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Gestational Hypertension

Women who develop gestational hypertension have increased health risks during pregnancy.

It's vital that your doctor watch and treat this condition to avoid any problems for you or your baby.

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What Is Gestational Hypertension?

Gestational hypertension is high blood pressure that forms during your pregnancy, often in the second or third trimester. It's also known as pregnancy-induced hypertension.

High blood pressure means the force of blood against your arteries is too high.

Normal BP is 120/80 mmHg. Hypertension means your BP is 140/90 mmHg or higher.

This condition can pose health risks for you, like having a stroke. It can also prevent your baby from getting enough oxygen.

In some cases, your doctor may need to induce labor so you can deliver your baby early.

Gestational hypertension happens in about 1 in every 12 to 17 pregnancies.

But you can manage it by staying in contact with your obstetrician. That allows them to check your blood pressure often and take steps to treat your pregnancy-induced hypertension.

What are the types of gestational hypertension?

There are 3 types of hypertension:

  • Chronic hypertension – You had high blood pressure before your pregnancy, or your doctor detects it early, before your 20th week. It might remain after your baby is born.
  • Gestational hypertension – You form high blood pressure after your 20th week of pregnancy or close to giving birth. It often goes away after your baby is born.
  • Preeclampsia – You have high blood pressure that formed before or during your pregnancy. But you also have protein in your urine or other problems with your kidneys, liver, or other organs.

Preeclampsia is the most dangerous type of pregnancy-induced hypertension. It's vital to know it can appear suddenly. And both chronic and gestational hypertension can turn into preeclampsia after week 20 of your pregnancy.

What causes gestational hypertension?

Doctors don't fully know what causes preeclampsia or gestational hypertension.

But chronic high blood pressure is more common if you have the following conditions:

  • Kidney disease.
  • Diabetes.
  • Obesity.
  • Obstructive sleep apnea.
  • Unhealthy lifestyle choices like smoking or drinking too much alcohol.

Women who don't have routine check-ups might not know they have high blood pressure until their obstetrician detects it.

What are gestational hypertension risk factors and complications?

There's no definitive test to tell if you will develop pregnancy-induced hypertension or preeclampsia.

Gestational hypertension risk factors

  • Are pregnant for the first time.
  • Have a BMI greater than 30.
  • Have diabetes.
  • Have kidney disease.
  • Have an autoimmune disease like lupus.
  • Have a family history of gestational hypertension.
  • Are carrying more than 1 baby.
  • Had preeclampsia or another hypertension disorder in a prior pregnancy.
  • Are older than 35.
  • Are a woman of color.

Make sure your doctor is aware if you have any of these risk factors.

You may need more frequent blood pressure checks in-office, or to use a home blood pressure cuff. This will help catch any problem early.

Complications of gestational hypertension

High blood pressure puts extra stress on your heart and kidneys.

It also limits the amount of blood flow to your baby. That means they'll get less oxygen and fewer nutrients, which affects their growth.

Mildly elevated blood pressure often isn't serious and doesn't cause complications. It's important to watch it though in case it increases suddenly.

If your blood pressure gets very high and doctors don't detect and treat it, it increases your risk of:

  • Heart problems.
  • Kidney disease.
  • Stroke, in which a blood vessel blocks blood flow to part of your brain.
  • Placental abruption, in which the placenta separates from your uterus wall too early. It can cause severe bleeding.
  • Fetal distress, which would require an emergency C-section.

Preeclampsia has more serious complications, which can turn deadly.

They include:

  • Liver dysfunction or bleeding in your liver.
  • Blood clotting problems.
  • Red blood cell rupture.
  • Seizures.
  • Stroke.

How can I prevent gestational hypertension?

The best way to prevent gestational hypertension is to manage any risk factors.

That means:

  • Eating a healthy diet and getting regular exercise to maintain a healthy weight, especially before becoming pregnant.
  • Managing other health issues such as diabetes, kidney disease, or autoimmune diseases (like lupus) that affect your heart or blood vessels.
  • Telling your doctor about your family history of gestational hypertension or preeclampsia.
  • Following up with your scheduled prenatal care so they can check your blood pressure at each visit.

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What Are The Signs And Symptoms Of Gestational Hypertension?

Most women don't have any gestational hypertension symptoms, especially if their blood pressure is only mildly elevated.

But if your blood pressure is very high or you develop preeclampsia, you may have some or all of these symptoms:

  • A severe headache.
  • Changes in vision, like blurry vision or seeing spots.
  • Swelling in your face or hands.
  • Sudden weight gain.
  • Pain in the upper part of your belly or in your shoulder.
  • Nausea or vomiting in the second half of your pregnancy.

Contact your doctor right away if you have any of these symptoms.

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How Do You Diagnose Gestational Hypertension?

Your doctor can diagnose gestational hypertension by checking your blood pressure.

It's not uncommon to have an occasional high blood pressure reading. If one reading is high, they will check it again a few times or over a couple of days to confirm.

Because high blood pressure is an early sign of preeclampsia, they will be extra cautious. Your doctor may also order:

  • A urine test to see if there's any protein, a sign of kidney damage related to preeclampsia.
  • Blood tests to assess your kidney function.
  • A fetal ultrasound to check your baby, placenta, and amniotic fluid.
  • A Doppler ultrasound to see how well blood flows through your placenta.
  • Electronic fetal heart checks to make sure your baby's heart is healthy.

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How Do You Treat Gestational Hypertension?

The goals of gestational hypertension treatment are to:

  • Lower or normalize blood pressure.
  • Avoid any complications of high blood pressure.
  • Deliver a healthy baby.

Medicine and lifestyle changes are often effective.

Lifestyle changes

Lifestyle changes can also help keep your blood pressure healthy, especially if it's only mildly high.

These include:

  • Eating a healthy diet with plenty of fruits and veggies. Limit highly processed, packaged foods because they're high in sodium and can raise your blood pressure.
  • If needed, work with a dietitian to improve your diet and aim for healthy weight gain during your pregnancy.
  • Don't smoke or drink alcohol. Both can harm your baby and raise your blood pressure.
  • If your doctor approves it, get routine exercise. Walking or swimming can help you stay at a healthy weight and reduce blood pressure.
  • Reduce your stress through meditation or gentle prenatal yoga.

Medicine to treat gestational hypertension

Not all blood pressure drugs are safe to take when you're pregnant.

If you need medicine to reduce your blood pressure, your doctor will prescribe a safe option.

They will also ask you to:

  • Use a home blood pressure cuff to take readings.
  • Record your baby's activity by counting their kicks.
  • Check in with your obstetrician's office by message, phone, or in-person more often.

If your blood pressure is very high or you get preeclampsia, you may need to stay in the hospital until giving birth.

This allows doctors to watch you and your baby closely. They can also make sure you get any medicines you might need.

If you're at least 34 weeks pregnant, they may discuss delivering your baby early.

Last reviewed by a UPMC medical professional on 2024-10-01.