*For medical professionals only
Not long ago, the release of the three-child policy can be described as a stone stirring up thousands of waves, and many "elderly" parents are eager to give birth to a new life. As living standards improve, work pressure increases, and elderly pregnant women increase, more and more women already have high blood pressure when they are trying to conceive, or there is a critical increase in blood pressure.
So, can you still get pregnant with high blood pressure?
Before trying to conceive
Do a thorough inspection
Compared with women with normal blood pressure, patients with hypertension have an increased risk of preeclampsia, eclampsia, fetal growth retardation, placental abruption and other diseases that endanger expectant mothers and fetuses after pregnancy. Therefore, before trying to conceive, it is necessary to go to a hypertension specialist for comprehensive diagnosis, evaluation and treatment.
Based on the medical history, blood pressure, biochemical examination, and imaging assessment, the specialist will determine whether there are secondary factors leading to hypertension, such as renal artery stenosis, abnormal hormone secretion, or autoimmune diseases, and carry out targeted treatment. For this category of patients with secondary hypertension who can find the cause, if the cause can be treated in time, the risk of pregnancy will be greatly reduced. In addition to finding the cause, it is also necessary to evaluate the heart, brain and kidney damage in the specialty, measure the risk of pregnancy, and develop an individualized treatment plan.
Draw the point
If female hypertensive patients can find out the cause of the disease before pregnancy, understand the damage to the target organs, follow the professional guidance of the doctor, and control the blood pressure before pregnancy, they can prepare for pregnancy normally.
Of course, for blood pressure that is still not well controlled after standardized treatment, or there are diseases that are not suitable for pregnancy, it is recommended to delay the preparation of pregnancy, and then decide whether to get pregnant after active diagnosis and treatment by a specialist.
When trying to conceive
Adjust the appropriate antihypertensive agent
For patients with pregnancy plans, it is recommended to inform the doctor to choose antihypertensive drugs that have less effect on the fetus, such as labetalolol or nifedipine extended-release tablets, which are currently considered safe during pregnancy. The "satan" or "puly" antihypertensive drugs have the effect of causing fetal malformations, and for women with chronic hypertension who have a pregnancy plan, they need to be discontinued in advance.
It should be emphasized that:
For patients with hypertension, taking antihypertensive drugs during pregnancy or pregnancy can help prevent severe hypertension during pregnancy, and at the same time prevent diseases such as eclampsia and placental abruption, prolong the baby's time in the mother's stomach as much as possible, and make the baby develop more perfectly, so it must not stop the drug at will, otherwise it will be unfavorable to the mother and the fetus.
Pregnant women with high blood pressure
These preparations are also needed
Although there is a doctor to escort, expectant mothers during pregnancy and pregnancy also need to do a good job of cooperation.
1
Exercise appropriately
It is recommended to ensure adequate rest and sleep time before and during pregnancy, and to ensure a certain amount of exercise, it is recommended to have at least 150 minutes of aerobic exercise per week, such as jogging, walking, playing table tennis, etc.
Sports should not be too intense, and sports involving physical contact, falls, risk of abdominal injury, weight lifting, etc. are not recommended. Sit-ups and other abs exercises are not recommended in the early stages of pregnancy to prevent a decrease in blood supply to the uterus.
2
Adjust your diet
We all know that a high-salt diet raises blood pressure, and limiting salt intake can help lower blood pressure. However, unlike the average patient with high blood pressure, pregnant mothers should limit salt moderately to prevent volume depletion due to excessive salt restriction and thus adverse effects on the fetus.
Therefore, it is recommended to control the daily salt intake at 6 grams, if you do not know how to take salt when cooking, you can use a salt limit spoon to help; when stir-frying, put less soy sauce, oyster sauce and other condiments with high salt content. At the same time, we should also pay attention to drinking less high-purine, high-salt, low-nutrient vegetable soups and broths; eat less pickled foods such as pickles, and eat more fresh vegetables and fruits.
3
Prompt obstetric examination
Compared with healthy expectant mothers, hypertensive expectant mothers who are preparing for pregnancy should increase the number of obstetric examinations during pregnancy, because hypertensive women are prone to various complications after pregnancy, and appropriately increasing the number of obstetric examinations can provide more protection for a smooth passage through pregnancy.
4
Monitor blood pressure
During pregnancy, it is necessary to do a good job of family blood pressure monitoring, if there is physical discomfort and blood pressure is too high, it is necessary to seek medical treatment in time.
Hypertension is not a contraindication to pregnancy, but patients with hypertension who have pregnancy needs must communicate with their doctors before pregnancy, listen to doctors' advice, and remember to avoid medical treatment.
author:
Cheng Aibang is a resident physician in the Department of Hypertension, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine
Tinghui Xu is the deputy chief physician of the Department of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Editing & Typography: iHEC Smart Blood Pressure
bibliography
[1] Expert Consensus on Blood Pressure Management in Hypertensive Diseases of Pregnancy (2019).Chinese Journal of Cardiovascular Diseases.2020,48(3):195-204.
[2]2020 ESC Guidelines on sports cardiology andexercise in patients with cardiovascular disease. Eur Heart J. 2021;42(1):17-96.
Source: iHEC