Preexisting High Blood Pressure
If you're among the 5 percent of women who had high blood pressure before you conceived, your pregnancy may be more complicated. Babies born to mothers with high blood pressure are at risk for being born prematurely or with a low birthweight. If you take care of yourself and have good prenatal care, however, you have an excellent chance of having a healthy baby. Here is what you need to know:
- ACE inhibitors are a no-no. These high blood pressure medications are dangerous to your baby, particularly during the 2nd and 3rd trimesters. In the mother they can cause low blood pressure, severe kidney failure, and too much potassium; for the baby they can cause death. It's best to stop taking ACE inhibitors before you conceive. If you're on them now, immediately contact your doctor, who will switch you to a safer kind of drug. Don't stop taking your medication unless your doctor tells you to.
- You are at risk for preeclampsia. One-fourth of women who have high blood pressure develop preeclampsia (also known as toxemia), usually after about 28 weeks of pregnancy.
- You are at risk for placental abruption. Placental abruption, or separation of the placenta from the uterine wall, is dangerous for mother and baby. It can cause severe bleeding, usually after week 20.
- Your doctor will monitor you closely. Your blood pressure will be checked regularly, and your urine will be tested for protein. (One of the signs of preeclampsia is excess protein in the urine.) Some doctors ask their patients to monitor their blood pressure at home.
- You can make a difference. Monitoring your weight gain, taking your medications religiously, and exercising will help cut your risk of complications.
Originally published in You & Your Baby: Pregnancy.
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