Hypertension occurring during pregnancy, or pregnancy-induced hypertension, must be detected and treated very quickly. In the absence of treatment, the consequences can be dramatic for the mother or the child, or both.
When a person has high blood pressure (HTA), it means that the pressure in their arteries is abnormally high. It is defined by the following two criteria: systolic pressure (pressure in the artery when the heart contracts) greater than or equal to 140 mmHg or diastolic pressure (pressure in the artery when the heart relaxes between two contractions) greater than or equal to 90 mmHg.
Hypertension occurring in pregnant women is quite common and affects 5 to 10% of pregnancies. We speak of pregnancy-induced hypertension if it occurred after 20 weeks of amenorrhea and if the patient did not have hypertension before her pregnancy.
What are the risks of hypertension in pregnant women?
In some women, hypertension will disappear spontaneously a few weeks after childbirth without any other consequences for the mother or the baby. In some cases, the complications concerning the unborn child in the absence of care are a risk of intrauterine growth retardation (with a break in the growth curve) or prematurity.
The most dreaded complication is pre-eclampsia, which is a disease of pregnancy. It results from a dysfunction of the placenta. Without care, it can be fatal for the mother and the child. Pre-eclampsia affects only 1 to 2% of pregnancies. Of these cases, only 10% will be severe.
In France, pregnant women benefit from a monthly follow-up with a gynecologist or a midwife. On this occasion, a measurement of the blood pressure is carried out using a tensiometer. In case of hypertension confirmed twice, a urine test will be prescribed. Urine must be deposited on a strip. This makes it possible to evaluate the presence of proteins in the urine (in favor of an evolution towards pre-eclampsia), the glucose level (suspicion of gestational diabetes), the level of nitrites and leukocytes (in favor of a urinary tract infection).
What is the support?
If the hypertension is mild or moderate, the pregnant woman should rest as much as possible. Drug treatment is not systematic. His follow-up will be closer: consultations, biological check-ups and more regular ultrasounds. As the term approaches, an induction of labor can be discussed on a case-by-case basis.
If hypertension is severe, hospitalization is inevitable. Hypertensive drug treatment is started. The number of molecules that can be prescribed during pregnancy is limited: nicardipine, labetalol, nifedipine, alphamethyldopa.