Postpartum hypertension can cause headaches, blurred vision, and sensitivity to light. We explain what this problem is about and figure out if it is possible to prevent it.
Postpartum hypertension, as its name suggests, is the increase in blood pressure above normal after delivery. It can be referred to as postpartum preeclampsia, although for this the presence of protein in the urine should be verified.
Postpartum hypertension usually develops shortly after the baby is born. However, in some cases it does not appear for 6 weeks or more. It is suffered, in its great majority, by women who have a previous history of high blood pressure.
The problem is that this condition carries serious complications and even puts the mother’s life at risk. Therefore, in this article we explain everything you need to know about postpartum hypertension and how it is treated.
What is postpartum hypertension?
Postpartum hypertension is a rise in the mother’s blood pressure after the baby is born. Specifically, it occurs during the puerperium stage. This stage includes from birth until after about 40 or 42 days.
It affects women who are already diagnosed with high blood pressure before or during pregnancy. Blood pressure is considered high when it exceeds the values of 140 millimeters of mercury (mmHg) for systolic pressure and 90 mmHg for diastolic pressure.
It is also more common in those women who have suffered pre-eclampsia or eclampsia during pregnancy. However, its appearance in any mother is not ruled out. That is why it is important to keep it in mind and know its symptoms.
In fact, as an article in the BMJ states, arterial hypertension affects between 6 and 10% of all pregnant women. The problem is that there are few studies dedicated to differentiating the incidence of postpartum hypertension as such.
It is important to emphasize again that the terms hypertension and postpartum preeclampsia are often used interchangeably. Both are hypertensive disorders. The main difference is that high amounts of protein are excreted in the urine in preeclampsia.
The hypertensive pictures of pregnancy are complex. They require continuous care during pregnancy because they increase the risk of postpartum hypertension.
Symptoms and associated risks
Both high blood pressure and postpartum preeclampsia can be difficult to identify. The reason is that, in most cases, the symptoms are very nonspecific.
As we have noted before, hypertension can appear shortly after giving birth or at any time during the puerperium. That is, during the first 40 days. According to specialists from the Mayo Clinic, one of the most common signs is a headache.
When blood pressure is very high or remains elevated over time, other symptoms usually appear. For example, vision changes. Some women suffer temporary loss of vision, blurred vision or hypersensitivity to light.
In the case of postpartum preeclampsia, there is also usually a decrease in the need to urinate and the amount of urine excreted. Also, protein can be elevated in the urine. There may also be pain in the upper abdomen.
What Causes Postpartum Hypertension?
The causes of postpartum hypertension are not well known. Blood volume overload is known to occur during pregnancy. This causes a tendency for blood pressure to increase and also for edema to appear, that is, accumulations of fluid in the soft tissues.
It appears that after delivery all the fluid in the extravascular space is reabsorbed and occupies the blood vessels. Therefore, the pressure that is produced against the arterial walls increases.
However, a number of factors have been identified that increase risk. The first thing is to have chronic high blood pressure. That is, the mother was already hypertensive before she became pregnant.
The same is true if blood pressure increased in a previous pregnancy or if there was pre-eclampsia. Finally, diabetes and obesity have a significant influence on postpartum hypertension.
Possible complications
Postpartum hypertension and preeclampsia can lead to serious complications. One of them is eclampsia, which consists of the appearance of damage to the rest of the body’s organs, such as the brain and kidneys. Eclampsia causes seizures.
There may also be pulmonary edema and thromboembolism. Pulmonary edema is the excessive accumulation of fluids in the lungs, which alters gas exchange. Thromboembolism, on the other hand, consists of the obstruction of a blood vessel by the presence of a clot.
According to a Cochrane publication, postpartum hypertension can lead to strokes. What happens is that a part of the brain stops receiving oxygenated blood.
Diagnosis and treatment of postpartum hypertension
Postpartum hypertension can go unnoticed. Therefore, the most important thing is to try to control your blood pressure figures.
In the case of a history of pre-eclampsia, postpartum medical follow-up is important. Urinalysis is usually done to differentiate postpartum hypertension from preeclampsia.
It is essential to establish a treatment to lower blood pressure. So-called antihypertensive drugs are often used. For example, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor antagonists (ARBs).
They are drugs that are considered safe while breastfeeding. However, they should always be indicated and prescribed by a specialist.
In some cases, drugs are also prescribed to prevent seizures. The main one is magnesium sulfate. It is used in women who have postpartum preeclampsia with severe symptoms.
Safe medications during breastfeeding to lower blood pressure values should be prescribed by a professional.
Can postpartum hypertension be prevented?
Postpartum hypertension is not always preventable. There are predisposing factors that cannot be changed, such as personal history or even age. However, there are many other aspects that can help reduce the risk of suffering from it.
It is recommended to lead a healthy lifestyle before, during and after pregnancy. Diet is a fundamental aspect. It should be a varied diet, do not abuse salt, alcohol or foods rich in saturated fat.
It is also advisable to maintain a suitable weight and perform moderate exercise frequently. In women who are identified at high risk of pre-eclampsia or hypertension, aspirin in regular doses may be recommended.
A risk disorder
Postpartum hypertension is a condition with a true incidence that is unknown, because it often goes unnoticed. The problem is that, if left untreated, it can lead to serious complications. For example, strokes.
Also, many times it is postpartum preeclampsia and not just hypertension. It is a situation that increases the risk even more. Mothers diagnosed with pre-eclampsia usually require a longer admission after delivery. That is why it is important that these women have good support from the people around them.
