Pre-eclampsia and High Blood Pressure During Pregnancy
Examinations and Tests
High blood pressure (hypertension) and pre-eclampsia are typically detected during regular prenatal checkups. Because these conditions can get worse rapidly and can be life-threatening to you and your fetus, it's important that you have regular checkups during your pregnancy.
Pre-pregnancy
A pre-pregnancy blood pressure reading is used to:
- Screen for chronic high blood pressure (hypertension). It's important to know whether you have chronic high blood pressure before becoming pregnant, because it increases your risk of developing pre-eclampsia.
- Provide a baseline measurement that can be compared with later readings during pregnancy.
Routine prenatal tests
Certain tests are given at each prenatal visit to monitor for high blood pressure and pre-eclampsia. These include a:
- Blood pressure reading. (See considerations about blood pressure readings during pregnancy for more information.)
- Urine test for excess protein in the urine (proteinuria), a sign of pre-eclamptic kidney damage.
- Weight measurement. (Rapid weight gain can be an indicator of pre-eclamptic fluid retention.)
Tests for pregnant women considered high-risk for pre-eclampsia
Additional tests may be used to monitor for signs of pre-eclampsia, including:
- Blood tests to check for blood abnormalities (as in HELLP syndrome) and for signs of kidney damage. (Elevated uric acid in the blood is often the earliest sign of pre-eclampsia.)
- Creatinine clearance test, which requires both a blood sample and a 24-hour urine collection, to assess kidney function.
- 24-hour urine collection test to assess protein in the urine.
Tests for women with pre-eclampsia
If results from one or more of the above tests suggest that you have pre-eclampsia, you and your fetus will be closely monitored throughout the remainder of your pregnancy. The type and frequency of testing depend on the severity of the pre-eclampsia and the time remaining until your pregnancy reaches full term (37 to 42 completed weeks). Testing is more frequent and extensive when pre-eclampsia is severe and the pregnancy is far from full-term (less than 36 weeks).
Tests that may be given to assess your health if you have pre-eclampsia include:
- A physical examination for signs and symptoms of worsening pre-eclampsia.
- Blood tests to check for blood abnormalities and kidney damage.
- A creatinine clearance test, which requires both blood and urine samples, to assess kidney function.
Tests for women with eclampsia
If you have a seizure (eclampsia), one or more of the following tests may be done after delivery to assess your brain function and condition:
- A computed tomography (CT) scan uses X-rays to produce detailed pictures of structures inside the body.
- Magnetic resonance imaging (MRI) uses a magnetic field and pulses of radio wave energy to provide pictures of organs and structures inside the body.
- An electroencephalogram (EEG) measures the brain's electrical activity using sensors attached to your head and connected by wires to a computer.
Tests for the fetus
If you develop high blood pressure, pre-eclampsia, or both, your fetus's health also will be closely monitored. The more severe your condition, the more frequent the fetal testing, ranging from once a week to daily.
Tests commonly used to monitor fetal health include:
- Electronic fetal heart monitoring (including non-stress tests), which records the fetal heart rate and the change in heart rate with fetal movement.
- Fetal ultrasound, which uses reflected sound waves to produce a computerized picture of the fetus, placenta, and uterus to check:
- Fetal well-being and growth.
- The condition of the placenta and the possibility of placenta abruptio.
- The amount of amniotic fluid surrounding the fetus.
Less commonly, amniocentesis is used to check fetal well-being if preterm delivery is being considered as a treatment option. For this procedure, a needle is inserted into your abdomen to collect amniotic fluid from inside the uterus. The fluid is then checked for chemical signs that the fetus's lungs are mature.
Early Detection
Throughout your pregnancy, prenatal visits will include routine blood pressure measurements and urine tests to screen for pre-eclampsia.
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| Author: | Shannon Erstad, MBA/MPH Carrie Henley | Last Updated: March 15, 2007 |
| Medical Review: | Joy Melnikow, MD, MPH - Family Medicine Anne C. Poinier, MD - Internal Medicine Gregory A L Davies, MD, FRCSC, FACOG - Maternal-Fetal Medicine William Gilbert, MD - Perinatology | |
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