Types of High Blood Pressure in Pregnancy

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Just what types of high blood pressure are there? MH finds out.

WORDS NURULHUDA SUHAIMI

 

Did you know there are different types of high blood pressure – also known as hypertension – that can develop during pregnancy? Dr Tony Tan, specialist in Obstetrician and Gynaecology at Raffles Women’s Centre, Raffles Hospital, lists the following types of high blood pressure:

 

Pre-existing hypertension. This refers to hypertension that developed prior to your pregnancy, or hypertension detected before 20 weeks of pregnancy.

 

Gestational hypertension. This is detected after 20 weeks of pregnancy. Gestational hypertension is usually temporary, and will usually go away after delivery.

 

Pre-eclampsia. This is a “new onset persistent high blood pressure first detected after 20 weeks, usually with new onset proteins in the urine first detected after 20 weeks, or sometimes with one or more adverse conditions including low platelet count, kidney insufficiency, abnormal liver function on blood tests, fluid accumulation in the lungs, or severe headache or visual blurring,” says Dr Tan.

 

 

Among the different types of high blood pressure,

pre-eclampsia is the most dangerous as it poses

an increased risk of premature delivery of the baby.

 

 

Pre-eclampsia superimposed with pre-existing hypertension or gestational hypertensionThis means a woman who already has hypertension before pregnancy, or develops gestational hypertension during pregnancy, develops pre-eclampsia later on.

 

Risk Factors

When it comes to pre-existing hypertension, the factors that may increase its risk of developing in pregnant women are the same as non-pregnant women. According to Dr Chen Lin Han, consultant obstetrician and gynaecologist at Specialist Women’s Clinic Pte Ltd, Mount Alvernia Hospital, these factors include:

  • Old age
  • Family history
  • Weight (overweight/obese)
  • Sedentary lifestyle
  • Tobacco usage
  • Excessive salt intake
  • High levels of alcohol consumption
  • Stress
  • Medical conditions such as kidney disease, diabetes and sleep apnoea
  • Steroid intake

 

As for pre-eclampsia, Dr Chen categorises the risk factors into maternal and foetal. Maternal risk factors include those mentioned above, as well as the following:

  • First pregnancy
  • Age (younger than 18 years or older than 35 years)
  • History of pre-eclampsia
  • Family history of pre-eclampsia in a first-degree relative
  • History of migraine
  • Use of antidepressants

 

Foetal risk factors include:

  • Multiple babies (the higher the number, the higher the risk)
  • Rare foetal/placental conditions such as hydrops fetalis (build up of fluids in the foetus’ tissues and organs), gestational trophoblastic disease (growth of tumours inside the uterus), and triploidy (a chromosomal abnormality, where the foetus has an extra set of chromosomes)
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