This leaflet has been given to you because you have developed either high blood pressure alone or a combination of high blood pressure and protein in your urine (pre-eclampsia) during your pregnancy.
Both of these conditions affect 5-10% of pregnancies. Complications can arise during pregnancy, but also after your pregnancy, with a potential significant impact on your health.
As recommended by NICE, this leaflet describes what those risks are and what you can do to reduce them.
What are the risks to you and your baby in this pregnancy?
- You will need to have increased contact with your maternity health professional including obstetricians, Antenatal day unit and fetal assessment unit staff.
- We will advise you if it is appropriate for us to be able to offer you home monitoring of your blood pressure or attendance to hospital.
- Hypertension in pregnancy and then the risk of developing pre-eclampsia can have effects on your health and the health of your baby. We will need to potentially start antihypertensive medications eg labetolol, nifidipine. These medications are safe in pregnancy. We will also need to monitor your bloods to look for the potential effect high blood pressure can have on your kidneys and liver.
- We also may need to discuss early delivery and the most appropriate mode of delivery with you. This will be individually tailored to your needs.
- We will also offer fetal growth scan as this condition can affect your babies placenta and how well it is working. This may also indicate to us another reason to recommend earlier delivery. In some circumstances this can be very early and in some circumstances you may expect your baby to be admitted to our neonatal intensive care unit and /or transitional care unit.
- All discussions and decisions about your care will be shared with you and you will have the opportunity to ask questions.
What will happen post delivery?
- If you are discharged home on medication your community midwife will review your blood pressure at home. On occasion you may need to be seen on Maternity Assessment centre if it is not under control.
- Your GP will then review you at 2 weeks post delivery and then again at 6-8 weeks post delivery.
- Most pregnant people with pre-eclampsia should expect to reduce their dose and likely stop their medication.
- If you have pregnancy induced hypertension you may have underlying blood pressure that you were not aware of prior to pregnancy and you may need to remain on medication.
What are the risks to your future health?
Long term health problems
People who developed high blood pressure or pre-eclampsia in pregnancy are at increased risk of long-term health problems compared to those without high blood pressure or pre-eclampsia in pregnancy (see table).
| Complications | Likelihood |
| Heart attack | Twice as likely |
| Death from heart attack | Twice as likely |
| High blood pressure requiring long term medication | 2-4 times more likely |
| Type 2 diabetes | 2-3 times more likely |
| Stroke | 1.5 times more likely |
If you have had pre-eclampsia but your postnatal check at 8 weeks was normal (normal blood pressure and no protein in your urine), you still have a small risk of developing serious kidney disease in later life.
What can you do to reduce these risks to your future health?
These risks may appear frightening, but it is important that you are aware of them and adapt your lifestyle accordingly to minimise your risk.
1. Stop smoking
2. Maintain a healthy weight
– Aim for your BMI to be between 18.5 and 24.9
3. Exercise regularly
– Aim to do 30 minutes of exercise 5 days per week
4. Eat a healthy balanced diet
– Choose brown bread, rice and pasta instead of white
– Reduce sugar, red meat, saturated fat and salt
– Aim to eat 5 portions of fruit and vegetables per day
– Aim to eat at least 2 portions of fish per week
– Aim to eat more unsalted nuts, seeds and pulses per week
What to expect in your next pregnancy?
Most people will not develop complications in their next pregnancy.
However, one in five people who have high blood pressure in a previous pregnancy are likely to develop high blood pressure again in their next pregnancy. In particular, if your baby was born earlier (less than 37 weeks), your risk of developing
pre-eclampsia in your next pregnancy can rise to 1 in 3.
You are more likely to have high blood pressure in pregnancy or pre-eclampsia if you have 10 or more years between your pregnancies. Your risk may change if you have a different partner in future pregnancies or you have other conditions such as diabetes.
During your next pregnancy, we will advise you take a daily Aspirin from 12 weeks gestation as evidence shows us this can reduce your risk of developing high blood pressure again. You may need to have extra growth scans in your next pregnancy.
If you have had pre-eclampsia in a previous pregnancy, please see your GP before planning to have your next pregnancy to discuss your health and risk factors. You may be referred to the hospital for pre-pregnancy counselling.
Hypertension in pregnancy can be serious. By following the steps above before your next pregnancy, you can improve your health and the outcomes for both you and your baby in future pregnancies.
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For more advice or to discuss further, please contact your community midwife or GP.