyelonephritis, glomerulonephritis, polycystic kidney disease, congenital abnormalities of kidney development), diseases of the adrenal glands, thyroid gland, diabetes mellitus, pathology of the central nervous system.

As a rule, in the presence of chronic arterial hypertension, an increased level of pressure is noted from the early stages of pregnancy.

Group 2 - hypertension that developed during this pregnancy. This group includes preeclampsia and gestational arterial hypertension (a condition when a consistently high blood pressure is recorded during pregnancy, not accompanied by clinical signs of preeclampsia and passing independently after childbirth).


Gestosis- a serious complication that develops in the second half of pregnancy (after 20 weeks), characterized by damage to vital organs. In the case of a severe course or lack of adequate treatment, it poses a danger to the life of the pregnant woman and the fetus. As noted above, gestosis is manifested by a triad of symptoms: edema, the appearance of protein in the urine and an increase in blood pressure. It should be noted that the presence of two of the listed signs is sufficient to establish the diagnosis of gestosis.

In rare cases (as a rule, in the absence of observation and treatment of gestosis), such dangerous complications as preeclampsia and eclampsia may develop.

The danger of gestosis is that it can begin with minimal clinical manifestations and develop rapidly, which dictates the need for careful monitoring of pregnant women with high blood pressure.

Risk factors for increased blood pressure during pregnancy are:

  • overweight;
  • multiple pregnancy;
  • the presence of arterial hypertension in close relatives;
  • long-term ongoing diseases of internal organs (for example, kidneys);
  • diabetes;
  • increased blood pressure during previous pregnancies;
  • the first pregnancy, as well as the age of primiparous less than 18 or more than 30 years.

How to lower blood pressure during pregnancy

If the expectant mother has hypertension or chronic diseases accompanied by an increase in blood pressure, this pregnancy is managed jointly by an obstetrician-gynecologist and a therapist or cardiologist.

Treatment methods that help lower blood pressure can be divided into non-pharmacological and medication.

Non-drug methods include the normalization of sleep patterns (the duration of night sleep is at least 9-10 hours, daytime - 1-2 hours), the elimination of stressful situations and heavy physical exertion. Walking in the fresh air at a calm pace, giving up bad habits (preferably at the planning stage of pregnancy), as well as a diet with a reasonable intake of salt (no more than 5 g per day, which corresponds to 1 teaspoon), rich in potassium (it is contained in bananas, dried apricots, raisins, seaweed, baked potatoes).

When choosing medications to normalize blood pressure, two conditions must be met: constant monitoring of blood pressure twice a day and the absence of an adverse effect of the drug on the fetus, even with prolonged use.

With a periodic insignificant increase in pressure, treatment begins with the appointment of sedatives based on herbal remedies - VALERIANA, DESERT, NOVOPASSIT, PERSEN, PION'S BOTTLE, etc. In most cases, these drugs are effective in combination with non-drug therapy.

With a steadily increased blood pressure the following groups of drugs are usually prescribed:

  • DOPEGIT (METHYLDOPA) is recognized as the “drug of choice” (that is, the most affordable, effective and safe), which can be used from the beginning of pregnancy, but the effect on lowering blood pressure is most pronounced at periods up to 28 weeks.
  • Calcium channel blockers (NIFEDIPINE, VERAPAMIL, NORMODIPIN) can be used from the second trimester of pregnancy. They are also effective for emergency care when blood pressure rises to high numbers. Forms with a slow release of the drug are available, which allows you to reduce the frequency of administration to 1 time per day.
  • β-blockers (ATENOLOL, LABETALOL, NEBIVOLOL) do not have teratogenic (provoking fetal malformations) action. They are prescribed from the second trimester of pregnancy. When taking these drugs, the fetal heart rate may decrease, so their appointment is carried out according to strict indications. While taking the medication, it is necessary to monitor the intrauterine state of the fetus.

