Women's Healthcare Topics

Is High Blood Pressure During Pregnancy a High Risk Pregnancy?

Reviewed by James Brann, M.D.

High Blood Pressure in Pregnancy is High Risk

Gestational hypertension or high blood pressure during pregnancy affects roughly one of every six pregnant women. While for some hypertension during pregnancy is easily resolved, for others hypertension can result in a high risk pregnancy, with increased risk for premature labor, and maternal complications.

What is Gestational Hypertension?

Gestational hypertension is one of many types of high blood pressure in pregnancy. It is seen in about 6 out of 100 pregnancies. Gestational hypertension is defined as:

  • A systolic blood pressure >140 mmHg and/or diastolic blood pressure >90 mmHg

  • It is recognized for the first time after the 20th week of pregnancy

  • There is no protein in your urine

The above definition distinguishes gestational hypertension from preeclampsia and chronic hypertension. Preeclampsia has protein in your urine and chronic hypertension you had high blood pressure before the 20th week of pregnancy. These differences are used to distinguish gestational hypertension from preeclampsia, which has a completely different course and prognosis, and chronic hypertension which affects your treatment and pregnancy outcome.

Whose At Risk?

Certain mothers are more at risk than others for high blood pressure problems during pregnancy. Mom's at risk include:

  • Young mothers under the age of 17 or older mothers aged 35 and above during their first pregnancy.

  • Mothers with a history of high blood pressure or family history of hypertension.

  • Women who are carrying more than one baby.

  • Women who are overweight or smoke, whether before or during their pregnancy.

  • Women who lack adequate nutrition or prenatal care during pregnancy.

  • Women with health problems complicating a pregnancy, including heart disease, diabetes or circulatory problems.

What Treatments Are Available For Gestational High Blood Pressure

Learn about normal and high blood pressure in pregnancy.

Pregnancy complicated by developing high blood pressure after the 20th week can be managed safely without hospitalization. Your doctor will see you weekly for your prenatal visits. You will be placed on bed rest. The American College of Obstetricians and Gynecologists (ACOG) suggests that your doctor should monitor your blood pressure once or twice weekly and check your urine for protein, and do blood work.

Since pregnancies complicated by gestational high blood pressure are at increased risk of developing preeclampsia you should let your physician know if you have a severe headache, vision changes, or abdominal pain. You should also inform your doctor of a decrease in baby’s movements, if you have any vaginal bleeding, and preterm contractions.

You baby will be watched closely with weekly non-stress testing to observe the baby’s heart rate and ultrasound to measure the amount of amniotic fluid. Together these two tests are called a biophysical profile. As well the baby’s growth will be monitored with serial ultrasound examinations every three weeks to make sure the baby is growing well.

No antihypertensive medications are used, unless your high blood pressure becomes severe (>160 mmHg systolic or >110 mmHg diastolic).

The American College of Obstetricians and Gynecologists (ACOG) endorses the recommendation that your baby should be delivered at 37 to 38 weeks of pregnancy. Early delivery is performed to avoid the risk of progression of gestational high blood pressure to preeclampsia and severe gestational high blood pressure (160/100 mmHg).


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