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High blood pressure and pregnancy: Know the facts

What should I do to prepare for pregnancy?

If you have high blood pressure, schedule a preconception appointment with the health care provider who'll be handling your pregnancy. Also meet with other members of your health care team, such as your family doctor or cardiologist. They'll evaluate how well you're managing your high blood pressure and consider any treatment changes you might need to make before pregnancy begins. If you're overweight, your health care provider might recommend losing the excess pounds before you try to conceive.

What can I expect during prenatal visits?

During pregnancy, you'll see your health care provider often. Your weight and blood pressure will be checked at every visit, and you might need frequent blood and urine tests.

Your health care provider will closely monitor your baby's health as well. Frequent ultrasounds might be used to track your baby's growth and development. Fetal heart rate monitoring might be used to evaluate your baby's well-being. Your health care provider might also recommend monitoring your baby's daily movements.

What can I do to prevent complications?

Taking good care of yourself is the best way to take care of your baby. For example:

  • Keep your prenatal appointments. Visit your health care provider regularly throughout your pregnancy.
  • Take your blood pressure medication as prescribed. Your health care provider will prescribe the safest medication at the most appropriate dose.
  • Stay active. Follow your health care provider's recommendations for physical activity. Keep in mind, however, that bed rest might be recommended if you develop signs of preeclampsia.
  • Eat a healthy diet. Limit the amount of sodium in your diet, and take your prenatal vitamins.
  • Monitor your weight. Gaining a healthy amount of weight — often 25 to 35 pounds (about 11 to 16 kilograms) — supports your baby's growth and development. There's no one-size-fits-all approach to pregnancy weight gain, though. Work with your health care provider to determine what's right for you.
  • Know what's off-limits. Avoid smoking, alcohol and illicit drugs. Talk to your health care provider before taking any over-the-counter medications.

If you had high blood pressure before you got pregnant, have a history of preeclampsia, are obese, are pregnant with more than one baby, are younger than 20 or older than 40, or have other conditions, such as diabetes, you're at increased risk of preeclampsia. Your health care provider might prescribe low-dose aspirin therapy during your pregnancy to reduce your risk of developing the condition.

What about labor and delivery?

Your health care provider might suggest inducing labor a few days before your due date to avoid complications. If you develop preeclampsia or other complications, induction might be needed even earlier. If you have severe preeclampsia, you might be given medication during labor to help prevent seizures. In some cases, a C-section might be needed.

Will I be able to breast-feed my baby?

Breast-feeding is encouraged for most women who have high blood pressure, even those who take medication. Discuss any medication adjustments you'll need to make with your health care provider ahead of time. Sometimes an alternate blood pressure medication is recommended. Your health care provider might also recommend avoiding breast-feeding right after you take your medication.

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References
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  11. Routine prenatal care. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/prenatal_care_4/prenatal_care__routine__full_version__2.html. Accessed March 30, 2011.
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  13. August P. Management of hypertension in pregnant and postpartum women. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  14. Norwitz ER, et al. Management of preeclampsia. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  15. Hypertension in pregnancy. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec18/ch261/ch261k.html. Accessed March 31, 2011.
  16. Bleeding during pregnancy. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp038.cfm. Accessed April 14, 2011.
PR00125 July 30, 2011

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