Pregnancy is a precious and often exciting time in a woman’s life. While regular antenatal checkups are essential, it’s important to stay informed about potential health complications that can jeopardise the wellbeing of both the mother and the baby.

High blood pressure is one such complication that can emerge during pregnancy, and it can be linked to more serious conditions like pre-eclampsia and HELLP syndrome. In this article, we delve into the significance of antenatal checkups and the vital role of monitoring blood pressure throughout pregnancy. Join us as we uncover the crucial aspects that every expectant mother should be aware of to ensure a safe and healthy journey.

Understanding high blood pressure, pre-eclampsia, and HELLP syndrome

High blood pressure during pregnancy 

High blood pressure, also known as hypertension, is a common condition. During pregnancy, it is extremely important to monitor blood pressure regularly as hypertension can have adverse effects on both the mother and the developing baby. Pregnant women may already have pre-existing hypertension, or it may develop because of the pregnancy. In 10% of pregnancies, hypertension may be part of a more complex and severe condition called pre-eclampsia.

What is pre-eclampsia? 

Pre-eclampsia is the most common serious complication of pregnancy. It typically arises after the 20th week of pregnancy but can also occur immediately after the baby is born. If unrecognised and untreated, it can get worse very quickly and lead to serious and even life-threatening complications for both the mother and baby. Pre-eclampsia can affect other parts of the body such as the liver, kidneys, nervous system, the blood clotting system (HELLP Syndrome) and can also lead to convulsions (Eclampsia).

Symptoms of pre-eclampsia

Along with high blood pressure, pre-eclampsia symptoms may include:

• Sudden excessive swelling of the hands, face and feet
• New or persistent headaches
• Changes in vision such as sudden blurred vision or loss of vision
• Pain in the upper right hand side of the abdomen over the liver
• Nausea, vomiting, shortness of breath

Tests may show: 

• Excess protein in the urine that indicate kidney damage
• Blood tests may show abnormal liver enzymes indicating liver problems and blood clotting abnormalities It is also possible to have pre-eclampsia but have no symptoms at all.

What is HELLP syndrome? 

HELLP syndrome is thought to be a severe form of preeclampsia when the mother’s blood clotting and circulation system are affected. HELLP stands for Hemolysis (breakdown of red blood cells), Elevated Liver enzymes, and Low Platelet count (the cells that cause blood to clot). HELLP syndrome requires immediate medical attention and often early delivery of the baby.

Causes and risk factors of these conditions

The exact causes of high blood pressure, pre-eclampsia, and HELLP syndrome are not fully understood, however, it is thought to be a problem with the placenta’s development and function.

Certain risk factors have been identified, including:

• If you have had pre-eclampsia before
• Family history of pre-eclampsia
• Pre existing high blood pressure or kidney disease
• Multiple pregnancies (twins or more)
• First-time pregnancy
• Obesity
• Age >40
• Certain medical conditions like diabetes or autoimmune disorders

Management and treatment 

Regular antenatal care is crucial to monitor blood pressure and detect any signs of high blood pressure or related conditions. If diagnosed with high blood pressure, pre-eclampsia, or HELLP syndrome, management may include close monitoring of blood pressure, bed rest and medication to control blood pressure and prevent complications. In severe cases, early delivery may be necessary to protect the health of both the mother and the baby.

For women who are known to be at increased risk of pre-eclampsia, it may be recommended by your doctor to take daily low dose aspirin during the pregnancy. Studies have shown that if commenced before 16 weeks and taken until 36 weeks, this may reduce your risk of developing pre-eclampsia by up to 80%.

High blood pressure, pre-eclampsia, and HELLP syndrome can be serious conditions during pregnancy. Symptoms of pre-eclampsia can be vague and similar to those that many women experience during pregnancy, so it is important to attend your regular antenatal appointments, have your blood pressure regularly monitored and speak with your doctor or midwife if you have any concerns.