The choice of labor management tactics depends on the severity of hypertension, preeclampsia, and the intrauterine state of the fetus. In severe cases, with a steady increase in blood pressure against the background of treatment, a caesarean section is performed, since the risk of increased blood pressure during childbirth increases.

When conducting labor through the vaginal birth canal, planned antihypertensive therapy (with the use of drugs of various mechanisms of action) is prescribed in advance for good blood pressure control, as well as adequate pain relief during labor. The optimal method of pain relief during labor with high blood pressure is epidural anesthesia (an anesthetic drug is injected into the epidural space located between the dura mater and the vertebrae after inserting a catheter in the lumbar region), since it not only has a strong anesthetic effect, but also helps to reduce pressure.


Prevention of pressure rise

To avoid an increase in arterial pressure during pregnancy, you need to follow a few simple rules:

  • You should ensure the normal duration of sleep - at least 8-9 hours at night. An afternoon rest for 1-2 hours is desirable.
  • Emotional and physical overload must be avoided; if they are possible at work, it is necessary to temporarily reduce the load (switch to lighter work).
  • Moderate physical activity (walking in the fresh air, visiting the pool, gymnastics for pregnant women, etc.) helps to improve the blood supply to the brain and internal organs, has a beneficial effect on the emotional and physical state of the expectant mother.
  • A reasonable approach to the organization of nutrition during pregnancy is needed: in order to prevent an increase in blood pressure, it is necessary to exclude strong tea, coffee, alcohol in any quantity. It is necessary to give up spicy, spicy, fried foods, canned food and smoked meats. The consumption of no more than 1.5? L of liquid per day and no more than 5 g (1 teaspoon) of table salt is an important point in helping to maintain the optimal level of pressure.
  • It is necessary to control the weight gain (for the entire pregnancy, it should not be more than 10–12? Kg, and with an initial weight deficit - more than 15? Kg).
  • An important point is to control the blood pressure level on both hands at least 2 times a day (morning and evening). On both hands, the pressure must be measured because the registration of different values ​​of blood pressure (differing by 5-10? Mm Hg. Art.) Indicates a violation of the regulation of vascular tone and is one of the early signs of the development of preeclampsia.

When to go to the hospital

If hypertension is diagnosed before pregnancy, I trimester(for up to 12 weeks) hospitalization in the cardiology department is required. In the hospital, the severity of the disease will be clarified, the issue of the possibility of carrying a pregnancy will be resolved, and drugs that are allowed for long-term use during pregnancy will be selected. In case of hypertension, planned hospitalization is carried out, in addition to the first trimester, at 28-32 weeks (the period of the greatest increase in circulating blood volume) and 1-2 weeks before delivery. Unscheduled hospitalization is indicated when complications of pregnancy develop or when the course of hypertension worsens.

When increasing blood pressure, which was first noted in the second half of pregnancy, hospital stay is required for further examination, clarification of the diagnosis and timely detection of preeclampsia.

Expectant mothers with diseases of the cardiovascular system are sent to the pathology department at 28–32 weeks of pregnancy. This period is considered critical, since at this time the greatest increase in the volume of circulating blood occurs and the deterioration of the condition of the pregnant woman is most often noted. Hospitalization helps to avoid complications.

Before childbirth (at 38–39 weeks), antenatal hospitalization is indicated to select the optimal method of delivery and preparation for childbirth.

If the condition of the expectant mother worsens (increased blood pressure during treatment, headache, signs of circulatory failure, etc.), urgent hospitalization is carried out regardless of the gestational age.

High blood pressure values ​​recorded at any stage of pregnancy (even with a good woman's condition and no clinical symptoms) require hospitalization for examination, identification of the causes of high blood pressure and selection of adequate treatment.

Such a pathological condition as hypertension during pregnancy is dangerous. Especially the risk of developing severe complications increases if a woman had problems with blood pressure before pregnancy, and if she is very overweight. Let's consider what causes can cause problems with blood pressure, what symptoms accompany this, what kind of treatment is indicated, and what possible risks await a woman who refuses medical care?

