Is a rise in blood pressure during pregnancy just a temporary, transient phenomenon, or does it have deeper implications? Does it continue to affect women later in life, or is it exclusively related to pregnancy? Let's take a retrospective look at this issue.
After reviewing recent research evidence, I decided to conduct a small exercise in my practice. I began asking women in their late 30s or early 40s who presented with abnormal menstruation, high blood pressure, diabetes, obesity, and other related issues about their previous pregnancies. Out of the 66 women I questioned, nearly 36 mentioned experiencing transient or even severe High Blood Pressure during Pregnancy (HTNP). Some even suffered complications such as seizures, ICU admissions, blood and component transfusions, and the need for long-term blood pressure medications. Many of them had conceived shortly after marriage, often before the age of 18, and most had variations of obesity or were overweight. Nearly all of these women with abnormal Body Mass Index (BMI) reported post-delivery weight retention that persisted to their current state.
These observations about the long-term effects of HTNP are enlightening and deserve serious consideration. This article is dedicated to my own cousin, who endured lifelong consequences of HTNP, which I will share at the end of this piece.
Does HTNP have lifelong consequences?
Yes, even if a woman experiences a transient rise in blood pressure during pregnancy, it can increase her susceptibility to developing HTNP in subsequent pregnancies and experiencing elevated blood pressure disorders within the next five years.
What are these lifelong consequences?
The long-term consequences of HTNP include developing blood pressure disorders that persist throughout life. Additionally, there is an increased susceptibility to heart attacks and kidney diseases in the future. These issues result from abnormal stimuli to the blood circulation regulatory system, which can be triggered by factors such as infection, anemia, and more. However, these consequences can be managed with certain measures.
Can these consequences be avoided or prevented?
Yes, they can be prevented to some extent. Lifestyle modifications can significantly reduce the risk of severe complications.
What are the important steps to prevent these long-term consequences?
If you have been prescribed blood pressure control medication, ensure that you take them as prescribed and attend regular check-ups to monitor your blood pressure. Even after it returns to normal levels, continue with periodic and annual check-ups.
Strive to return to your pre-pregnancy weight and work towards achieving an ideal BMI within a year after delivery.
Adopt healthy eating habits and engage in a regular physical exercise program.
When planning your next pregnancy, aim to have an ideal BMI, stay up-to-date with vaccinations, and manage conditions like anemia, hypothyroidism, or diabetes. Consider starting a folic acid supplement.
The Story I Promised
Mrs. Seema experienced two miscarriages at 12 and 14 weeks, during which she was diagnosed with high blood pressure. She was advised to undergo evaluations and preconception optimization, but unfortunately, she did not follow through with these recommendations. When she conceived for the third time and reached 24 weeks of pregnancy, her blood pressure began to rise. Further evaluations revealed that she had a thrombophilia known as APLA syndrome, an autoimmune condition associated with high blood pressure and miscarriages. At 34 weeks, she suffered a massive internal hemorrhage, leading to surgery. Her womb had to be removed to save her life, and sadly, her baby couldn't be saved. She required extensive blood and blood component transfusions, ICU care for 72 hours, and two months of dialysis due to acute kidney failure. Twelve years later, at the age of 39, she developed kidney failure, necessitating dialysis.
If we had diagnosed her condition early and she had planned her pregnancy more effectively after stabilization, we might have been able to prevent this malady.
Let's come together and make an effort to become healthy women, passing on the legacy of health to our daughters and future generations.