Ever wondered why your doctor or midwife is always worriedly checking your blood pressure every visit? And why it is that you must come every week at the end of pregnancy to have what seems is a quick and routine check over? Why you might have to pee on a stick? Well what it really boils down to is that prevention is better than cure.
Even more cryptic?
Well now for a brief history lesson: Pre-eclampsia (or toxaemia as it was previously known) is a serious illness that only arises in pregnancy. It is characterised by high blood pressure and protein in the urine. The protein is an indication of the disease affecting the kidneys. Other symptoms could be significant swelling of hands and feet, headaches, blurring of vision, severe upper abdominal or stomach pain and in its most severe form the woman can have a seizure (eclampsia), a stroke or lose her baby’s or her own life.
Fortunately in this day and age (and in this country) these more serious outcomes are very rare. It was the desire of doctors in the early 20th Century to found proper antenatal care as a means to reduce maternal deaths. By setting up a schedule of regular visits during a woman’s pregnancy they thought that they could perhaps stop the eclampsia related deaths. We now know, and it seems so obvious too, that when the early signs are recognised then often medication can be started to control blood pressure, prevent seizures if necessary and a plan for delivery made.
Not all blood pressure issues will develop into pre-eclampsia. Often in these cases the women are already on medication for blood pressure before pregnancy or have a high reading at their first visit. This is usually due to essential hypertension (or a type that runs in families). In most of these circumstances the blood pressure can be controlled well on medication and usually delivery would be planned by your due date. Occasionally blood pressure problems can indicate another underlying disease such as kidney problems.
What can you do to help prevent blood pressure issues?
Most of the time pre-eclampsia happens out of the blue and cannot be prevented. Planning to be in the best physical condition before pregnancy is always the best; keeping BMI ideally under 30, quitting cigarettes and keeping up gentle exercise to manage stress levels is. Sometimes there are indicators from your history that you are at increased risk. In these circumstances you may benefit from additional calcium supplementation or low dose aspirin.
Sadly despite all that we do; throughout the world but especially in developing countries, blood pressure related maternal deaths account for too many young lives lost.
So just remember all of this at your next antenatal visit when you’ve been waiting for ages to see the doctor! A simple and rather rudimentary test can be so reassuring.
This post was written and provided by Dr Miranda Robinson