Causes and course

The reasons due to which pressure may increase are very diverse, but the most significant are:

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  • heredity, in which hypertension worries family members and is inherited;
  • a woman has an untreated, chronic kidney disease;
  • disruption of the functioning of the endocrine system;
  • pathological hormonal imbalance;
  • a mental or neurogenic disorder that can provoke hypertension.

The chronic form of the disease is life-threatening for the pregnant woman and the fetus.

In most cases, hypertension occurs even in the pre-pregnancy period, but often pathology develops after conception. If arterial hypertension bothered a woman before conception, then after the symptoms will worsen, and if the situation is not controlled, the risks of a serious complication are high, which can cost the woman and the baby's life. In severe cases, pregnancy and childbirth are contraindicated, and if a woman succeeds in getting pregnant, premature termination is indicated. During the period of bearing a child, depending on the factors provoking pathology, they are distinguished:

  1. Arterial hypertension of pregnancy, when the pressure rises in the second trimester, but after childbirth, the pathology does not bother.
  2. Chronic hypertension, in which high blood pressure worried a woman before, during, and after pregnancy.
  3. Preeclampsia, when chronic diseases and other kidney pathologies have worsened during the period of childbearing, which affects the work of the cardiovascular system.

Symptoms of pathology

With arterial hypertension, the most dangerous symptom is a sharp increase in blood pressure. In this case, the accompanying symptoms are as follows:

  • cardiopalmus;
  • tinnitus;
  • deterioration of visual and auditory functions;
  • severe headaches;
  • blood may flow from the nose;
  • sleep worsens, signs of anxiety, irritability, fatigue appear.

Diagnostic methods


At risk are women with a possible hereditary nature of hypertension.

The course of hypertension is not always possible to diagnose in time, since many women take symptoms of deterioration in well-being as a sign of pregnancy. Therefore, not everyone immediately rushes to the hospital and finds out what exactly is bothering them. If in the family a pregnant woman on the female line had problems with blood pressure, it is worth regularly measuring blood pressure, and in case of an increase, inform the doctor.

Diagnostics, first of all, consists in the regular measurement of blood pressure, and monitoring of protein in the urine. If there are isolated cases of increased pressure, then there is nothing terrible, since this phenomenon occurs often in pregnant women. But if the pressure rises rapidly, and the woman feels bad, this indicates the development and exacerbation of pathology. In this case, the pregnant woman is shown to stay in the hospital, where qualified care will be provided, and, if necessary, first aid is provided.

Hypertension treatment

Treatment of hypertension during pregnancy should be supervised by a physician.

If a woman suffers from severe arterial hypertension, the doctor will advise you to stay in the hospital for a more complete examination and determine the cause of this condition. When the danger passes, medications for hypertension are prescribed, which are important to take strictly according to the proposed scheme, the course will last until the very birth. It is worth strictly following all the doctor's recommendations, taking the prescribed medications, and monitoring your condition. Do not try to fix the problem yourself, this will only aggravate the situation and cause dangerous consequences.

When the pathology is mild, the doctor will advise you to reconsider the diet, adjust the daily regimen, get more rest, and walk in the fresh air. It is not necessary to take pills, it is only important to monitor your well-being, and in case of a rapid deterioration, urgently go to the hospital, and not self-medicate. Increased pressure before childbirth is a fairly common situation, but with adequate measures, the pathology can be controlled and complications avoided.

High pressure delivery

Natural childbirth with hypertension and high blood pressure is contraindicated, since the pressure can rise critically, and this is dangerous for the life of the expectant mother and child. Therefore, before giving birth, the doctor will weigh all the risks and advise you to have a cesarean section. Such childbirth with hypertension is the safest, and the doctor will be able to constantly monitor the situation and prevent dangerous complications during childbirth.

If a hypertensive woman suffered from high blood pressure even before conception, while the condition was accompanied by serious consequences, it is contraindicated for her to become pregnant and give birth to a child, because the consequences of such a disease can be unpredictable.

