Preeclampsia: Spot high blood pressure symptoms during or after pregnancy

High blood pressure is a serious health concern. In the U.S., cardiologists and family practice doctors regularly check for high blood pressure and discuss it with patients. Obstetricians check blood pressure in their patients weekly at the end of pregnancy. But women who have recently given birth aren’t as likely to get the recommended follow-up they need. 

High blood pressure (hypertension) that occurs during pregnancy is called preeclampsia. While the exact number of women who develop preeclampsia is unknown, some estimates suggest that it affects approximately 3.4 percent of pregnancies in the U.S. When blood pressure reaches greater than 160/110, it’s considered a medical emergency that requires treatment to prevent severe complications, such as stroke or bleeding in the brain. In fact, severe hypertension is among the leading causes of maternal death in Texas and across the country. 

In the field of obstetrics, there’s been an increased focus on how health care providers should address treatment of high blood pressure during pregnancy and following delivery. A large part of the discussion is doing a better job of educating patients about the symptoms of preeclampsia. But information on the subject is sparsely distributed and tends to be shuffled into the stacks of literature we send home with pregnant women and new mothers who often are focused more on their babies’ health than their own.

Health care providers need to do a better job of educating patients about the symptoms of preeclampsia. It’s vital that women know what to look for and that they seek help quickly if symptoms arise.

What are the symptoms of preeclampsia?

Preeclampsia symptoms can be vague and easy to dismiss as expected body changes. During pregnancy, many women will experience these symptoms. But if any arise suddenly or are noticeable by someone who sees you regularly, contact your doctor right away:

● Headache: A headache that persists after a dose of acetaminophen or ibuprofen could indicate very elevated blood pressure or even swelling or bleeding in the brain.

● Pain in the right upper quadrant of the abdomen: Pain in this area that doesn’t go away after taking an antacid could indicate swelling of the liver.

● Shortness of breath: Acute shortness of breath always warrants a call to the doctor or a trip to the hospital because of concerns such as an increased risk of blood clots. Extra fluid in the chest also can be caused by high blood pressure or problems with your heart.

● Swelling of the hands and face: A sudden increase in swelling could indicate that you are retaining fluid.

● Visual changes: You might have blurred vision or see sparkly lights in your visual field.

Related reading: Preeclampsia can strike suddenly during pregnancy

Sometimes women feel well even though they’re hypertensive. This can be a problem because if you don’t know you’re ill, it’s unlikely you’ll seek the help you need. This is especially true if your blood pressure begins to rise in the weeks after delivery.

Hypertension can strike after delivery

During the hospital stay after delivery, nurses and doctors will watch your blood pressure, which can rise during delivery and shortly thereafter. But once blood pressure goes down to normal, which for healthy people is lower than 120/80, too often providers assume everything is fine. The truth is that blood pressure can start to rise again in the days after delivery, so it’s important to have your blood pressure checked a week to 10 days after delivery. Some women need medication to control their blood pressure for a period of time after they have a baby.

Hypertension after delivery can happen even if you didn’t have high blood pressure before or during pregnancy. No woman should think, “I didn’t have high blood pressure when I had the baby, so I shouldn’t have any concerns now.” In fact, these women might be at the biggest disadvantage because it’s not even on their radar.

The people surrounding new moms after delivery must be aware of the signs of hypertension. If you notice a physical change or if the woman mentions a symptom, don’t write her off. Urge the woman to call her doctor or nurse – trust me, we won’t be bothered or annoyed. We absolutely prefer that patients call and come in to be seen rather than waiting out their symptoms.

I know going to an extra doctor appointment can be annoying and time-consuming during or after pregnancy. But the consequences of not putting your own health first can be dire. In order to be healthy for your newborn, make time to learn about preeclampsia symptoms and, if you notice them, call your doctor or nurse right away.

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