High blood pressure During Pregnancy

Blood pressure with systolic blood pressure  ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg on two occasions at least 4 hours apart, can be categorized into the following 6 main conditions.

1. Gestational Hypertension: Blood pressure of ≥ 140 mm Hg systolic or ≥ 90 mm Hg diastolic, on two occasions at least 4 hours after 20 weeks of gestation, and blood pressure levels return to normal in the 12th week after birth.

2. Preeclampsia (with and without severe features)

• Gestational hypertension with proteinuria
  • The presence of protein or albumin in urine amounting to 300 mg or more in 24 hours.
• Without proteinuria, gestational hypertension with the new onset of any of the following:
  • Thrombocytopenia
  • Renal insufficiency
  • Impaired liver function
  • Pulmonary edema
• Preeclampsia with severe feature
  • Systolic blood pressure of ≥ 160 mm Hg or diastolic blood pressure of ≥ 110 mm Hg
  • Thrombocytopenia
  • Renal insufficiency
  • Impaired liver function
  • Pulmonary edema
  • Visual disturbance
  • Headache unresponsive to medication

1. Treatment depends on the severity of the condition and gestational age. When high blood pressure is identified, doctors may admit the mother to the hospital in order to assess the severity of the condition, while also closely monitoring the symptoms and health of both mother and child. In cases where symptoms of preeclampsia are displayed, doctors will prescribe the necessary medication designed to prevent against severe features of preeclampsia or eclampsia alongside blood pressure drugs. Where the pregnancy has reached its full term or the mother’s underlying health disorders appear to be worsening, an induced birth may be required in women whose pregnancy is nearing its full term, and the cervix is already preparing to induce labor. In cases where the cervix is not yet ready, or there are other significant indicators present, such as placenta previa or fetal macrosomia, then a caesarean birth may be considered instead.
2. However, for those who have not yet neared the pregnancy’s full term and for whom their underlying health disorders are difficult to manage, consideration may be given to terminating the pregnancy, especially in cases where doctors believe that the continuation of the current pregnancy may carry risk for both mother and child.

• Get plenty of rest and avoid stress
• Count the number of fetal movements per day
• Keep an eye out for signs that your condition may be deteriorating (headache, visual disturbance and epigastric pain)
• Monitor the situation by attending appointments with your doctor

In any case, if you experience any abnormalities or you observe that your infant has made less than 10 movements in a day, you should seek medical attention immediately.

The increase in blood pressure that comes with this condition may not return to normal levels immediately after birth. New mothers should, therefore, undertake postnatal blood pressure screening. Generally, high blood pressure that comes with a pregnancy will return to normal no more than 12 weeks after the birth. Where the blood pressure remains high subsequent to this period of time, it could be a signifier of pre-existing hypertension, for which treatment from a qualified physician should be sought.

Hypertension has the potential to affect one repeatedly, with each subsequent episode likely to increase in severity. For this reason, any subsequent pregnancies should be placed under the care of a doctor as soon as the pregnancy is known because of the associated health risks and possibility of preeclampsia occurring. 

Placing your pregnancy under the care of a medical team is of great importance. It is also essential that you attend all doctor consultations as each one will involve measuring your weight and taking your blood pressure, as well as screening for proteins and glucose in your urine. In cases where doctors identify risk factors or high blood pressure during pregnancy, they will be able to offer treatment and/or prevention against numerous other health complications, including preeclampsia.

Samitivej has a team ready to help and provide services for:

• Treatment Plan Consultation with a doctor via online video-call (second opinion)
• Treatment Planning if you have medical records or a price estimate from another hospital 
• Cost Planning by our Appraisals Team with price guarantee (only for procedure packages without complications)
• Check Initial Coverage Eligibility with Thai and international insurance companies (only for insurance companies in contract with the Hospital)