Possible complications and consequences


An exacerbation of the disease can lead to extremely negative consequences for the health of the mother and child.

If arterial hypertension worsens during pregnancy, the likelihood of developing late toxicosis is high, which is dangerous both for the woman herself and for the unborn child. Another, extremely dangerous complication that provokes high blood pressure is hemorrhagic stroke. With hypertension, the entire body suffers, since high blood pressure leads to a violation of the blood supply to the internal organs. This negatively affects the development of the fetus, and as a consequence - a violation of the formation of the cardiovascular and central nervous system, intrauterine bleeding, detachment of the placenta, and premature birth in the early stages.

A little about AED (this is important with such diagnoses, if I knew about this during pregnancy, I would behave a little differently ...)
PERINATAL ENCEPHALOPATHY

"I call fire on myself" - this is exactly what the central nervous system does in the perinatal (that is, adjacent to childbirth) period, which is critical for the entire future life of a person - the last 12 weeks of intrauterine life and the first week after birth. For this "heroism" the baby's brain often has to pay with a disease with the alarming name "perinatal encephalopathy", which nowadays occurs in 8 out of 10 newborns.

Causes of perintal encephalopathy

What could be a more reliable protection for the nascent life than the blissful warmth of the mother's womb? Alas, more and more often this natural barrier from the vicissitudes of the outside world "breaks through" the unfavorable ecology, stresses and illnesses of the expectant mother - from a cold on her feet or anemia that does not affect her well-being to hypertension and diabetes mellitus provoked by pregnancy.

And if, while expecting a child, a woman should generally "carry" herself with the care of a crystal vase, then in the last 3 months of pregnancy a comparison suggests itself not even with crystal, but with a priceless porcelain figurine. The expectant mother during this period is obliged to be especially attentive to her health: not to overwork, be outdoors as often as possible, be sure to limit meat food, coffee, chocolate, not only not to smoke herself, but also prohibit others from doing this in their presence, in "influenza" time to give up travel in transport and receptions. In addition, in the last weeks of pregnancy, it is necessary to visit the antenatal clinic every 10 days, take blood and urine tests and certainly undergo a second ultrasound examination, which will provide invaluable information about the state and location of the fetus and placenta in the uterus and the placenta, which will provide invaluable information for determining labor management tactics.

Indeed, even such a seemingly once and for all naturally programmed process, like childbirth, rarely proceeds "as written" in an obstetrics textbook. Equally at risk of injury is the "hurry", rapidly overcoming obstacles of the birth canal, and the "slow-witted" who did not have time to pass them by the due date, and the "kesarenok", for whom a sharp drop in pressure and temperature serves as a test of strength when removing it for the light of God on the operating table.

The 91st day of the perinatal period is inscribed in the biography of each child, when the body includes the program of transition to the mode of autonomous existence, and therefore is extremely vulnerable. The central nervous system "commands the parade" of adaptation, which itself is still being formed and matured, primarily causing the "fire" of unfavorable influences on itself. In the first place among them - oxygen starvation (hypoxia), then in decreasing order of importance - traumatic and toxic factors, infections and metabolic disorders. Under their influence, due to the narrowing of the vessels feeding the child's brain, cerebral circulation and circulation of cerebrospinal fluid are disrupted.

This is how perinatal encephalopathy occurs - damage to the brain, the outcome of which usually becomes clear by the beginning of the second year of life.

Did your baby come out safely from the perinatal weeks, or did he take encephalopathy as a memory of them? This question should be answered by a pediatric neurologist - it is desirable that a meeting with him took place already in the first month after birth. But if the doctor discovers signs of perinatal brain damage, first of all, do not be alarmed and do not take the diagnosis as a final judgment. The brain of an infant grows and develops rapidly, doubling its original mass by the age of nine months. At this time, he possesses a truly fabulous ability to, with proper treatment, like a phoenix from the ashes, rise almost unharmed from the fire of damaging influences.

But remember: you only have one year left when the miracle of healing can and should occur.