Gestational hypertension

Every 10th woman has raised blood pressure during pregnancy. In approx. 4% of cases, this is accompanied by increased protein excretion in the urine (protein urea). This clinical picture is known as pre-eclampsia or gestosis. Pre-eclampsia is a risk for mother and child. Women with pre-eclampsia must be diagnosed in good time and monitored.

Raised blood pressure in pregnancy exists if the blood pressure is over 140/90 mmHg. The doctor needs to differentiate whether the blood pressure was already raised or whether this only occurred during the pregnancy. If it is the latter, the patient in question is suffering from a case of gestational hypertension. Besides raised sugar levels, increased excretion of protein (proteinuria) can be seen over the urine. In such cases, this is known as pre-eclampsia, which represents an increased risk for mother and child. Pre-eclampsia can cause miscarriage or development disorders in the child. Eclampsia can also develop from pre-eclampsia (known as pregnancy poisoning), which is a life-threatening condition for mother and child. Therefore, the blood pressure must be regularly checked during the pregnancy so a possible case of pre-eclampsia can be discovered in good time.

The exact causes of pre-eclampsia are unknown. Hormonal and immunological adjustments of the maternal organism to the numerous changes which occur during pregnancy definitely play a role. Several risk factors are known to facilitate the development of pre-eclampsia. They include diabetes, blood pressure before pregnancy, excessive weight, renal disease or if the pregnant woman is much older or very young.

Pre-eclampsia usually develops in the second half of the pregnancy. Besides raised blood pressure and increased excretion of protein, the following symptoms are evidence of pre-eclampsia:

  • Oedema and water retention in the hands or in the face
  • A sudden increase in weight
  • Growth deficits on the side of the unborn child
  • In severe cases or during the development of life-threatening eclampsia, the patient can suffer headaches, blurred vision and seizures.

A diagnosis is made on the basis of the symptoms, taking the blood pressure and examing the urine. There are now blood examinations available which permit a risk assessment for women with suspected pre-eclampsia.

There is no causal treatment against pre-eclampsia. The treatment consists primarily of monitoring it closely and observing its course. If pre-eclampsia develops, the pregnancy must usually be monitored in hospital. In severe cases, premature birth by caesarean can be necessary. Find out more in the caesarean section.