All pregnant women require proper healthcare as a way of ensuring their safety and the well-being of their unborn child. This is because, during pregnancy, a woman’s body undergoes various changes that require close monitoring and support.

This article provides information on the signs and symptoms of high blood pressure (hypertension) in pregnant women. Also known as “gestational hypertension’’. We have also explained how pregnant women experiencing hypertension can receive free treatment in Kakuma and Dadaab refugee camps in Kenya.

 

What is Gestational Hypertension

Gestational hypertension is different from other forms of hypertension. It specifically begins after 20 weeks of pregnancy and usually goes away by 12 weeks after giving birth. 

It is characterized by increased blood pressure levels, and laboratory tests show an absence of protein in the pregnant woman’s urine.  

This form of hypertension is identified when a pregnant woman gets their blood pressure checked during a visit to the clinic and have a reading greater than or equal to 140/90mmHg on two separate occasions. 

Although gestational hypertension goes away after delivery, it can increase the risk of developing long-term hypertension later in life for some women.

Identification of hypertension in pregnant women

Hypertension in pregnant women can be identified through the following steps:

  • Medical history and symptoms: A healthcare worker at a maternity clinic will ask for the pregnant woman’s history including previous occurrence of high blood pressure on her or any family member
  • Blood pressure test: A blood pressure test is done using a special machine at the clinic to attain an accurate diagnosis. Readings of a pregnant woman’s blood pressure are taken on multiple occasions and the measurements are taken in both arms. 
  • Additional tests may be conducted to confirm the existence and extent of hypertension, such tests include blood tests, urine tests, and examination of the functioning of the heart.

Preparation before going for a blood pressure test

To ensure accurate blood pressure readings and a proper diagnosis, one is advised to follow the steps below before their medical appointment:

  • Avoid caffeine - caffeine is found in coffee, black and green tea, cocoa, soft drinks such as soda, and energy drinks. Caffeine can increase blood pressure.
  • Avoid smoking - This can temporarily raise blood pressure.
  • Rest and Relax – Taking time to rest helps to ensure that the measurement is not influenced by recent physical activity or stress.
  • Wear appropriate clothing - One should choose clothing that allows easy access to the upper arm, so avoid tight clothes. 
  • Follow dietary recommendations - Avoid excessive salt in your food as it can influence blood pressure.
  • Any medications in use-Share with the health care worker information about any medications or supplements being taken before they test your blood pressure. Some medicines and supplements can affect blood pressure readings.

 
Who is at risk of getting high blood pressure (Hypertension)during their pregnancy?

Although the exact cause of high blood pressure during pregnancy is not well known, several factors can increase the risk of developing gestational hypertension. 

  • First time pregnancy:  Women who are pregnant for the first time are at a higher risk of developing gestational hypertension compared to those who have had pregnancies before. 
  • Women over 35 years, often referred to as advanced maternal age.
  • Obesity or being overweight before pregnancy increases the risk of gestational hypertension.
  • Women carrying multiple babies (twins or multiples) are at higher risk due to the increased demands on the heart in terms of pumping of blood to and other parts of the body.
  • Women with a history of long-term hypertension (high blood pressure before pregnancy) are more likely to develop gestational hypertension.
  • Diabetes: Pre-existing diabetes (both type 1 and type 2) or diabetes acquired during pregnancy ( gestational diabetes)
  • Kidney disease patients – Women whose kidneys aren’t working properly or are beginning to lose their function are at increased risk of gestational hypertension
  • Having a family history of gestational hypertension or preeclampsia can increase the risk.
  • Certain racial and ethnic groups, such as African Americans, Africans, have a higher prevalence of gestational hypertension.

Signs of high blood pressure during pregnancy

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It is important for pregnant women to be aware of signs and symptoms that may indicate high blood pressure or other serious conditions. Below are some of the signs and symptoms:

  •  Swelling (Edema)- Swelling in the hands, face, and legs can occur with high blood pressure. Although swelling is normal during pregnancy, severe swelling may be a cause for concern.
  • Persistent or severe headaches that are not relieved by hydration or rest or other remedies can be a sign of high blood pressure. 
  • Changes in vision – One can also experience blurred vision, seeing spots or flashes of light and sometimes temporary loss of vision.
  • Persistent nausea or vomiting, especially if it occurs mostly after the 13th week of pregnancy.
  • Sudden weight gain, typically more than a kilogram per week.
  • Passing only a little bit of urine at a time - decrease in the amount of urine.
  • Pain in your belly – This is characterized by severe pain just below the ribs, particularly on the right side.

