Chronic hypertension is high blood pressure that is present prior to conception, or diagnosed prior to the middle of the second trimester, often before the twentieth week of pregnancy. This type of high blood pressure, often associated with genetic predisposition or lifestyle habits, doesn't resolve with delivery, but can still cause significant issues with the pregnancy. High blood pressure that occurs as a result of pregnancy, gestational hypertension, can have significant effects and may lead to a condition called preeclampsia.
Chronic Hypertension
Chronic hypertension can narrow or constrict the blood vessels in the uterus. These vessels are responsible for ensuring that the fetus receives plentiful oxygen, nutrients and circulation from the mother. The effects of chronic high blood pressure can create severe issues for development even before a child is conceived. Therefore, according to the National Institutes of Health, it is critical that blood pressures be monitored and controlled, preferably long before conception, as hypertension prior to or during pregnancy can pose profound risks for both mother and fetus.
Preeclampsia
Hypertension, even in the mother who was previously healthy, can occur as a result of pregnancy. Due to bodily changes that occur during pregnancy, some mothers are susceptible to gradual or even sudden rises in blood pressure. Significantly increased blood pressure in the pregnant patient that occurs after the twentieth week of pregnancy and towards the mid to late second trimester, is often a condition classified as preeclampsia. This change in blood pressure is closely associated with the presence of protein detectable in the urine. This can be a dangerous condition which, if not detected and treated by a physician, can progress to eclampsia whereby life-threatening seizures develop during the pregnancy. The most common signs and symptoms of preeclampsia include sudden swelling and edema, sudden weight gain over 2 to 3 days or more than 2 to 3 lbs. in one week, and headaches that don't seem to go away. More significant signs and symptoms include severe abdominal pain, nausea/vomiting, unexplained agitation, changes in vision and decreased urine output. The March of Dimes recommends that any of these changes should be addressed immediately by a physician.
Health Issues for the Expecting Mother
Hypertension can be dangerous for the mother despite the cause or origin. As with any patient with high blood pressure, constricted blood vessels and increase stress on the heart and circulatory system can lead to heart attack, heart failure, kidney failure, stroke and other conditions that result from insufficient circulation. These effects caused by high blood pressure can occur whether the condition is chronic or acute, as in gestational hypertension or preeclampsia. The Mayo Clinic emphasizes that is crucial to not underestimate the impact of blood pressure on almost every organ system in the body, including the unborn child.
Health Issues for the Developing Fetus
There can be significant impact on fetal development due to any decrease in circulation and the subsequent delivery of oxygen and nutrients, and the removal of waste products. The National Institutes of Health recognizes that low birth weight and slowed fetal growth are commonly described conditions that result from hypertension during pregnancy. The potential for miscarriages, spontaneous abortions and placental abruptions are also greatly increased in the presence of hypertension. Placental abruption involves the separation of the placenta from the wall of the uterus, which can occur prior to or during delivery. This condition often results in severe blood loss, which can lead to shock endangering both mother and child.
