If You Have Chronic Hypertension
The first step to take in preparing to become pregnant is to see your doctor for counseling. Because you are at higher risk to develop problems during pregnancy, you will want to control as many factors affecting your pregnancy as you can.
Your Medical History and Medicine
Be prepared to discuss your previous medical history. If you have been pregnant before, you will want to review this information with your doctor as well as talking about any medications you are taking.
Many people now take herbal tablets of various kinds. It is known that people
often will forget to mention herbal preparations in discussions with their doctors.
If you are taking an herb, remember to tell your doctor what it is, why and
how much you are taking.
You should also mention any over-the-counter medications you take, including
cold and headache remedies.
Screenings
Blood tests can identify carriers of inherited diseases.
If you are African American, you may be screened for the blood disorder, Sickle-cell
Disease. There is a relationship between Sickle-cell Disease and hypertension.
Other Conditions
It's possible to have diabetes and not know it. Women with diabetes are at increased risk to have problems with pregnancy and babies with birth defects. Your doctor may test you for diabetes.
Your doctor may also test your kidney function to see if your kidneys are functioning
properly or if there is protein in your urine. Women with chronic hypertension
may have some kidney problems and not know it, and this can effect pregnancy,
too.
Your doctor may also look beyond your blood pressure readings and study the
flow characteristics of your blood pressure. If your heart is pumping too much
blood, it can be an early sign of problems and your doctor may treat you aggressively.
Your doctor will also want to know if you have a history of having a thyroid
disorder, blood clots or an autoimmune disease.
If You Are Pregnant
Once you are pregnant, you need to follow your doctor's advice, keep all of
your prenatal care appointments and be on the alert for warning
signs of preeclampsia.
Tests You Can Expect Before or During Pregnancy
Blood Pressure - If preeclampsia is suspected you can expect a number of tests. Your blood pressure will be checked for abnormally high readings. For example, if your blood pressure was 90/50 mm Hg in early pregnancy and then rose to 120/80 mm Hg, this would mean a dramatic rise in pressure even though both the original and secondary readings are not in the high range.
Urine - You may have a urine test to see if your body is putting out
too much protein. Because one office reading may not be accurate, you may be
asked to give a specimen again in 12 or 24 hours. This may be a simple "dip
stick" test in your doctor's office. If your urine is high in protein but
your blood pressure is in the normal range, this may indicate that you should
be watched carefully for other signs of preeclampsia. .
Other Lab Tests - Laboratory tests are critical in establishing a diagnosis. If you have preeclampsia, the tests will help your doctor understand how serious the problem is. Lab tests may be done early in your pregnancy so that your doctor has a "baseline" of information to use in comparison with later lab tests.
In addition to urine and blood tests, your doctor may conduct liver and kidney
function tests and platelet counts for early detection of complications that
sometimes affect women with preeclampsia.
You may undergo an ultrasound scan to check on the growth of the baby. Preeclampsia can cause small babies and it's important to tell if the fetus is having growth problems and to see if the placenta is working properly.
The baby's heart, respiration and movement may be monitored externally with ultrasound to make sure that all is well.
Sources for this information include patient education from the American College of Obstetricians and Gynecologists; Thomas Easterling, M.D., associate professor of Gynecology and Obstetrics at the University of Washington and the March of Dimes.
