Blood pressure during pregnancy

One of the first questions of the obstetrician-gynecologist, when registering a future mother at the antenatal clinic, is the blood pressure figures that are normal for the patient in everyday life. Does she belong to the ranks of hypotensive or hypertensive patients, since the pressure during pregnancy is an indicator of the quality of the course of this period.

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Normal blood pressure during pregnancy

From the very moment of conception, the female body undergoes colossal changes, the load on all vital systems of the expectant mother increases and one of the signs of the absence of pathological changes that can affect the development of the fetus can be called pressure during pregnancy.

Significant fluctuations in blood pressure can cause irreparable harm to both the physical and psychological development of the future human being. It can change, but the digital values should remain within the limits: upper (systolic) 90 – 120, lower (diastolic) 60 – 80 mm Hg - this is normal pressure during pregnancy.

Therefore, at each consultation with a doctor, blood pressure is measured and entered into the exchange card. If the deviations are significant, the obstetrician-gynecologist immediately takes measures. It will be great if the pregnant woman can independently control it at home. Your own records should be shown to your doctor.

It is not out of whim that gynecologists recommend women to register no later than 12 weeks. The first trimester of fetal development is very important. At this time, the female body is completely rebuilt, preparing for future birth. The fetus develops at a rapid pace. During the first trimester, all the organs of the future person are laid down and any failure in the program is fraught with further pathology, often leading to disability, or even death.

[6], [7]

Low Blood Pressure During Pregnancy

If a woman's comfortable blood pressure is 120/80 mm Hg, the baby will also be comfortable in this state in the womb. A decrease in blood pressure to 100/65 mm Hg is already stressful for both the mother and the baby (if the mother is hypotensive and such figures are normal for her, then the baby will feel and develop normally).

What are the consequences of low blood pressure during pregnancy?

• With hypotension, the speed of blood movement in the cardiovascular system decreases. Blood is a "vehicle" for oxygen and other nutrients necessary for the proper functioning of the mother and child. A decrease in the speed of blood circulation leads to their deficiency, which provokes the progression of hypoxia (oxygen starvation). Lack of oxygen in the cells of the uterus is directly related to pathological changes in the formation of the fetus and problems during the birth process itself.
• The placenta is the "dining room" for the fetus, where it gets all the nutrients and oxygen. A decrease in the rate of blood circulation in it leads to placental insufficiency. There is a failure in the development of the fetus, the baby begins to suffocate.
• If the problem is ignored, hypoxia can lead to spontaneous abortion in the late stages of pregnancy and gestosis (complex disorders of body functions).
• Hypotension can provoke collapse. This condition leads to fetal death and severe pathology in the woman.

Reasons

First trimester. For this period, a slight decrease in blood pressure is normal. The reasons for low blood pressure during pregnancy are hormonal changes in the female body, preparing to bear and give birth to a healthy child. Progesterone begins to be produced more intensively, which has a relaxing effect on the uterine muscles, preventing spasms, and, accordingly, miscarriage. But the walls of blood vessels are exposed to the same effect. Reacting to progesterone, the cross-section of the vessels expands, which in turn leads to a decrease in the rate of blood circulation, and hence to a drop in pressure, a deficiency of nutrients and oxygen in the organs and systems of both the pregnant woman and the fetus.

Representatives of the fair sex who have a history of vegetative-vascular dystonia, which provokes vascular instability, as well as anemia caused by voluntary or forced dietary restrictions, are more prone to hypotension.

It is worth avoiding conflicts, watching “stressful” programs and films.

Severe bleeding or dehydration can also cause hypotension during pregnancy.

Symptoms

There is nothing to worry about in blood pressure fluctuations if the amplitudes do not cross the threshold of normal values. When the numbers are below the permissible values, symptoms of hypotension during pregnancy begin to appear:

• Periodically observed fainting.
• Morning nausea gradually begins to be felt throughout the day.
• Decreased vitality, drowsiness.
• Tinnitus.
• Decrease in working capacity.
• There is a feeling of lack of air.
• A pre-fainting condition, accompanied by dizziness and darkening of the eyes.
• Head pain.

