High blood pressure Hypertension causes, signs, symtoms, complications, diagnosis, treatment
 
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How are women with gestational hypertension and chronic hypertension treated?
Most of these women have successful pregnancies. Their health care providers monitor their blood pressure and urine carefully for signs of preeclampsia or worsening hypertension. Tests such as ultrasound and fetal heart rate testing may be recommended to check on fetal growth and well-being. If tests are normal, they may not need to be repeated unless the mother’s condition changes. The provider may recommend that the pregnant woman cut back on her activities and avoid aerobic exercise.

Can a woman with preeclampsia have a vaginal delivery?
A vaginal delivery is preferable to a cesarean for a woman with preeclampsia because it avoids the added stresses of surgery. It generally is appropriate for women with preeclampsia to have epidural anesthesia for pain relief during labor and delivery.

Women with severe preeclampsia or eclampsia generally are treated with a drug called magnesium sulfate to help prevent seizures during labor and delivery. It is less clear whether women with mild preeclampsia benefit from this drug.

What causes preeclampsia and who is at risk?
Doctors do not know what causes preeclampsia. However, women are more susceptible if they have any of these risk factors1,3:

  • First pregnancy
  • Family history of preeclampsia
  • Personal history of chronic high blood pressure, kidney disease, diabetes, systemic lupus erythematosus (a disease often characterized in its early stages by arthritis-like stiffness, a butterfly-shaped rash across the nose and cheeks, fatigue and weight loss), and certain thrombophilias
  • Multiple pregnancy
  • Age less than 20 years, or over 35
  • African-American
  • Higher than normal weight
  • Personal history of preeclampsia

Is preeclampsia likely to recur in another pregnancy?
Women who have had preeclampsia are more susceptible to developing it again in another pregnancy. The risk of recurrence appears to be highest when preeclampsia has occurred before the 29th week of gestation and, in some cases, may be as high as 65 percent in another pregnancy.5 About 20 percent of women who have developed preeclampsia after the 37th week of pregnancy develop it again.5

Can preeclampsia and gestational hypertension be prevented?
Currently, there is no way to prevent preeclampsia or gestational hypertension. However, a 1999 British study suggested that some high-risk women (including women who had preeclampsia in a previous pregnancy) may be able to reduce their risk of preeclampsia by taking vitamins C and E through the second half of pregnancy.6 The high-risk women who took the vitamins reduced their risk of developing preeclampsia by about 75 percent. The researchers caution that more studies are needed before this treatment can be widely recommended. Other treatments that looked promising in early studies (such as aspirin and calcium) have not proven helpful in preventing preeclampsia.

Does the March of Dimes fund research on preeclampsia and other forms of high blood pressure in pregnancy?
The March of Dimes has supported a number of studies aimed at improving understanding of the causes of preeclampsia and at improving treatment for this and other types of high blood pressure in pregnancy. Recent grantees have been seeking to identify genes that may play a role in preeclampsia to identify susceptible women earlier in pregnancy and, ultimately, devise ways to prevent this disorder. Another grantee has been investigating whether certain fatty acids found in fish, such as salmon and mackerel, may help reduce the risk of preeclampsia.
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