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How Can I Lower My Blood Pressure After Preeclampsia?

Preeclampsia is a condition in which high blood pressure (hypertension) and evidence of organ injury develops in a pregnant woman after 20 weeks of pregnancy. It can also occur after delivery (postpartum). The treatment and cure for preeclampsia is the delivery of the fetus and placenta.
Preeclampsia is a condition in which high blood pressure (hypertension) and evidence of organ injury develops in a pregnant woman after 20 weeks of pregnancy. It can also occur after delivery (postpartum). The treatment and cure for preeclampsia is the delivery of the fetus and placenta.

The treatment and cure for preeclampsia is delivery of the fetus and placenta.

  • Pregnancies complicated by preeclampsia at term (37 weeks) are delivered to resolve the condition and minimize the risk to the woman and her fetus from worsening preeclampsia. A fetus that is at or near term is not at high risk of complications and usually does not need special care in a nursery.
  • When preeclampsia develops before term and no severe signs of the disease are present, delivery may be delayed to 37 weeks to allow the fetus time to mature. If severe signs develop, delivery may be necessary to prevent complications in the woman or her fetus. Women who may need pre-term delivery (before 34 weeks) may be given steroid injections to accelerate fetal lung development. Oxytocin (Pitocin) may be given intravenously to induce labor.
  • High blood pressure and protein in the urine usually resolve after delivery within a few days but it may take weeks. If blood pressure is only mildly elevated for a few weeks or months it is generally not harmful. 
  • Severe hypertension (severely high blood pressure) should be treated. To lower blood pressure after preeclampsia some women may need lifestyle modifications or medications. Lifestyle modifications and medications to lower high blood pressure after preeclampsia are the same as those used to treat high blood pressure in general. 
  • Lifestyle modifications to treat high blood pressure include: 
  • Medications used to treat high blood pressure include: 
    • Diuretics 
    • Angiotensin-converting enzyme (ACE) inhibitors 
    • Angiotensin II receptor blockers (ARBs) 
    • Calcium channel blockers 
    • Beta-blockers 
    • Alpha blockers  
    • Direct vasodilators  

What Is Preeclampsia?

Preeclampsia is a condition in which high blood pressure (hypertension) and evidence of organ injury develops in a pregnant woman after 20 weeks of pregnancy. It can also occur after delivery (postpartum). Organs that may be affected include the kidneys, the liver, platelets, lungs, and the brain.

What Are Symptoms of Preeclampsia?

Preeclampsia may not cause any symptoms in some women so prenatal visits usually include high blood pressure checks.

Maternal symptoms of mild preeclampsia include: 

  • Mildly high blood pressure of 140/90 mmHg or greater
  • A small amount of excess protein in the urine (proteinuria) of 0.3 g or more, which is found during a routine urine test at your OB/GYN visits

Maternal symptoms of severe preeclampsia include: 

  • Persistent severe headache
  • Blood pressure of 160/110 mmHg or greater more than once 
  • Vision problems (blurred or double vision, flashes of light or squiggly lines, blind spots, vision loss)
  • Pain in the mid- or right-upper quadrant of the abdomen (similar to heartburn)
  • Low platelets
  • New-onset shortness of breath 
  • Abnormal kidney tests 
  • Liver abnormalities 
  • Fluid in the lungs
  • Seizure 

Preeclampsia can also affect the fetus. Effects on the fetus may include: 

  • Slowed fetal growth 
  • Abnormal testing of fetal well-being (for example, a nonreactive nonstress test or low biophysical profile score)
  • Decreased amount of amniotic fluid 
  • Decreased blood flow through the umbilical cord

What Causes Preeclampsia?

Preeclampsia is caused by abnormal development of the placenta early in pregnancy but the reason for this is unknown.

Risk factors for developing preeclampsia include:

  • Chronic high blood pressure, kidney disease, lupus, or diabetes prior to pregnancy
  • First pregnancy (not including miscarriages and abortions)
  • Gestational diabetes
  • History of preeclampsia
  • Family history of preeclampsia in a sister or mother
  • Multiple gestation (e.g., twins or triplets)
  • Age under 20 years or over 35 to 40 years
  • Obesity

How Is Preeclampsia Diagnosed?

A pregnant woman’s blood pressure is checked routinely in prenatal visits. 

If the blood pressure reading is 140/90 mmHg or higher, especially after the 20th week of pregnancy, urine tests may be indicated to check for the presence of protein in the urine.

High blood pressure during pregnancy (140/90 mmHg or higher) is one of the first warning signs of preeclampsia during pregnancy and excess protein in the urine (proteinuria) of 0.3 g or more is also a sign of preeclampsia. 

Additional tests may also be indicated:

  • Blood tests 
  • Ultrasound to assess fetal size 
  • Fetal heart rate check

A physical exam will also be performed to check for:

  • Swelling in the mother's face, hands, or legs 
  • Abdominal tenderness 
  • Enlarged liver
  • Vision problems

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References
https://www.uptodate.com/contents/preeclampsia-beyond-the-basics?search=Preeclampsia&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://www.uptodate.com/contents/high-blood-pressure-treatment-in-adults-beyond-the-basics?search=Preeclampsia&topicRef=6720&source=see_link

https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/diagnosed