Features of pregnancy management in hypertension

2 min. to read

26 October 2018 (upd. 04 July 2025)

Content

What examinations does a pregnant woman with hypertension undergo Genera Advantages of contacting the EMC

pregnancy management in hypertension Pregnancy with hypertension is not contraindicated, even if a woman is constantly taking medications to maintain normal blood pressure levels. However, it must be borne in mind that a number of medications are unsafe during gestation, so they must be replaced at the stage of preparation for pregnancy.

In the case of good blood pressure control, the prognosis for pregnancy is favorable.

What examinations does a pregnant woman with hypertension undergo

For women with arterial hypertension, the basic examination protocol does not differ from the standard one. Additional and mandatory are consultations with a cardiologist and daily monitoring of blood pressure.

The risks of pregnancy with elevated blood pressure

If there is a persistent increase in blood pressure before pregnancy, hypertension is diagnosed.

There are situations when the patient has never had problems with blood pressure before pregnancy, but during pregnancy the pressure begins to rise. An increase in blood pressure before the 20th week of pregnancy indicates the development of gestational hypertension. And if elevated blood pressure levels are detected after 20 weeks of pregnancy, additional tests should be performed to rule out preeclampsia.

Hypertension that exists before pregnancy or first appears during pregnancy is a risk factor for preeclampsia and premature birth. In this regard, additional preventive measures are recommended for pregnant women with an established diagnosis.

Regardless of the time of occurrence, safe and approved medications are used to normalize blood pressure.

Genera

Arterial hypertension is not a direct indication for caesarean section. In the absence of complications, a patient with elevated blood pressure can give birth through the natural birth canal, with mandatory pressure monitoring and with the use of epidural anesthesia.

If obstetric complications develop and blood pressure is not amenable or difficult to correct, a cesarean section is performed in the interests of the patient's health.

Special attention

The main criterion for arterial hypertension is an increase in blood pressure to 140\85 mmHg. However, during pregnancy, blood pressure normally decreases and already at numbers from 130\85 Mhg, hypertension can be expected to develop.

It is very important for a pregnant woman to self-monitor blood pressure in situations of worsening well-being: headaches, nausea, decreased visual acuity, dizziness, etc. In case of any deviations from the norm, it is necessary to consult your doctor.

General recommendations

The effectiveness of medical care largely depends on its timeliness.

If a woman suffers from hypertension and is planning pregnancy, she should consult a doctor before conception to determine the possibility and safety of pregnancy. At the stage of preliminary preparation, the doctor will draw up an individual examination plan, suggest preventive measures, select a safe antihypertensive drug and give advice on lifestyle and nutrition normalization.

Advantages of contacting the EMC

An international team of doctors. Obstetricians and gynecologists who have worked in the best perinatal centers in Europe, the USA and Israel.
Specialists with 20-30 years of experience.
Pregnancy management and childbirth of any complexity.
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Questions and answers

Dermoid cyst and pregnancy

An ultrasound revealed a mass in my left ovary during the first pregnancy. I was told that it is a dermoid cyst. Five years have passed since then. I gave birth to a second child. An ultrasound was performed annually. There were differences in size, but not significant. Since I’m going to have the 3rd child, another

ultrasound was done today. The doctor said that the cyst had increased. I am concerned about it. Don't know where to start. What tests are needed? Thank you.

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Surgical treatment is strictly indicated in your case given the long history of the mass in the ovary and its rapid growth in recent times. In our clinic, we perform such an intervention laparoscopically through 3 small punctures. Patients go home next morning after the surgery and may return to work after 3 days.

This surgery must be as delicate to preserve healthy ovarian tissue (considering your reproductive plans) as radical at the same time to remove the mass together with the capsule. At the preoperative stage an expert level ultrasound with Doppler is required, as well as blood tests for Ca-125 and НЕ-4 tumor markers. The decision concerning the necessity of FEGDS and colonoscopy is taken based on the results of these tests.

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Total knee replacement

My mom suffers from gonarthrosis for the past three years. Despite treatment by injections the pain is still present. MRI revealed a meniscal tear in the posterior horn, the presence of small bony osteophytes on the patella, a small amount of fluid in the joint cavity (signs of exudative synovitis were detected)

joint space is asymmetrically narrowed in the medial segment. The pain is ongoing but the knee remains flexible. Tell me, please, whether the surgery is contraindicated for meniscal tear in case of arthrosis? Is it possible to do an arthroscopic surgery on the meniscus in our case or it should be «major» surgery? And what would you advice concerning knee replacement for the patient in the age of 57? What is the life time of the artificial joint?

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It is necessary to make an X-ray of the knee in direct projection in standing position. If it turns out that there is no medial cartilage in the medial area, then the knee replacement is the only solution. The age of 57 is normal for the prosthetics. Modern artificial knee joint (when properly placed of course) will

serve for a lifetime. You can make an appointment via phone +7 (495) 933-66-44.

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Kardanov Andrey

07 September 2016

Pain

I am 19 years old, professionally engaged in weightlifting. I did an arthroscopy of both knee joint a year ago, now feel pain in them and it prevents me from training at full capacity. I visited a traumatologist, and «osteoarthritis of 1 degree» was diagnosed. Could you advise me some medicines or anything else to

relief the pain? Thank you very much for the answer!

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First of all you should undergo an MRI and find out what was done at arthroscopy; if it’s really an arthrosis of 1 degree, hyaluronic acid injections are possible and physiotherapy is not required. Anyway, you are always welcome to consultation for thorough examination.

Question to Dr. Yakobashvili

Tell me, please, at which age child's hearing should be checked-up if we were informed at the hospital before discharge that one ear does not hear. At the moment the child’s age is 1.5 months. Thank you.

These tests done in the hospital are often false negative. Hearing can be tested now, it is necessary to make an appointment to the audiologist.

Cought

A child of 11 years old, suffers from cough for more than six months. The cough is dry, sometimes attack-like, mainly begins during the day, and often occurs before sleep. There is no cough at night. CBC is normal, glucose is 4.16, total IgE 111.80, Toxocara, Ascaride are negative, Cytomegalovirus, Mycoplasma are

negative, PPD test is negative as well. A chest x-ray is normal. We have already consulted with a therapist, otolaryngologist, pulmonologist, neurologist, gastroenterologist... the cough is still present. What should we do?

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First of all, there are no results of whooping cough testing among the results provided above. The disease cannot be ruled out, even if your child was vaccinated. The blood test for antibodies against the whooping cough germ is required (blood test for class M and G antibodies against Bordetella pertussis). Second,

even a slight increase in class E antibodies is a reason to visit an allergist and to perform an evaluation of respiratory function with bronchodilator. This method will detect a latent bronchial spasm in your child. Even if the results of the test will be normal, allergologist mast rule out the allergic nature of the cough even if it's not obstructive syndrome. Third, this cough can be due to gastroesophageal reflux. It is difficult to draw any conclusions having no data of gastroenterologist’s consultation. 24-hour acidity monitoring of the stomach and esophagus is carried out to confirm or exclude the presence of reflux. Fourth, you didn’t mention whether x-ray of nasopharynx and paranasal sinuses was done. Perhaps, after all, the pathology is associated with ENT organs.

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