Gynecology And Obstetrics-

Lowering blood pressure during pregnancy

definition

Elevated blood pressure during pregnancy occurs in about 10% of pregnancies. Since the therapy recommendations in pregnancy generally differ from the standard recommendations, there are also great differences in the therapy of high blood pressure between treatment outside and during pregnancy.
During therapy it must be ensured that not just one person but two people are treated.

What can I do to lower my blood pressure?

The blood pressure can be lowered by various measures.
So is at mild to moderate high blood pressure first to General measures devices. These are that Check body weight regularlyto ensure a weight gain of less than 1kg / week.
Physical conservation and Elimination of stress factors are in the foreground in lowering blood pressure. Strict bed rest and avoidance of salt are not advisable, however, as they have no proven effects on high blood pressure and, above all, a low salt intake can even be dangerous for the child.
Also taking vitamin C and Vitamin E. can have a positive effect on blood pressure.

At severe high blood pressurewhich cannot be brought under control by general measures drug measures used.
The only causal treatment for pregnancy-induced high blood pressure, pre-eclampsia and Eclampsia is the Childbirth, a measure that depends on the week of pregnancy, blood pressure levels and the risk of eclampsia.

Read more about the topic here: Diagnosis and therapy of high blood pressure in pregnancy

What drugs are there?

Drug treatment for high blood pressure during pregnancy is different from treatment outside of pregnancy.
In the absence of large, placebo-controlled studies, the recommendations are based on smaller observational studies.

The means of choice in Germany is alpha-methyldopa. In addition, the beta blockers Metoprolol as well as the Calcium channel blocker nifedipine (not in the first trimester of pregnancy).
Also Dihydralazine used for treatment, but has more severe side effects in the mother.
To treat Blood pressure crises for acute lowering of high pressure Nifedipine first of all.

With heavier Preeclampsia / eclampsiae becomes an anticonvulsant intravenous magnesium administered.

Absolutely contraindicated and therefore Under no circumstances should ACE inhibitors be used, especially in the second and third trimester of pregnancy are toxic to the child and too Malformations and Miscarriages being able to lead.

Are antihypertensive drugs dangerous for my baby?

There are also anti-hypertensive drugs during pregnancy Little extensive placebo-controlled studiesbecause drugs are not tested on pregnant women.
The recommendations are composed primarily of smaller observational studies.

Of that there is alpha-methyldopa most, as well as a study on the long-term effect on children up to 7 years and since there was no evidence of damage, this drug is considered to be first choicel in Germany.
Metoprolol may have an impact on the child's growth, Nifedipine in animal studies showed harmful effects on the child within the first trimester of pregnancy, which is why it is only prescribed afterwards.
At Diuretics there is a risk of impaired blood flow to the placenta, as the blood volume decreases. So these drugs are only prescribed with reservations and careful consideration of the benefits and risks.

ACE inhibitors and angiotensin antagonists are dangerous for the child and therefore must not be taken under any circumstances, as these have been shown to lead to developmental disorders and possibly to the death of the child.

Is high blood pressure dangerous for my baby?

Pure pregnancy high blood pressure is usually harmless to the unborn child. The main risks for the child arise from severe high blood pressure and preeclampsia.
The exact mechanisms are unclear, but the blood flow to the placenta is disrupted. This can lead to extensive placental infarction and premature placental detachment.
Other organs of the mother, such as the brain, lungs, and kidneys, can also be affected.
The risk of premature birth or miscarriage increases significantly and the child's developmental disorders can occur.

Find out more about the topic here:

Pregnancy Hypertension- Is It Dangerous?
Placental insufficiency

When should the blood pressure be lowered?

Even if high blood pressure is indicated from> 140 mmHg, it should be during pregnancy first be treated with medicationwhen it is not possible to him keep <160 mmHg systolic or <100 mmHg diastolic by general measures.

This is because the risk for the mother and child with mild hypertension is small, while having a significant decrease in blood pressure to Circulatory disorders of the Planzenta and one of those Under-provision of the child can lead.
The risk is low if there are no abnormalities on the physical exam, the EKG is normal, and there is no protein in the urine (which suggests preeclampsia).

If protein is detected in the urine, a growth retardation or placenta detachment is diagnosed by ultrasound or an undersupply of the child is found, preeclampsia is suspected, which, depending on the severity, is treated as an inpatient by lowering the blood pressure, among other things.

Home remedies to lower blood pressure during pregnancy

Meaningful, non-drug measures against high blood pressure during pregnancy Protection and Stress reduction.
There are hardly any other effective, natural remedies, as they often only have a minor effect on blood pressure and, above all, there are no adequate examinations during pregnancy to assess the benefits or risks.

The Reduction of saltthat is recommended outside of pregnancy is during pregnancy not useful.
Also the positive effect of magnesium The reduction in blood pressure has not been clearly proven, and a reduction in the risk of preeclampsia has not been confirmed.

The often used home remedies Hawthorn and Garlic tablets should also be avoided during pregnancy as the effects have not been adequately studied.