Diagnostics

It is desirable to have such a device as a tonometer in any family, then the diagnosis of low pressure during pregnancy will be easy. Having a little experience, a pregnant woman can take measurements on her own. If the patient encounters difficulties when using a mechanical tonometer, it is worth buying its electronic version. Here, no special skills are needed, and no outside help is required.

A wide range of different modifications will allow you to acquire a compact travel device or a device with a memory function, which is effective in tracking changes in blood pressure over time.

It is necessary to measure blood pressure daily (morning and evening at a certain time). If discomfort or doubts arise, it is advisable to take measurements several times a day. Blood pressure readings at home are more informative, since the pregnant woman is in a familiar environment. In the queue for an appointment with an obstetrician-gynecologist, a woman may feel tired or nervous, which will immediately affect the measurement result.

How to measure your blood pressure correctly? You need to measure your blood pressure in a calm state, if the pregnant woman is excited, you should relax and bring yourself back to normal.

• Take a chair with a comfortable back and sit on it, leaning your back. Put your hand on the table.
• Place the tonometer cuff on your arm above the elbow. Fix it so that a finger can fit between the arm and the cuff.
• Next, depending on the model and type of tonometer, follow the instructions.

Treatment

How to raise blood pressure with hypotension? Treatment of low blood pressure during pregnancy usually comes down to non-drug therapy.

• Daily routine with 10 hours of sleep.
• Diet adjustments: berries, vegetables and fruits, fruit and vegetable juices. Food rich in vitamins, protein, minerals and microelements. The food is balanced and varied.
• Increase salt intake to 7-9 grams per day. This will make the pregnant woman drink more fluids and, accordingly, stimulate blood circulation. Just don't overdo it, to avoid swelling.
• A small amount of coffee.
• Hot tea.
• Don't jump out of bed abruptly after resting. You should first lie down, already awake, sit up slowly, then get up slowly.
• A contrast shower ending with an icy stream.
• Walking in the fresh air and toning exercises are effective for maintaining physical fitness and restoring the elasticity and firmness of blood vessels.
• When resting, place a high pillow under your head.
• In case of nausea attack, it is necessary to take a lying position, raising the legs above the head. This will help to achieve the outflow of blood from the extremities to the brain.
• You should not lie on your back for long periods of time, especially in the later weeks of pregnancy. In this case, the growing fetus presses on the genital artery with its increasing mass, which worsens the blood flow to the mother's heart.
• Multiple acupuncture massages are beneficial, activating the work of various organs.
• It would be a good idea to master the technique of correct breathing, which allows you to saturate your blood with oxygen as much as possible.
• Take a deep, strong breath in and exhale actively.
• Hold your breath for 15 seconds.
• Do six breathing exercises.
• Perform breathing procedures three times a day.
• Three to four weeks of daily exercise is enough to eliminate this problem.
• Aromatherapy with essential oils of basil, laurel and rosemary.

In case of more significant deviations in blood pressure, medications are used. It is not recommended to use dihydroergotamine or etilephrine in this case. Their side effects include negative effects on the fetus.

Gutron. Prescribed only by a doctor after a detailed study of the anamnesis. Prescribed to take 2.5 mg in the morning and evening, if necessary, add a third dose.

Cortineff. This drug can adversely affect the endocrine system of the expectant mother. Therefore, only a doctor can assess the need for its use. The dosage is prescribed individually. The drug is taken after meals with plenty of water. From 100 to 200 mcg three times a day.

Recently, medications containing succinic acid have been used to raise blood pressure. Such medications stimulate vital forces and activate cardiac activity.

Ethylphrine (Effortil). The drug is taken orally at 5 mg two to three times a day. In case of a critical drop in blood pressure or if it is necessary to achieve quick results, a 1% solution of the drug is injected under the skin or into the muscle at 1 to 2 ml. If medically necessary, the procedure is repeated after two hours.

Treatment of hypotension during pregnancy can also be done using folk remedies.

• Introducing celery root into your diet, preferably fresh (salads).
• Strawberries. They promote the growth of hemoglobin and normalization of blood pressure.
• Onion broth. Put an unpeeled onion (with the husk) into half a liter of water. Boil for a quarter of an hour. Drink 100 grams throughout the day in small sips.

Prevention

If there are no significant pathological changes in the pregnant woman’s medical history, then it is possible to maintain normal blood pressure without much effort.

