What is dangerously low blood pressure in pregnancy




















It's often benign. Postpartum diarrhea after a C-section is normal. Sharing our experiences of pregnancy and infant loss can help us heal. Health Conditions Discover Plan Connect. Medically reviewed by Debra Rose Wilson, Ph. Blood pressure and pregnancy Low blood pressure Risks Effects on the baby Symptoms Diagnosis Treatment Self-care Postpartum blood pressure Outlook Overview Having low blood pressure during pregnancy is common.

Effects of pregnancy on blood pressure. Other factors that can contribute to low blood pressure include: dehydration anemia internal bleeding prolonged bed rest certain medications heart conditions endocrine disorders kidney disorders infections nutritional deficiencies allergic reaction. Some people have low blood pressure their whole lives and have no signs of it. Dangers of low blood pressure during pregnancy.

Extremely low blood pressure can lead to falls, organ damage, or shock. Does blood pressure affect the baby? Symptoms of low blood pressure. Signs and symptoms of low blood pressure may include: dizziness lightheadedness, especially when standing or sitting up fainting nausea tiredness blurred vision unusual thirst clammy, pale, or cold skin rapid or shallow breathing lack of concentration Call your healthcare provider if you develop any symptoms of low blood pressure during pregnancy.

Low blood pressure is diagnosed with a simple test. Self-care for low blood pressure during pregnancy. Eat small meals throughout the day. Drink more water. Wear loose clothing. Postpartum blood pressure.

Parenthood Pregnancy Pregnancy Health. Occasionally, low blood pressure may be indicative of some other problem. It may be the result of an ectopic pregnancy , in which a fertilised egg becomes implanted outside your uterus. Low blood pressure has a variety of symptoms. If you experience any of these, you should mention them to your doctor. We know a lot less about the effects of low blood pressure on babies than the effects of high pressure.

Some research suggests that it may lead to stillbirth and low birth weight, but this correlation is difficult to establish because there are so many other variables and risk factors involved during pregnancy. At entry, detailed demographic, socioeconomic, and behavioral information was collected by in-person interview. A medical history was obtained, and a physical examination was also given. Women were interviewed, and physical findings were recorded in all following prenatal visits.

Blood pressure was recorded at entry, during each prenatal visit, during labor and delivery, and postpartum. Either Korotkoff phase 4 muffling or phase 5 disappearance was used for DBP 1. A validation study in which the information on blood pressure was checked against that in the original medical records showed remarkable accuracy 1. In that study, the authors selected recordings suspected of error because of wide deviations from the sequence of blood pressures recorded in that patient during the course of pregnancy.

The percent error for these blood pressure readings was 1. Furthermore, since assessment of blood pressure has not changed substantially in the last 40 years, the current data are suitable and reliable for the purpose of our study. A total of 58, pregnancies were included in the Project. We restricted our analyses to singleton pregnancies with a first prenatal visit before 25 weeks, at least three prenatal visits, and birth between 25 and 45 weeks inclusive.

Since it is well established that high blood pressure during pregnancy causes poor perinatal outcomes, we limited our analysis to women with baseline DBP less than 80 mmHg. A total of 28, subjects were eligible. The baseline DBP is defined as the average of all the DBP measures from 15 to 24 weeks of gestation 83 percent of subjects had at least two measures. Since blood pressure progressively rises in the second half of pregnancy and intrapartum blood pressure is affected by other factors, we considered the last antepartum DBP to be more likely to reflect true DBP and, therefore, preferable to the actual highest recording.

Postpartum blood pressure was defined as blood pressure at least 5 weeks after delivery. Main outcomes include preterm births less than 34 weeks based on the last menstrual period and severe small for gestational age SGA less than the 5th percentile 4.

To reduce potential misclassification owing to erroneous gestational age, infants with birth weights of 3, g or more were considered to have a gestational age of 34 weeks or more 4. Univariate analysis was conducted first. We used multiple logistic regression for preterm birth and SGA to adjust for potential confounders.

Appropriate transformation of the variables was made before they were incorporated into the statistical models. However, this trend was reversed among those with excessive rise in DBP.

The striking and consistent pattern prompted us to ask who these subjects with low baseline DBP were. Table 1 indicates that these women were generally younger, shorter, lighter, leaner, poorer, and more often minority and that they gained less weight.

These are well-known risk factors for poor perinatal outcomes. After we had controlled for race, socioeconomic status, prepregnancy body mass index, and smoking during pregnancy, low blood pressure was no longer associated with very preterm birth.

The adjusted relative risks were 1. Likewise, low blood pressure was not associated with severe SGA figure 2. We reran the logistic regression for severe SGA without net weight gain. The results were similar. Figure 2 further suggests that rise in DBP in late pregnancy does not seem to influence the risk of SGA in most women. However, women with relatively high baseline and excessive rise in DBP had twice the risk of having a baby with severe SGA. Characteristics of women with a low diastolic blood pressure at the baseline, Collaborative Perinatal Project, — Analysis of variance and chi-square test were used to test the significance of differences among levels of baseline diastolic pressure for continuous and categorical variables, respectively.

Our study indicates that the association between low blood pressure during pregnancy and poor perinatal outcomes is due to confounding by other risk factors. After multiple factors are adjusted for, low DBP in early pregnancy is no longer associated with poor perinatal outcomes.

Literature on this association is not only scarce but is also inconsistent. Incidence of preterm birth, low birth weight, significant meconium staining of the amniotic fluid, and maternal postpartum complications was about twice as high in the former group as in the latter. However, the hypotensive group was significantly younger 26 vs. No confounders were controlled in their analysis.

Accurate blood pressure measurement is difficult to achieve. In the best conducted study so far, Churchill et al. Twenty-four-hour recordings of blood pressure were obtained at around 18, 28, and 36 weeks' gestation. After adjustment for maternal age, height, weight, cigarette smoking, alcohol intake, ethnic origin, gestational age, and pregnancy hypertension syndromes, maternal mean hour DBP at 28 weeks' gestation was inversely associated with birth weight. A 1-mmHg decrease in DBP was associated with This association persisted at 36 weeks' gestation.

Despite the inconsistent findings on whether low blood pressure in midpregnancy is actually beneficial to fetal growth, careful analyses suggest that low blood pressure at least does not impose an additional risk to fetal growth.

Paradoxically, such an epidemiologic observation seems contradictory to limited evidence from clinical studies. Placental perfusion at 28 weeks' gestation and onward was measured by radioisotopes.

More than 80 percent of the patients were considered to have uteroplacental underperfusion. Thirty patients reported only slight discomfort i. The latter were then given mineralocorticoids intramuscularly. Overall, placental perfusion rate improved significantly after treatment. Compared with the untreated women, those who were treated had a lower incidence of preterm birth 5 vs.

These findings were confirmed in a prospective study by the same authors 8 , which involved 60 women with hypotension in pregnancy. Half of the women were treated and compared with the other, untreated half.



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