How do I keep blood pressure level normal during pregnancy?

Dear Doctor,

I’m three months pregnant with my first child. I’ve heard of abnormal blood pressure levels during pregnancy and I would like to know more about that. What causes it? How can I ensure normal levels? Betty

Accept my sincerest congratulations and best wishes on your first pregnancy.  Normally, one can have high blood pressure levels during pregnancy if hypertension was present before. It may be augmented during pregnancy.  If such is the case, they should be more careful about the diet. If necessary, the antihypertensive medication may be changed to some medication more suitable for pregnancy. It means a medicine that does not cause any harm to the baby.

Five to eight per cent of women world over develop gestational hypertension, i.e. hypertension during pregnancy, which normally goes off after delivery.  Women with a history of gestational hypertension during previous pregnancy, those with family history of hypertension, a mother or sister having gestational hypertension, are more at risk of developing this problem. Apart from this, very young women(<20 years) or elderly(>40 years) , those with multiple pregnancies, women with African ethnicity, taking excess salt, taking alcohol or tobacco, and or caffeine, women  who are under stress for any reason,  those with diabetes ,  any  kidney disease, are also at increased risk of developing high blood pressure during pregnancy. Being overweight, a sedentary lifestyle, are other risk factors. Gestational hypertension can lead to eclampsia of pregnancy, a potentially fatal complication.

Checking the blood pressure forms part of the routine, regular antenatal examination during pregnancy.  Any blood pressure reading >140/90 mm. Hg. warrants attention and due measures with medication.  High blood pressure during pregnancy can lead to miscarriage in early pregnancy, pre term birth, small sized baby or even intra uterine death. It can also cause severe headache, anxiety, nose bleeds, palpitations, shortness of breath, swelling over feet and face, one or more of these symptoms.

Hypertension during pregnancy can be prevented by a healthy lifestyle. Taking a healthy diet with fresh vegetables, fruits, whole grains and less fats and salt, avoiding alcohol, smoking and caffeinated products is beneficial. One should drink at least eight to 10 glasses of water every day. Taking adequate rest and being stress free is important. If one has pre-existing hypertension and diabetes, it should be kept well controlled by regular medication and dietary measures.

Regular physical exercise helps to prevent hypertension and if one already has it, helps in better control. However, exercise should be done as per one’s stamina and over exertion should be avoided.

At times, some women have low blood pressure during pregnancy. This causes dizziness, light headedness and easy fatigue.  It can be prevented by taking adequate amount of fluids, frequent small meals including breakfast, and resting with legs elevated. 

 Dr. Rachna   Pande is a specialist in internal medicine.