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Gestational Hypertension?

post #1 of 6
Thread Starter 
Hi ladies,

Okay,, here's the low down. My blood pressure has been picture perfect my entire life (quite to the surprise of most health care professionals, considering I'm well in to the Obese category of BMI). Including all the way through this pregnancy, my first, up until 30 weeks.

Previously, my blood pressure was always 120/80, pretty much right on the dot every time. But before my 30 week midwife appointment, it was really hot out and I had a ton of errands to do so I was exhausted and voerheated and a bit stressed when I got to my appointment. That day my blood pressure was 124/84. Now, my midwife is a bit anti-fat and I feel a bit like she was waiting for something to go wrong. She made a big deal about the slight rise in blood pressure. In my head I wrote it off as her over reacting.

But, it bothered me. And it began to bother me more and more until I finally did some reading on it. I think that only got me more worked up, to the point that for my 32 week appt today, I was completely stressed out about my blood pressure. And of course my blood pressure was higher - systolic was at least, at 140/80.

So now, I have a bunch of questions. First of all, what will it actually mean for me and for the baby if my blood pressure stays high? What should I be worried about and watching for? What can I do to try to lower my blood pressure? Herbs, supplements, exercises, acupuncture? Any information or personal experiences would be much appreciated!
post #2 of 6
Here's what I have to say just as a perinatal nurse... I'm not a doctor or licensed midwife so dont quote me. But it's pretty accurate to my knowledge...

So I would say the 124/84 is normal and especially with your normal should not be an issue at all. 140 is a different story. Although your diastolic was still 80 (which is good) the fact that it can get to 140 is at least cause for noticing. if she's taking it right after you walk in, it could be a fluke if you were running late and stressed. If you were my patient at the hospital I'd retake it again every 10-15 minutes for an hour or so. If they came right back down after you were settled then I would expect for nothing to be done other than keep an eye out for any long term increases, especially in both the systolic and diastolic. ETA: a lot of docs will use an increase over baseline of 30/15 as a rough idea what's elevated. For my normally 90/60 pressures, 130/80 would be really high but not bad for someone else, kwim.

That being said, I would also make sure to check your urine for protein. if you were starting to spill protein then I might be more inclined to want to see your "PIH panel" labs- BUN, Creatinine, Uric Acid, CBC (mostly just platelets and hct), AST, ALT. If those were wacky and/or you were having other symptoms like pitting edema, brisk reflexes, headaches, visual disturbances, epigastric pain, then I would say you for sure would need further evaluation. Which would include a 12-24 hour urine collection for protein. To be actually diagnosed gestational hypertension, you need two elevated blood pressures more than 6 hours apart and abnormally high proteinuria. The other symptoms are suggestive but not diagnostic. If the baby starts measuring small I'd be worried.

I would suggest you continue/start to eat a high quality diet (dont avoid protein either) and get moderate exercise for 30+ mins 3+ (5 is better) times a week. I dont know a lot about alternative medicines/herbal treatments so I cant comment there.

I hope that helps a little!
post #3 of 6
Personally, I wouldn't worry about one high reading, especially at your appointment and since you were stressed. My blood pressure goes up high when I'm stressed. Normally, it's low, like 102/60, but in the first few weeks of this pregnancy when I was very worried about miscarriage (since I've had many) every time I had my BP checked at the doc's office, it was high for me, like 14-150/80+. Once I got out of the 1st trimester and started to relax my BP dropped back down to my normal. My dad seems to have the same issue, as do a lot of people. They get nervous or stressed just about going to the doc's office so their BP is higher than normal. Whenever my dad takes his BP at home, it's low but it's always high at the doc's office. If you are really concerned that your BP might stay up, you could try one of those home pressure cuffs. Take your BP several times during the day while you are at home and relaxed and see what the average is.

As far as having high BP alone during pg, I don't really know what the dangers of that are. I have always been told it's not just BP but also protein in urine. If you aren't dumping protein into your urine, maybe it's not such a big deal. Eat lots of protein. Try to get at least 80 grams a day but 100 is better. Drink lots of water and exercise (walk) if you can.
post #4 of 6
Thread Starter 
She did check for protein in my urine and there wasn't any, so I guess that's a good sign. I also haven't had any of the other warnings signs - headaches or blurred vision or sudden swelling or any of that.

I am thinking maybe a home blood pressure cuff would be a good idea. My midwife also offered to meet me on the weekend if DH and I were in town and take my BP then (maybe I'd be less stressed).

Increased protein intake - that I can do smile.gif I'll have to make more of an effort to walk on my lunch breaks at work.

Thanks for the input!!!
post #5 of 6
the dangers of gestational hypertension are mostly related to endothelial damage. So your blood vessels start to not work as well, which causes less elasticity (hence the blood pressure increase) and damage to the vessels in your kidneys (the protein leaking out when normally it wouldn't). The biggest risks are that the vessels feeding the placenta start to harden and not work as well leading to small infarcts which cause the baby to get less nutrients/oxygen. That's why I said I'd be worried if the baby started measuring small or dropping off the curve. In worst case scenarios, there is bad enough damage to decrease supply to you too which causes seizures (eclampsia). That's the big thing you try to avoid when it gets bad enough to start causing HELLP and the other symptoms (visual changes etc.).
It wouldnt hurt to check your BP's at home just to get a good baseline. Write them down too. It doesn't sound like you have gestational hypertension but now is the time gestation wise that it really starts ramping up so I'd say keep an eye on them but dont be worried or stressed.
post #6 of 6

I have gestational hypertension. This is my 3rd pregnancy, first time I've had it. I have a home cuff, but it's not the best way to be monitored. When you are at home you are typically at your most relaxed. So let's say at home you are getting 120/80 at home-that means you could be walking around at 130/90 or stressing over traffic at 140/95, or arguing with your spouse at 150/100 kwim? That's the way my midwife and ob put it to me anyway. Those spikes still can cause damage. 


At this point in pregnancy, I'm having weekly NSTs to make sure the baby is doing well. So far, so good. I'm currently in the middle of a 24 hour urine collection to check for pre-e, but they are doubtful that I have pre-e.


Besides what a PP mentioned, one of the other dangers is you are at a much higher risk for a placenta detaching. My ob is going to be inducing me at 40 weeks.

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