• To stop fainting, it is worth reviewing your diet. It is necessary to focus on protein products, diversify the diet. Make meals frequent, but in small portions.
• Long walks in the fresh air.
• Regulating weight gain.
• Avoid stress.
• Morning green tea is recommended.
• Keep to a daily routine: alternating rest and exercise.
  • At least 10 hours of sleep at night.
  • Two-hour daytime rest.
• Contrast shower.
• Swimming in the pool.
• Continuous monitoring of blood pressure.
• It is also worth undergoing a medical examination, as low blood pressure can be caused by diseases (for example, gastric ulcer or pituitary dysfunction). In this case, prevention of low blood pressure during pregnancy comes down to treatment or supportive therapy of the diagnosed disease.

[8], [9], [10]

High blood pressure during pregnancy

The pathology of reverse hypotension is hypertension - high blood pressure during pregnancy. This is a very alarming symptom in this condition. Hypertension indicates that the blood vessels are spasmodic. The flow section is narrowed, which does not allow the blood to be pumped in the required volume, and with it, nutrients and oxygen do not reach the vital systems and organs of the mother and child, which causes fetal development pathology, early placental abruption and premature birth. The consequences for the body of the expectant mother are also unpredictable.

If measures are not taken in time, hypertension can worsen and lead to preeclampsia, a form of late toxicosis that is life-threatening for both the child and its mother.

Even one attack of high blood pressure is enough to go to the hospital for examination. It is necessary to identify the cause and take measures for adequate treatment.

One of the dangerous diseases caused by long-term hypertension is gestosis. Its clinical manifestations are high systolic pressure, swelling and protein in the urine. Diagnosing this disease is a bad sign. There is a failure in the permeability of blood vessels, which causes fluid to penetrate into the tissues, while protein goes into the urine, and with it from the pregnant woman's body. Emergency medical measures are necessary. Otherwise, it is necessary to artificially terminate the pregnancy.

Therefore, it is necessary to constantly monitor blood pressure.

Causes

Pathological increase in blood pressure is said to occur when systolic readings exceed 140 mm Hg. But one should not be so categorical. After all, if before pregnancy a woman felt fine with readings of 90/70 mm Hg, then a reading of 120/90 can already be considered critical.

The causes of hypertension during pregnancy are as follows:

• Chronic hypertension even before childbirth.
• Neuroendocrine diseases:
  • Diabetes mellitus.
  • Thyroid pathology.
  • Adrenal problems.
  • Vegetative-vascular dystonia of the hypertensive type.
• Neuralgia:
  • Encephalitis.
  • Myelitis.
  • Spinal cord or brain injury.
• Kidney and heart diseases.
• Hereditary pathology.
• Constant stress and nervousness.
• Smoking and alcoholism.
• Overweight, obesity.
• "Poor", unbalanced nutrition.
• Sedentary work.
• Sedentary lifestyle.

Symptoms

As in normal life, the symptoms of high blood pressure during pregnancy are similar.

• Ringing noise in the ears.
• Headaches of varying intensity and localization.
• Flies start to fly before your eyes and your vision deteriorates.
• Dizziness.
• The work of the sweat glands is activated.
• Tachycardia (rapid heartbeat).
• Arrhythmia (abnormal heart rhythm).
• Nausea not only in the morning, but also throughout the day.
• Redness of the skin.
• Pain in the abdominal area.

Diagnosis

At any visit to the obstetrician-gynecologist, the expectant mother's blood pressure is measured with a tonometer. This is the only, but quite simple, diagnostic of high blood pressure during pregnancy. The symptoms mentioned above also help in making a diagnosis.

Laboratory tests are also performed to check blood clotting parameters, the number of red blood cells, and the biochemistry of liver enzymes. A clinical urine test is prescribed.

In order not to miss a pressure surge, a pregnant woman should buy a tonometer for herself. Taking readings daily and recording them in a diary, the resulting statistics should be shown to the doctor at the next scheduled visit.

Treatment

First of all, in order not to miss a critical moment, the expectant mother should register with a doctor at the antenatal clinic in time, not miss scheduled examinations and consultations. Diagnosis and treatment of high blood pressure during pregnancy begins when at least one surge in blood pressure is recorded.

