#31 High Blood Pressure in Pregnancy

When you’re pregnant your blood pressure will be checked on your prenatal visits, but it’s important for you to monitor your blood pressure at home. In fact, it’s a good idea to know what your blood pressure is before you get pregnant, so you have a baseline to refer to as you track your blood pressure during pregnancy. Your physician will check your blood pressure on your prenatal visits, but you should track your blood pressure every day and know what is normal for you at your stage of pregnancy.

I strongly recommend you purchase a wrist blood pressure cuff and keep it handy during your pregnancy. Take your blood pressure about the same time at least once a day. These wrist cuffs may not be as accurate as a cuff that wraps around your upper arm, but they are accurate enough to watch the increases and decreases in your blood pressure.

Blood pressure normally goes up and down during the length of your pregnancy. Your blood pressure usually drops in the first trimester, stays low in the second trimester, and then gradually increases in the third trimester.

The American Academy of Obstetricians and Gynecologists recommend that a patient’s blood pressure needs attention once her blood pressure reaches 160/100. In my experience, this is too high. A blood pressure of 140/90 may well indicate developing pre-eclampsia. In fact, an elevated blood pressure is often the only sign of the onset of pre-eclampsia.

If we use only the hard and fast rule that a patient is safe until her blood pressure reaches 160/110, many pregnant women will have a seizure. High blood pressure in pregnancy (140/90) or more may signal developing pre-eclampsia. Know your pre-pregnancy, first trimester, and second trimester blood pressures. Yes, it’s true that elevated blood pressure is often the first sign of pre-eclampsia.

If you have high blood pressure, try to get it under control before becoming pregnant. Many pregnant women can develop trouble with high blood pressure once pregnant. Again, your obstetrician has an opportunity to help you control your blood pressure with antihypertensive medications such as Aldomet if your blood pressure becomes a problem while you are pregnant. I can’t say it often enough. High blood pressure is a precursor to pre-eclampsia.

Based upon what I’ve seen in 6,000 pregnancies, blood pressure hardly ever rises precipitously. It almost always rises slowly and predictably. In my experience, it is far better to treat the rising blood pressure in its early stages.

Many of the stories about pregnancy complications start with blood pressure that was not properly monitored or was ignored or misunderstood. This is why it is important for you and your doctor to monitor your blood pressure from the start of your pregnancy, including postpartum. As one of the indicators of pre-eclampsia, tracking your blood pressure and getting it under control can help you prevent further complications.

As previously mentioned, it is also important to monitor your blood pressure even after the baby is delivered. Often, people assume that the possibility of eclampsia subsides postpartum, but it doesn’t work that way. Sometimes, the postpartum period is the worst time for blood pressure elevations.

Blood pressure is relative. What is normal for you may be high for someone who starts their pregnancy at a lower blood pressure than is normal for you. And continue to take your blood pressure after you are home. If it goes up, call your doctor.