Pregnant women with hypertension must take medications regularly to reduce the risk of preeclampsia or premature birth, a doctor has said.
The risk of preeclampsia or premature birth before week 35 of pregnancy can be lowered if women with chronic hypertension receive treatment and keep their blood pressure within a normal range, they said, citing a recent medical study.
The research — which was led by the Heart, Lung and Blood Institute of the US National Institutes of Health and published last month in the New England Journal of Medicine — studied 2,408 pregnant women who were diagnosed with chronic hypertension prior to week 23 of pregnancy.
Photo courtesy of Chang Gung Memorial Hospital
As Taiwanese delay getting married and having children, more women have diseases related to hypertension during pregnancy, Hung Tai-ho (洪泰和), president of the Taiwan Society of Perinatology and a physician in Chang Gung Memorial Hospital’s obstetrics and gynecology department, said yesterday, citing the study.
Five percent of pregnant women are estimated to experience diseases related to hypertension — including chronic hypertension, which is diagnosed prior to pregnancy; hypertension, which is diagnosed after week 20 of pregnancy and continues beyond week 12 after giving birth; gestational hypertension, which is diagnosed after week 20 of pregnancy, but where the blood pressure returns to normal after week 12 following giving birth; preeclampsia, which is gestational hypertension combined with high levels of protein in the urine; eclampsia, which is preeclampsia with widespread seizures; and a combination of chronic hypertension and preeclampsia.
Pregnant women with chronic hypertension have a higher risk of developing gestational diabetes mellitus — a condition in which a hormone made by the placenta prevents the body from using insulin effectively — serious hypertension that leads to stroke, and preeclampsia and eclampsia, which can jeopardize the mothers’ heart, lungs, liver, kidneys and blood coagulation, Hung said.
Such women are likely to have placentas that malfunction, which could restrict the growth of the fetus, cause premature birth, or require medical personnel to induce labor if the condition of the mother or fetus deteriorates, he said.
Retrospective and observational studies have shown that prescribing antihypertensive medications for pregnant women with mild hypertension — a systolic blood pressure of between 140mm and 160mm and a diastolic blood pressure of between 90mm and 110mm — seems to be related to the bearing of small babies — birthweights below the 10th percentile for babies of the same gestational age, Hung said.
The relationship might result from the effect of the antihypertensive medications on blood flow in the placenta, leading to the restriction of fetal growth, he added.
Hypertension is among the top three leading causes of death for pregnant women in Taiwan, Hung said, adding that the study published in the New England Journal of Medicine could serve as an important reference for gynecologists and cardiologists treating pregnant women with hypertension.
Pregnant women with hypertension should measure and record their blood pressure in the morning and at night, which could help their doctors adjust their medications, he said.
If these women experience headaches, blurry vision, shortness of breath or severe pain in the upper or right upper abdomen, they should seek medical attention immediately, he added.
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