• First of all, the diet is adjusted. Food should contain the necessary vitamins and microelements. Thrombus-forming products are excluded from the diet. Sweets, smoked foods, salty and fatty foods are reduced in quantity or completely eliminated.
• The daily routine is also subject to correction. The loads should be insignificant, a walk in the fresh air is obligatory.
• Swimming and water treatments are effective.
• If such correction does not bring significant results, the doctor resorts to drug treatment, trying to prevent further complications.

In this case, the following medications are often prescribed:

Nifedipine. The doctor prescribes the medicine, dosage and duration of the course individually for each pregnant woman.

The introduction of Nifedipine is not associated with food intake. The drug is administered orally at 10-30 mg three to four times a day, but the daily dosage should not exceed 120 mg. The course of treatment is from one to two months.

To relieve a hypertensive crisis, 10 mg of the drug is taken under the tongue (sublingually). The patient should lie down for half an hour to an hour. If a medical need arises, the drug can be taken again after 20-30 minutes. If necessary, the dosage is increased to 20-30 mg.

Metoprolol. The drug is administered orally at a dose of 100 mg per day in one or two doses. If medically indicated, the daily dosage is increased to 200 mg. When administering metoprolol as an intravenous injection, the dose is 2-5 mg. If necessary, repeat the injection after five minutes. The maximum daily dosage when taken orally is 400 mg, a single intravenous dose is 15-20 mg.

Retard. The drug is taken orally before meals with a small amount of water. Dosage 60 - 120 mg three times a day. The maximum daily dosage should not exceed 360 mg.

Hydralazine. Initial dosage is 10-25 mg two to three times a day. The amount of medication is gradually increased. The dosage can be increased to: single dose - 100 mg, daily dose - 300 mg. Duration of treatment is from two weeks to a month. The drug is discontinued gradually.

Taking the drug may cause side effects:

• dizziness and headaches,
• swelling,
• nausea, turning into vomiting,
• lacrimation and sweating,
• tachycardia.

The drug hydralazine is absolutely contraindicated for people with hypersensitivity to its components, with a history of gastric ulcers, cerebral and cardiac vascular pathology.

All medications prescribed by the obstetrician must be absolutely harmless to the baby growing in the womb. Therefore, in order to reduce blood pressure, in the case of treating hypertension during pregnancy, do not use diuretics that work effectively at other times. Drugs that have diuretic properties reduce the degree of blood circulation and can lead to a deficiency of oxygen and nutrients in the placenta, which inhibits fetal development. The worst case scenario is that the placenta begins to be rejected. Therefore, in no case should you self-medicate.

Over many centuries, people have collected their own recipes to combat hypertension during pregnancy. It should be noted that they should also be taken with the consent of the supervising obstetrician-gynecologist. Complex treatment is most effective.

• Cranberry juice. Wash half a glass of berries thoroughly and squeeze out the juice. Place the resulting pulp in hot water and boil for no more than five minutes over low heat. Strain. Add three teaspoons of semolina to the resulting liquid. Put on low heat for another 10-15 minutes, stirring constantly. Add four tablespoons of sugar, after boiling, remove from heat. Beat the boiled mass in a blender, gradually adding cranberry juice. Take the resulting medicine several times a day, three teaspoons at a time.
• Corn grits. Get corn flour by grinding the grits in a coffee grinder. Dilute half a glass of flour with one glass of warm water. Let it brew for 24 hours, stirring occasionally. Take the “medicine” before meals, two tablespoons at a time.

Prevention

The above-mentioned folk medicine recipes can also be used as a preventative measure against high blood pressure. In addition, the prevention of high blood pressure during pregnancy includes other recipes and methods of influencing the body.

