How to Manage High Blood Pressure in Pregnancy (including Hypertension and Preeclampsia)

Introductory Explanation

High blood pressure during pregnancy is more common than many women realize, and it needs careful attention to keep both mother and baby safe. There are different types of high blood pressure in pregnancy. You might already have high blood pressure before getting pregnant (called chronic hypertension), or it can develop after 20 weeks of pregnancy (called gestational hypertension). The most serious type is preeclampsia, which combines high blood pressure with signs that your organs - especially your kidneys and liver - aren't working properly. Preeclampsia can happen suddenly, even if your blood pressure was normal just weeks before. Understanding these conditions and how to manage them can help protect you and your baby throughout pregnancy.

3 Important Facts About High Blood Pressure in Pregnancy

1. Preeclampsia Is a Medical Emergency That Needs Quick Action

Preeclampsia affects about 2 to 8 out of every 100 pregnancies worldwide, with 98% of these occurring in developing countries. It is one of the leading causes of maternal death and foetal loss. What makes it dangerous is that it can damage your liver, kidneys, brain, and other organs while also reducing blood flow to your baby through the placenta. This means your baby may not get enough oxygen and nutrients to grow properly. The condition usually appears after 20 weeks of pregnancy, most often in the last three months. However, it can also develop within the first 6 weeks after giving birth (called postpartum preeclampsia). Warning signs include severe headaches that won't go away, seeing spots or blurred vision, pain under your right ribs, sudden swelling of your face and hands, and difficulty breathing. If you experience any of these symptoms, go to the hospital immediately - don't wait.

2. Regular Antenatal Care Is Your Best Protection

Many women with preeclampsia don't feel sick at all in the early stages. This is why attending every antenatal appointment is crucial. At each visit, your healthcare provider will check your blood pressure and test your urine for protein - two key signs of preeclampsia. If you have risk factors such as previous preeclampsia, chronic high blood pressure, kidney disease, diabetes, lupus, being over 40 years old, carrying twins or triplets, or having a family history of preeclampsia, your doctor will monitor you even more closely. Some women are advised to check their blood pressure at home between clinic visits. If your readings are 140/90mmHg or higher on two separate occasions or a single reading of >160/100mmHg, this needs immediate medical attention.

3. Some Medications Can Help Prevent Preeclampsia in High-Risk Women

Research has shown that taking a small dose of aspirin daily (usually 75-81 mg, sometimes called "baby aspirin") can reduce the risk of developing preeclampsia by up to 24% in women at high risk. This works best when started between 12 and 16 weeks of pregnancy and continued until delivery or 36 weeks. Low-dose aspirin is safe during pregnancy and helps improve blood flow to the placenta. However, you should never start taking aspirin on your own - always discuss it with your doctor or midwife first. They will determine if you're at high risk and whether aspirin is right for you. In Nigeria, aspirin is affordable and widely available, making it an accessible preventive option for many women. Calcium has also been found to reduce the risk of developing preeclampsia, especially in women with low dietary calcium intake which is very common in Nigeria. Calcium reduces preeclampsia by up to 50% in women at high risk.

What Do Patients Need to Know About This Topic?

Know Your Risk Factors: Understanding your personal risk helps you and your healthcare team plan better care. High-risk factors include having had preeclampsia in a previous pregnancy, chronic high blood pressure before pregnancy, kidney disease, autoimmune diseases like lupus, diabetes (type 1 or 2), and carrying multiple babies. Moderate-risk factors include first pregnancy, being 35 years or older, having a body mass index over 30, family history of preeclampsia, and having a gap of 10 years or more since your last pregnancy.

Managing Chronic High Blood Pressure During Pregnancy: If you had high blood pressure before pregnancy, it's important to continue working with your doctor throughout pregnancy. Some blood pressure medications are not safe during pregnancy and will need to be changed. Never stop taking your medication without talking to your doctor first. Eating healthy foods (especially foods low in salt), staying at a healthy weight, managing stress, and avoiding cigarettes and alcohol all help control blood pressure. Your doctor may adjust your medication doses as your pregnancy progresses.

Treatment for Preeclampsia: There is no cure for preeclampsia except delivering your baby and placenta. If preeclampsia is diagnosed, your healthcare team will decide whether to deliver your baby immediately or try to manage the condition to give your baby more time to grow. This depends on how severe the preeclampsia is and how far along you are in pregnancy. If your blood pressure reaches dangerous levels (160/110 or higher), you'll need medication to lower it quickly. You may also receive magnesium sulfate injections to prevent seizures. If you're less than 37 weeks pregnant and the preeclampsia is not severe, your doctor may recommend bed rest, frequent monitoring, and hospital admission to watch you and your baby closely.

Life After Preeclampsia: If you had preeclampsia, your risk of developing high blood pressure, heart disease, and stroke later in life increases. This makes it even more important to maintain a healthy lifestyle after pregnancy - eating nutritious foods, exercising regularly, maintaining a healthy weight, and having your blood pressure checked regularly. Also, inform future healthcare providers about your history of preeclampsia, as this information is important for your long-term health care.

If You Could Share One Thing About This Topic With All the People of Nigeria, What Would It Be?

Attend every antenatal appointment and never ignore warning signs - preeclampsia can kill, but it can be managed if caught early. In Nigeria, where maternal mortality remains a significant concern, preeclampsia is one of the leading causes of death during pregnancy and childbirth. The tragedy is that many of these deaths are preventable with early detection and proper management. Unfortunately, some women skip antenatal visits due to cost, distance to health facilities, or believing they're only necessary if something feels wrong. But preeclampsia is often silent - your blood pressure can be dangerously high while you feel completely fine. By the time symptoms appear, the condition may already be severe. This is why regular check-ups are not optional; they're life-saving. Additionally, Nigerian women should not be afraid to advocate for themselves. If something feels wrong - severe headache, vision changes, severe swelling - insist on being checked immediately, even if your family or others tell you it's normal pregnancy discomfort. Trust your instincts. Your life and your baby's life depend on it. Remember: preeclampsia doesn't care about your age, education, or economic status - it can happen to anyone. But with proper antenatal care, awareness of warning signs, and quick action when problems arise, you can protect yourself and deliver a healthy baby.