The Basics

Written by the doctors and editors at UpToDate
Can women with high blood pressure have a normal pregnancy? — Yes. Most women with high blood pressure will have a normal pregnancy. But women with high blood pressure have a higher chance of having certain problems during pregnancy, such as:

• • Preeclampsia – Women with preeclampsia have high blood pressure and too much protein in their urine or problems with certain organs. Preeclampsia usually happens during the second half of pregnancy, and can be a dangerous condition. It can cause problems with a baby’s growth in the mother’s uterus. It can also affect the mother’s liver, kidneys, blood, heart, eyes, and nervous system.
  • Placental abruption – The placenta is the organ inside the uterus that brings the baby nutrients and oxygen, and carries away waste. It is attached to the inside wall of the uterus. A placental abruption is when part or all of the placenta separates from the uterus before the baby is born. If this happens, the baby might not get enough nutrients and oxygen.
  • Slowed growth of the baby – The baby can be small and not grow normally

What should I do before trying to get pregnant? — Before you try to get pregnant, talk with your doctor. He or she will work with you to get your blood pressure under control. If you are taking blood pressure medicines, this might involve changing your dose or switching to a different medicine. Your doctor will also make sure that your blood pressure medicine is safe to take during pregnancy.
Will I have tests during pregnancy? — Yes. At each visit, the doctor or nurse will check your blood pressure and your baby’s growth.You will also have tests to check your baby’s health at different times during pregnancy.

Will I need to take blood pressure medicine during pregnancy? — Maybe. This depends on how high your blood pressure is. If it is very high, you will need to take medicine during pregnancy to keep it under control.
When should I call my doctor or nurse? — Call your doctor or nurse right away if:

• • • You don’t feel your baby move as much as usual.
    • You start having contractions. A contraction is when the uterus muscle squeezes. This can cause pain and make your belly hard.
    • You have belly pain.
    • You have bleeding from the vagina.
    • You have any symptoms of preeclampsia. These can include:
      • A bad headache
      • Changes in vision, such as blurry vision or flashes of lights
      • Pain in the upper belly

Can I have a normal vaginal delivery? — Yes. Most women can have a normal vaginal delivery.

Will my baby be healthy? — Probably. If you have high blood pressure during pregnancy, you are more likely to give birth earlier than normal. That’s because if you have preeclampsia, a placental abruption, or a baby that is small for its age, the doctor might need to deliver your baby early. But if your blood pressure is under control during pregnancy, chances are good that your baby will be healthy.

Reference: High blood pressure and pregnancy, Lexicomp, Wolters Kluwer Health, Inc