• Acupuncture:
  • Visually divide the cervical spine into three equal parts. In these places, stepping back from the spine in different directions (horizontally), find three pairs of points. Alternately act on each pair, pressing (with the pads of the thumbs of both hands) both points of the pair simultaneously for 10 seconds. Go over each pair of points three times.
  • Find the junction of the head and neck (the place where they connect). With the pad of the thumb of your right hand (if you are left-handed, your left hand) find the pain point "at the bottom" of the occipital fossa. Press on it and mentally count to ten. Break contact. Perform this manipulation twice.
  • Find the solar plexus (the central point of divergence of the "wings" of the chest along the midline of the abdomen). Bring together the ring, middle and index fingers of both hands and simultaneously press on the found point. Hold for 10 seconds. Release. Do 10 approaches to this manipulation.
  • Feel anxious and nervous. Massage the anti-stress point located in the middle of the chin. Massage with your index finger. First, nine circular movements clockwise, then nine circular movements counterclockwise.
• Birch sap, which should be taken one glass daily, also has a good blood pressure-lowering effect.
• Freshly squeezed beet juice. Take half an hour before meals. Take half or a quarter of a glass of liquid, after keeping it in an open container for two hours.
• Pumpkin decoction with honey. Grind 200 grams of pumpkin pulp and boil over low heat until soft. Throw in a colander or sieve. Cool. Mash and add a little honey.

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Pressure surges during pregnancy

It is not uncommon for blood pressure to fluctuate during pregnancy. For example, it is low in the morning, reaches high values by lunchtime, and then drops again by evening.

Symptoms of sudden blood pressure surges:

• Throughout the day, the tonometer shows numbers that are either higher or lower than normal, or normal.
• Dizziness and nausea are suddenly replaced by a wave-like rush of blood to the limbs and head.
• The body is sometimes cold, sometimes hot.
• It gets dark before your eyes and “gnats” start flying around.

This pathology is very dangerous and can not only push the body to hypoxia, but also, if the problem is ignored, lead to the death of the fetus. For a woman, this is fraught with serious heart problems, stroke.

Causes

In most cases, the causes of pressure surges during pregnancy are rooted in heredity, unbalanced nutrition (excessive consumption of fatty, salty and sweet foods), improper organization of the day, as well as complications during pregnancy.

Other reasons for pressure surges during pregnancy may include:

• Lack of fluid intake (affects blood density). Therefore, every pregnant woman should determine her daily fluid intake. Do not deprive the kidneys of work or overload them.
• Pathological changes in the heart.
• Increased fluid intake (causes hypertension, swelling, and makes breathing difficult).
• Severe condition of the vascular system.
• Change in blood formula.
• Stressful situations.
• Increased physical activity.
• High intracranial pressure.
• Deficiency of oxygen in the blood. Long walks in the fresh air are recommended.

Especially dangerous is the sudden pressure directly during labor. Sharp changes in blood pressure can provoke the cessation of labor, cause profuse bleeding, lead to a heart attack. Therefore, you should not leave this situation to chance, but self-medication is not the best way out of this situation.

Diagnosis and treatment should take place under the constant supervision of an obstetrician-gynecologist.

Treatment

If there is a sharp change in blood pressure during the day from low to high figures and back, treatment of pressure surges during pregnancy is carried out only in a hospital setting. In this case, the diet and fluid intake are adjusted. Multivitamins and medications of a supportive nature are prescribed. They do not directly affect the tonometer readings, but by providing adequate nutrition, they stabilize the functioning of the entire body and the vascular system in particular.

• You can balance the jumps by massaging acupuncture points (the exercises are described above).
• Oxysize breathing exercises (four-stage diaphragmatic breathing):
  • Take a deep breath through your nose, filling your “belly” with air. The gluteal muscles are tense.
  • Contracting the muscles of the lower abdomen, take three breaths, filling the lungs with air to capacity.
  • Exhale through the small space created between the compressed lips. Try to draw your stomach under your ribs while exhaling.
  • At the end, make three sharp exhalations of air, emptying the lungs as much as possible.

Herbal infusions based on Rhodiola rosea, ginseng, and eleutherococcus will also help normalize blood pressure.

Prevention

A simple, but the only prevention of pressure surges during pregnancy is constant monitoring of blood pressure, reducing physical activity, and normalizing the psycho-emotional state of the expectant mother.

Reasonable alternation of loads and hours of rest, balanced nutrition, long walks in the fresh air in combination with constant monitoring of blood pressure will minimize the harmful effects of blood pressure surges on the body of a woman and the future human being, and if necessary, an obstetrician-gynecologist will be able to promptly take adequate measures. By monitoring blood pressure during pregnancy, you can always be sure that your child's health and your own are in good hands.

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