Pregnancy Problems

Pregnancy-Induced Hypertension (PIH)

All the answers you're looking for about PIH.

 What is pregnancy-induced hypertension?

As you might have guessed, pregnancy-induced hypertension (aka PIH) is where a woman develops abnormally high blood pressure during pregnancy. You’ll also retain water and have higher-than-normal levels of protein in your urine. This is also called toxemia or preeclampsia.

What are the signs of PIH?

You may have some swelling, but often there are no symptoms at all. In severe cases PIH can cause headaches, blurry visionnausea and vomiting, pain in the upper right abdomen, and sudden swelling in the hands and face.

Are there any tests for PIH?

Yep. Your typical prenatal visits usually include blood pressure and urine tests, both of which can help diagnose PIH. Other tests you may need include kidney and blood-clotting function tests and scanning to measure how well blood is flowing to the placenta.

How common is PIH?

Pregnancy-induced hypertension occurs in about 5 to 8 percent of all pregnancies. It happens in about 10 percent of first pregnancies and in 20 to 25 percent of pregnancies where the mom-to-be has chronic hypertension.

How did I get PIH?

Young moms-to-be (teens) and women over 40, as well as those who are carrying multiples, have a family history of PIH or had high blood pressure or kidney disease before pregnancy are all at increased risk.

How will PIH affect my baby?

PIH can affect the level of blood flow to the placenta, which means less oxygen and nutrients for your baby. That means she may have a low birth weight, especially if she is delivered preterm. So your OB will likely monitor you closely (see next page for treatments, prevention and resources).

What’s the best way to treat PIH?

If your PIH is considered mild and your baby isn’t yet fully developed, your OB will keep a close eye on you (so expect more frequent appointments) and advise you to drink at least eight glasses of water a day, consume less salt and rest, preferably on your left side — to take the baby’s weight off your major blood vessels. If your hypertension is more severe, you may be put on blood pressure medication. If you’re closer to your due date, your doctor may recommend delivering your baby pronto.
 
What can I do to prevent PIH?

Most of the time, preventing PIH is out of your hands, although there are some steps you can take to minimize your risk. Luckily, they’re all part of having a healthy pregnancy: Eat right, exercise, drink plenty of water, and get enough rest. You can also try cutting back on salt and elevating your feet during the day when you have a chance.

What do other pregnant moms do when they have PIH?

“I had it and was monitored a lot toward the end. They just need to make sure your blood pressure stays in a relatively safe area, or the baby will get less oxygen and that’s not good. They will check it frequently and maybe put you on bed rest if it’s high enough.”

“I had it the worst with my third. I was there every other day for an NST — even weekends. I also had a BPP 2x a week. I did 24-hour urines every few days. Finally, blood work showed my liver and kidneys weren’t doing so hot, and I was induced at 38 weeks after a horrible NST, where her heart rate dropped into the 80s.”

“I had it. It was stressful! I was a mess thinking DS would be born too soon! I was induced three days before my due date, but it was because I had low fluids, not because of the hypertension.”

“Mine started getting high around 28 weeks, so I was monitoring it at home. I ended up in the hospital due to high BP about 30 weeks. I was discharged four days later when all results came back fine. Luckily I was checking my blood pressure myself, because it skyrocketed and DS was born a few hours later.”

Are there any other resources for PIH?
 
March of Dimes

Plus, more from The Bump:

Preeclampsia

Hypertension During Pregnancy

HELLP Syndrome

By C. Joseph Cadle, MD, ob-gyn, Kaiser Permanente, Atlanta, GA