During this period, women are advised to conduct regular prenatal visits since they essential for monitoring blood pressure and overall health during pregnancy.

 

Dangers of hypertension during pregnancy

  1. Seizures - This is abnormal electrical activity in your brain that causes changes in awareness and muscle control.
  2. Stroke - This can happen when blood flow to the brain is reduced or cut off due to blood vessels blockage or bleeding in the brain.
  3. Temporary kidney failure
  4. Liver problems
  5. Blood clotting leading to heavy bleeding – Hypertension makes your body more likely than normal to make blood clots.
  6. High risk of caesarean section ( C-Section ) During delivery

Can hypertension during pregnancy affect the unborn baby?

Yes! Developing high blood pressure when pregnant can affect your unborn baby if not well controlled. If proper care and medical attention is not sought, it can lead to:

  • Low Birth Weight- High blood pressure can restrict blood flow to the placenta, leading to poor growth of the unborn baby and ultimately low birth weight.
  • Premature baby – Hypertension in pregnancy can lead to the early delivery of your child. This means that the baby will be born before the pregnancy attains 37 weeks.
  • Stillbirth – This refers to a baby born dead.
  • Early labour before baby is full term. 

Treatment of gestational hypertension

High blood pressure that develops during pregnancy requires proper management to ensure the health and safety of both the mother and the baby.

Below are key treatment strategies for managing hypertension:

  • Regular monitoring of blood pressure - Regular check-ups with a healthcare provider to monitor blood pressure and overall health. Also, one should keep records of their blood pressure readings at home and during clinic visits. 
  • Medications – Use of prescribed medications to help lower blood pressure.
  • Lifestyle modification – One is required to adjust to a healthy eating and exercise regularly.
  • Hospitalization - In case of severe gestational hypertension or preeclampsia, hospitalization may be necessary for close monitoring and management.

Is it possible to have a safe delivery if I have hypertension during my pregnancy?

Yes! Given proper care and close monitoring of a pregnant woman, they can have a safe delivery. One should take the following steps for a safe delivery if they have gestational hypertension.

  • Take blood pressure medication as prescribed by the doctor.
  • Attending all prenatal visits clinics.
  • Your doctor might recommend that you have an early delivery if needed.
  • Maintaining a healthy diet and using less salt.
  • Following your health instructions regarding activity and exercise.

Other Forms of Hypertension

We can also have other forms of high blood pressure which can be categorized as chronic hypertension and preeclampsia. 

  • Chronic Hypertension: Also referred to as primary or silent hypertension is the most common form of high blood pressure. It develops over time and has no identifiable cause. Here are a few factors that contribute to chronic hypertension 
    Age, family history, obesity, lifestyle, unhealthy diet (high in salt and low in potassium), excessive alcohol consumption and stress. If left untreated or poorly managed, chronic hypertension can lead to serious health problems such as heart disease, stroke, kidney damage, and vision loss.
  • Preeclampsia: This is a form of hypertension that occurs during pregnancy or shortly after child birth. This kind of hypertension is characterized by high blood pressure and signs of damage to organs like liver and kidneys. It involves excess protein in the urine. Other symptoms may include swelling , sudden weight gain, visual disturbances, abdominal pain, and impaired liver function.

You can visit the following health facilities in Kakuma and Dadaab Refugee Camps.

HEALTH FACILITYLOCATION
1. Kaapoka Health Centre / Main Hospital  Kakuma 1 
2. Lochangamor Dispensary / Clinic 4  Kakuma 1 
3. Hong-Kong Dispensary / Clinic 2  Kakuma 1 
4. Nalemsekon Dispensary/ Clinic 5 Kakuma 2 
5. Nationokor Dispensary / Clinic 6  Kakuma 3 
6. Ammusait General Hospital / Clinic 7  Kakuma 4 
7. IRC Main Hospital  Hagadera 
8. Health post L6 Hagadera 
9. Health post E6 Hagadera 

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