blood pressure in pregnancy

Overview

Blood pressure is the force of blood pushing against the walls of your arteries. During pregnancy, some women develop high blood pressure (hypertension). This can be a temporary condition called gestational hypertension, or it can be part of a more serious condition called preeclampsia. Sometimes women already have high blood pressure before pregnancy, which is called chronic hypertension.

Yes, high blood pressure is a common condition during pregnancy. About 6 to 10 out of every 100 pregnant women will develop it. Gestational hypertension and preeclampsia are the most common types.

It can affect any pregnant woman, but it is more common in first-time mothers, women carrying twins or more, women over 40, those with a family history of high blood pressure or preeclampsia, and women who are overweight or have pre-existing health conditions like diabetes or kidney disease.

Symptoms

Common symptoms

• Persistent headache that does not go away with usual pain relief
• Blurred vision or seeing flashing lights
• Swelling (oedema) in the hands, feet, or face – especially if sudden or severe
• Shortness of breath
• Pain just below the ribs, usually on the right side

Causes

Main causes

• The exact cause is not fully understood, but it is thought to be related to problems with the placenta (the organ that supplies the baby with nutrients and oxygen).
• High blood pressure in pregnancy may also be linked to the immune system reacting to the pregnancy, or to blood vessel problems.
• For chronic hypertension, the cause is often the same as high blood pressure in general – genetics, lifestyle factors, or other medical conditions.

Risk factors

• First pregnancy
• Age over 40
• Carrying more than one baby (twins, triplets)
• Previous high blood pressure or preeclampsia in a past pregnancy
• Obesity (Body Mass Index over 30)
• Pre-existing conditions like diabetes, kidney disease, or autoimmune disorders
• Family history of high blood pressure or preeclampsia

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above – call your local emergency number immediately.
• If you notice sudden swelling in your face or hands, or severe headaches that do not get better with rest.

Book a routine appointment if:

• Attend all your antenatal (pregnancy) check-ups – your midwife or doctor will check your blood pressure and urine at every visit.
• If you have a home blood pressure monitor and your readings are higher than 140/90 mmHg, contact your maternity team for advice.

Diagnosis

High blood pressure in pregnancy is diagnosed by measuring your blood pressure with a cuff on your arm. Your doctor or midwife will also test your urine for protein (which can be a sign of preeclampsia) and may do blood tests to check your liver, kidneys, and overall health.

Tests that may be done

• Blood pressure measurement
• Urine dipstick test (to check for protein)
• Blood tests (full blood count, liver function, kidney function, and sometimes clotting factors)
• Ultrasound scan to check the baby's growth and the amount of amniotic fluid
• Fetal heart rate monitoring (cardiotocography) to check the baby's wellbeing

What to expect at your appointment

If you are diagnosed with high blood pressure during pregnancy, your care team will monitor you more closely. This may include more frequent antenatal visits, home blood pressure monitoring, and extra scans. You might be referred to a specialist pregnancy clinic. The goal is to keep your blood pressure in a safe range and watch for any signs of preeclampsia.

Treatment

Treatment aims to keep your blood pressure at a safe level for both you and your baby. If you have mild or moderate hypertension, you may not need medication, but you will be monitored closely. If your blood pressure is high or you develop preeclampsia, medication may be recommended. Your doctor will choose the safest option for pregnancy.

Self-care at home

• Rest as much as you can – lying on your left side can help improve blood flow to the baby.
• Avoid added salt and salty foods, but do not cut salt out completely.
• Stay active with gentle activities like walking, but check with your doctor first.
• Drink plenty of water to stay hydrated.
• Monitor your blood pressure at home if your healthcare team advises it.

Medical treatments

Medications to lower blood pressure may be prescribed. Common types include labetalol, nifedipine, and methyldopa – these are considered safe in pregnancy. Never stop or change your medication without talking to your doctor. If severe preeclampsia develops, you may need hospital care and medication to prevent seizures (magnesium sulfate). Your doctor will discuss the risks and benefits with you.

When is surgery considered?

Surgery is not a routine treatment for high blood pressure in pregnancy. However, if preeclampsia becomes severe and threatens your or your baby's safety, your doctor may recommend delivering your baby early. This could be by vaginal induction of labour or caesarean section.

Living with this condition

Living with high blood pressure during pregnancy means staying in close contact with your maternity team. You will have regular checks and may need to adjust your daily routine to include more rest. Keep a record of your blood pressure readings if asked, and note any new symptoms. Your baby's growth will be monitored with ultrasound scans.

Lifestyle tips

• Get plenty of rest, especially in the afternoon.
• Avoid stressful situations as much as possible.
• Do gentle exercise like walking or swimming, but only if your doctor says it is safe.
• Do not smoke or drink alcohol – both can worsen high blood pressure and harm your baby.
• Ask your partner, family, or friends for help with household chores and childcare if you have other children.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, whole grains, and lean protein. Limit processed foods and foods high in salt. Stay well hydrated. Gentle exercise, such as walking or prenatal yoga, can be helpful, but always check with your healthcare provider first – especially if your blood pressure is high or you have signs of preeclampsia.

Mental health and emotional wellbeing

Having a high-risk pregnancy can be stressful and worrying. It is normal to feel anxious or overwhelmed. Talk to your midwife, doctor, or a counsellor about your feelings. If you are feeling low or hopeless, let someone know – support is available. Remember to take time for yourself and do things that help you relax.

Prevention

It is not always possible to prevent high blood pressure in pregnancy, but you can reduce your risk by maintaining a healthy weight before pregnancy, eating a balanced diet low in salt, staying active, and managing any pre-existing health conditions like diabetes or chronic hypertension. If you had preeclampsia in a previous pregnancy, your doctor may recommend low-dose aspirin to reduce the risk of it happening again – ask your doctor if this is right for you.

Screening programmes

There is no routine screening test for high blood pressure or preeclampsia before symptoms appear. However, your blood pressure and urine will be checked at every antenatal visit. If you are at higher risk, your doctor may recommend more frequent monitoring or additional tests such as blood pressure checks at home or urine protein dipsticks.

Complications

If left untreated

• Preeclampsia – a serious condition that can affect your liver, kidneys, and blood clotting.
• Eclampsia – seizures (fits) caused by severe preeclampsia, which can be life-threatening.
• Placental abruption – when the placenta detaches from the womb too early, causing bleeding and risk to the baby.
• Preterm birth – your baby may need to be delivered early, which can lead to breathing and feeding problems.
• Low birth weight – because the placenta may not deliver enough blood and nutrients to your baby.
• Stroke or heart problems in the mother.

Long-term outlook

Most women with high blood pressure in pregnancy have a positive outcome. With careful monitoring and the right treatment, the risks to both mother and baby are greatly reduced. After delivery, blood pressure usually returns to normal within a few weeks. However, some women may continue to have high blood pressure or have a higher chance of developing it later in life. Your healthcare team will give you a plan for follow-up after the birth. Remember, you are being watched closely so that any problems can be caught early and managed well.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.