What is hypertension? Can I have it in pregnancy?\u00a0\r\n\r\nHypertensive disorders in pregnancy are a major cause of maternal, foetal and neonatal morbidity as well as and mortality in both developing and developed countries. Women with hypertension in pregnancy have a higher risk of complications such as placental abruption, wherein the placental lining separates from the uterus of the mother, stroke, blood clots and abnormal bleeding as well as a premature birth or miscarriage.\r\n\r\n\r\n\r\nHypertension in pregnancy includes:\r\n\r\n\tPre-eclampsia. This is the most serious form of hypertension during pregnancy. The only way to control this condition is to deliver the foetus, which can lead to complications, including death of the mother and\/or child. Preeclampsia typically occurs after 20 weeks.\r\n\tGestational hypertension. This form of hypertension occurs only during pregnancy and usually isn\u2019t a problem for the mother after delivery. Gestational hypertension can appear near the end of a pregnancy.\r\n\tChronic hypertension. This form of hypertension develops prior to pregnancy or in the early stages of pregnancy (before 20 weeks).\r\n\r\n\r\nHow do I know whether I am suffering from hypertension during my pregnancy?\u00a0\r\n\r\nThere are various symptoms that you may observe to ascertain whether you have hypertension during pregnancy. These include, severe headaches, blurred vision or flashing before the eyes, vomiting, severe gastric pain, breathlessness and sudden swelling of the face, hands or feet.\r\n\r\n\r\nWhat can I do, if I am suffering from hypertension during my pregnancy?\u00a0\r\n\r\nAll pregnant women should receive antenatal education so that they are aware of the symptoms associated with hypertension and when to obtain medical advice.\r\n\r\nNevertheless, if you developed the above symptoms, it is best to seek your doctor\u2019s advice immediately. Depending on your blood pressure, weeks of pregnancy and blood flow in the placenta, he will be able to advise you on the best management method.\r\n\r\nIn non chronic cases, the doctor will keep you under close observation, recommend that you reduce your daily activities and possible stress inducers and to get more bed rest. In cases of chronic hypertension and pre-eclampsia, you may be advised to take some medication to reduce the maternal and foetal risk factors. For example, if you are at risk of pre-eclampsia, the doctor may usually recommend that you take\u00a0 75mg aspirin from he 12th week of pregnancy to delivery.\r\n\r\nSome pregnant women who do not suffer from pre-eclampsia may also be advised to\u00a0take 75mg aspirin daily from the 12th week of pregnancy, if they are in any two of the following categories :\r\n\r\n\thaving their first pregnancy at age 40 or older\r\n\tlast pregnancy was over ten years ago\r\n\tobese women with a BMI of 35 or higher\r\n\tfamily history of pre-eclampsia\r\n\thaving a multiple pregnancy\r\n\tsuffering from renal disease in pregnancy\r\n\texperiencing psychological changes in pregnancy\r\n\r\n\r\nHow do I know if I am at a high risk of developing pre-eclampsia during my pregnancy?\u00a0\r\n\r\nGenerally, women who are at risk of developing pre-eclampsia are those who have had hypertension in a past pregnancy, suffered from chronic kidney disease or autoimmune diseases such as\u00a0 systemic lupus erythematosus (SLE) or antiphospholipid syndrome, or women with diabetes.\r\n\r\n\r\nHow will my doctor help keep my pregnancy hypertension in check?\u00a0\r\n\r\nYour doctor will first asses the severity of your hypertension before prescribing the most suitable treatment method for you.\r\n\r\nGenerally this will include keeping you under close observation or to provide you with medication in order to help keep your blood pressure to under 150\/100 mm Hg.\u00a0In addition, he may also conduct ultrasound examinations to assess foetal growth and amniotic fluid volume\u00a0 at 28-30 weeks and 32-34 weeks of your pregnancy if mild or moderate hypertension develops before this time.\r\n\r\nGiven that women with pre-eclampsia may suffer some complications during labour, the doctor will discuss the the management plan for delivery with you and your husband based on your health and the progress of your baby during the said pregnancy. For example, patients with mild or moderate pre-eclampsia are usually delivered between 34+0 to 36+6 weeks depending on assessment of risk and availability of a special care baby unit, with foetal monitoring and after a course of corticosteroids to reduce the risk of infant respiratory distress syndrome.\r\n\r\n\r\nWill the hypertension go away once I have given birth?\u00a0\r\n\r\nIn mild or transient hypertension, this may well be the case. However, in more severe cases, your doctor may continue to measure your blood pressure after birth. He may also continue you on the medication until your blood pressure falls to a healthy range.\r\n\r\n\r\nIs there anything I can do to prevent hypertension in pregnancy?\u00a0\r\n\r\n\tKnow your blood pressure level before getting pregnant. Make an appointment for a checkup with your primary care doctor or ob-gyn and make a note of your blood pressure. You can also monitor your blood pressure yourself with the home blood pressure monitor available at most pharmacies.\r\n\tKick the salt habit. High salt, or sodium, intake can raise blood pressure. If you typically sprinkle salt on every dish, now is the time to break the habit. Most adults should keep salt intake to 1 teaspoon per day \u2014 that includes what comes out of the shaker as well as the hidden sodium in processed foods.\r\n\tGet off the couch. Get up and get moving before you conceive. If you\u2019re already pregnant, ask your doctor about starting a regular exercise programme. Sedentary women are likely to gain weight, which can increase the risk of hypertension during pregnancy, as well as before and after. Try to start your pregnancy at a healthy body weight.\r\n\tPay attention to medication. Make sure you aren\u2019t taking medication that can raise blood pressure levels \u2014 check with your doctor to see what\u2019s safe. You may not realise that popping a decongestant, such as pseudoephedrine (Sudafed and others), for something minor like a stuffy nose can cause an increase in blood pressure. Think twice about using any medication unless your doctor approves. If you already have high blood pressure, talk to your doctor about medication use before and during pregnancy. It is very important to have your blood pressure under control and stable before becoming pregnant, as those nine months are not the best time to try new or additional medication. Work with your doctor to make sure that you are taking a medication that will be safe to continue during pregnancy.\r\n\tGet regular prenatal checkups. If your blood pressure starts to rise during pregnancy, you want to catch it early. Make sure to keep all appointments and consider checking your blood pressure more frequently at home.