Hypertension is one of the most common medical complications during pregnancy Increased maternal and perinatal morbidity and mortality. The incidence of hypertensive disorder in pregnancy worldwide: 10% of all pregnant women experience preeclampsia, with a 3-5% chance of preeclampsia.

1. HYPERTENSION IN
PREGNANT WOMEN

2. • Hypertension is one of the most common
medical complications during pregnancy
• Increased maternal and perinatal
morbidity and mortality.
• Incidence of hypertensive disorder in
pregnancy
• worlwide-10% of all pregnant women
Preeclampsia-3-5%
• in India - 8-10%
preeclampsia 7.8%
(prevalence)
• in Asia and Africa one-tenth of all maternal
deaths are associated with hypertensive
disorder in pregnancy.
Introductio
n

3. BLOOD PRESSURE
•Blood pressure is the force of blood against artery walls.
•Blood pressure is measured with two numbers (e.g., 120/80
mmHg)
• Systolic pressure (top number): Pressure when heart
beats
• Diastolic pressure (bottom number): Pressure when
heart rests
•Hypertension is diagnosed when blood pressure is
consistently elevated BP >140 mmHg.
3
Increased Blood
Pressure
Placental damage
Placental abruption
Decreased Blood
Pressure
Placental won’t get
blood
Baby won’t grow and develop

4. RISK FACTORS 4
• Diabetes
• Chronic hypertension
• Twins
• High body mass index
• Male partner whose previous partner had
preeclampsia
Title: Risks of Hypertension in
Pregnancy
•Risks to the mother:
• Preeclampsia
• Eclampsia (life-threatening
seizures)
• Increased risk of stroke
• Organ damage
•Risks to the baby:
• Premature birth
• Low birth weight
• Placental abruption
(placenta detaches
from the uterus)

5. RISK
Untreated hypertension in pregnancy can increase the risk of serious
complications for both the mother and the baby. These complications
can include:
• Preeclampsia: Preeclampsia is a serious condition that can
develop during pregnancy and is characterized by high blood
pressure and protein in the urine. It can lead to serious health
problems for both the mother and the baby, including seizures,
stroke, and even death.
• Placental abruption: This is a condition in which the placenta
separates from the wall of the uterus prematurely. It can cause
serious bleeding and can be life-threatening for both the mother
and the baby.
• Intrauterine growth restriction (IUGR): This is a condition in
which the baby does not grow at the expected rate in the womb. It
can lead to premature birth and low birth weight, which can
increase the baby's risk of health problems later in life.
• C-section: Women with high blood pressure are more likely to
5

6. CAUSES
•Gestational hypertension: Develops after 20
weeks of pregnancy
•Chronic hypertension: High blood pressure
present before pregnancy or develops early in
pregnancy
•Preeclampsia: A potentially dangerous
condition that includes hypertension and
protein in the urine
•Chronic hypertension with superimposed
preeclampsia: Women with chronic
hypertension develop preeclampsia symptoms

7. 1. CHRONIC HYPERTENSION IN PREGNANCY
7
• Chronic hypertensive disease (CHD) is defined as the presence of hypertension of
any cause present before pregnancy or is diagnosed before 20 weeks of gestation.
• The majority of women with CHD are low risk and have satisfactory maternal and fetal
outcomes without any antihypertensive therapy
• Requires ongoing management through lifestyle changes and potentially
medication
•Increased Risks: Compared to women with normal blood pressure, those with chronic
hypertension are at increased risk for complications during pregnancy, including:
• Preeclampsia: A more serious condition characterized by high blood pressure
and protein in the urine.
• Placental abruption: Detachment of the placenta from the uterus.
• Preterm birth: Delivery of the baby before 37 weeks of gestation.
• Fetal growth restriction: Baby not growing at an expected rate.

8. 8
2. Gestational hypertension
• This is high blood pressure that develops for the first time during
pregnancy, typically after 20 weeks of gestation and usually
resolves after delivery.
• Elevated blood pressure (systolic ≥ 140 or diastolic ≥ 90 mm Hg,
• Previously normal blood pressures
• No protein in the urine.
•Complications:
While usually not directly life-threatening, gestational hypertension can increase the
risk of developing preeclampsia, a more serious condition characterized by high blood
pressure and other complications.

