Janjivan Bureau / New Delhi : A recent study has indicated that diagnosis of hypertension during pregnancy is associated with an increased risk of maternal cardiovascular disease. Those with a previous hypertensive disorder are twice at risk.This makes it imperative to monitor blood pressure before discharge and after giving birth, through the postpartum period.
Heart failure, or peripartum cardiomyopathy, can occur up to five months after giving birth. Some symptoms of this condition include tiredness, shortness of breath, swollen ankles, swollen neck veins, and feeling of missed heartbeats or palpitations.
Speaking about this, Dr Manoj Kumar, Head – Cardiac Cath Lab, Max Balaji, Patparganj, said, “Hypertension during pregnancy is a major risk factor for both the mother and the baby. High blood pressure can hamper blood flow throughout the body including to the placenta and uterus. Thiscan further affect fetal growth andcause premature detachment of the placenta from the uterus. If not closely monitored before, during, and after childbirth, high blood pressure may even become a major cause of heart problems including heart failure in such women. Some other fatal repercussions of high blood pressure include pre-term birth, seizures, or even death of the mother and the baby.”
The seriousness of peripartum cardiomyopathy can be measured by what is called the ejection fraction. This is the amount of blood that the heart pumps out with each beat. A normal ejection fraction number is about 60%.
Adding further, Dr Kumar said, “Women diagnosed with high blood pressure postpartum should remain hospitalized for some time. Although the damage caused by heart failure is irreversible, it can still function with the help of some medications and treatment. Heart transplant may be needed in severe cases. Women must take steps to bring blood pressure under control from the time they wish to conceive, through certain lifestyle changes.”
Drugs such as beta-blockers can help reduce blood pressure.Diuretics are another class of drugs that help lower blood pressure by removing excess water and salt from the body. Some other treatment options include coronary artery bypass surgery and implantable cardioverter defibrillators (ICDs). ICD is a small device placed in the chest or abdomen. It helpsin treating irregular heartbeats called arrhythmia. During pregnancy, digoxin, beta-blockers, loop diuretics, and drugs that reduce afterload such as hydralazine and nitrates have been proven to be safe and are the mainstays of medical therapy of heart failure. Post-delivery, the treatment mechanism is identical to the one for non-pregnant women with dilated cardiomyopathy.
What to do
· Know your blood pressure level before getting pregnant.
· High salt, or sodium, intake can raise blood pressure. Aim at eating less salt.
· Get up and get moving before you conceive. Sedentary women are likely to gain weight, which can increase the risk of hypertension during pregnancy, as well as before and after.
· Make sure you are not taking medication that can raise blood pressure levels.
· If you already have high blood pressure, talk to your doctor about the steps that need to be followed.
· Get regular prenatal checkups.
· Tobacco and alcohol are not safe during pregnancy and must be avoided.