9. 3. PREECLAMPSIA
9
• This is a serious condition that can develop during pregnancy and is characterized by high
blood pressure and protein in the urine after 20 weeks of gestation.
• It can also cause other symptoms, such as severe headaches, vision changes, and upper
abdominal pain.
• Can lead to severe consequences for both mother and baby if not managed effectively.
• Not all women with preeclampsia experience all of these symptoms.
• Some women may only have mild symptoms, while others may experience severe
complications.
Causes:
•The exact cause of preeclampsia is unknown, but it's believed to be related to problems with
the placenta, the organ that nourishes the developing baby.

10. 10
•Superimposed preeclampsia is more severe than either
preeclampsia or chronic hypertension alone.
Diagnosis:
•Requires careful monitoring of blood pressure, protein levels in urine, and other tests.
•Differentiating superimposed preeclampsia from chronic hypertension alone can be challenging and
requires close medical evaluation.
4. Chronic hypertension with superimposed preeclampsia
•Occurs when preeclampsia symptoms develop in a woman already diagnosed with chronic
hypertension.
•Can be difficult to diagnose because some symptoms, like high blood pressure, might already be
present due to chronic hypertension.
Management:
•Focuses on close monitoring of the mother and baby's health.
•This might involve more frequent prenatal appointments, hospitalization, and
potentially delivery of the baby early depending on the severity of the case.
•Medication may be needed to manage blood pressure and other symptoms

11. MANAGING HYPERTENSION IN
PREGNANCY
11
•Lifestyle changes:
• Healthy diet
• Regular exercise
• Stress management
•Medication: Blood pressure medications may be
prescribed if lifestyle changes aren't sufficient.
•Close monitoring: Regular prenatal checkups with blood
pressure monitoring

12. ANTIHYPERTENSIVE DRUGS
12
Here are the choices of drugs given during
pregnancy:-
1. Alpha and Beta blockers-Labetalol hydrochloride
2. calcium channel blockers-Nifedipine
3. alpha blockers-Methyldopa
4. vasodilators-Hydralazine hydrochloride

13. Labetalol binds to alpha-1 adrenergic receptors in blood vessels
This vasodilation (widening of blood vessels) reduces peripheral vascular
resistance
ultimately lowering blood pressure
Methyldopa does not directly lower blood pressure itself. Instead, it is converted
to alpha-methyl norepinephrine (alpha-MNE) in the central nervous system
(CNS). Alpha-MNE then acts as a false neurotransmitter, binding to and
stimulating central alpha-2 adrenergic receptors. This leads to a series of events
that ultimately reduce blood pressure
Alpha and Beta blockers-
Labetalol
alpha blockers-
Methyldopa

14. Nifedipine works by blocking calcium channels in the smooth muscle cells of blood
vessels. Calcium is necessary for muscle contraction, and by blocking these
channels, nifedipine relaxes the blood vessels, allowing them to wide
calcium channel blockers-Nifedipine
vasodilators-Hydralazine hydrochloride
Hydralazine relaxes the smooth muscle cells in the walls of blood vessels, causing
them to widen. This directly reduces peripheral vascular resistance, ultimately
leading to lower blood pressure

15. Antihypertensives risk
ACE inhibitors, ARBs Risk of foetal damage, growth
retardation
Diuretics placental perfusion, miscarriage,
stillbirth
Nonselective beta blockers Propranolol cause low birth weight,
decreased placental size
Sad nitroprusside Contraindicated Contraindicated in eclamps
Antihypertensives to be avoided during pregnancy

16. THANK
YOU
•Hypertension in pregnancy is a serious
condition but can often be managed
effectively.
•Early detection and proper treatment
can significantly reduce risks for both
mother and baby.
•If you are pregnant or planning to
become pregnant, discuss your blood
pressure history with your doctor.