High Blood Pressure (Hypertension) During Pregnancy With Dr. Sean Daneshmand | San Diego Health

High Blood Pressure (Hypertension) During Pregnancy With Dr. Sean Daneshmand | San Diego Health

High Blood Pressure (Hypertension) During Pregnancy With Dr. Sean Daneshmand | San Diego Health

High blood pressure during pregnancy can cause complications for both mother and baby. Pregnant women are increasingly suffering from high blood pressure and other related conditions, such as obesity and diabetes, which may cause problems with the heart, lungs or brain. A major concern is preeclampsia, which can occur at any time during pregnancy or after delivery for as long as six weeks.

In this video, host Susan Taylor and medical director for the Scripps Clinic Perinatology Program, Dr. Sean Daneshmand, discuss hypertension in pregnancy. Learn more: http://www.scripps.org/7288y

0:45 - Why is high blood pressure (hypertension) on the rise during pregnancy?
1:09 - What are the symptoms of high blood pressure?
1:28 - How does high blood pressure put the mom and her unborn baby at risk?
2:11 - What is preeclampsia?
2:43 - How can you control high blood pressure during pregnancy?
3:55 - Should you have a conversation with your doctor about high blood pressure and hypertension before getting pregnant?
4:21 - What if you have high blood pressure before getting pregnant?
5:02 - After you’ve given birth, and if you have high blood pressure during pregnancy, what are you at risk for?
5:50 - How do you monitor your blood pressure before, during and after pregnancy?
6:21 - How does the Scripps Clinic Perinatology program help high-risk patients?
7:35 - Final thoughts


Content

0.648 -> (lively music)
6.86 -> - Hi, I'm Susan Taylor with Scripps Health
8.41 -> in San Diego, California.
10.05 -> According to the CDC,
11.35 -> the Centers for Disease Control and Prevention,
13.98 -> one out of 12 to 17 women will develop hypertension,
18.24 -> high blood pressure during pregnancy.
20.78 -> If left untreated,
22.37 -> this can cause major complications for the mom
24.97 -> and unborn child.
26.44 -> Joining us to talk about this
28.02 -> is obstetrician and gynecologist, Dr. Sean Daneshmand.
31.83 -> He's medical director of the Scripps Clinic
34.28 -> Perinatology Program.
35.83 -> Doctor, thanks so much for being with us.
37.72 -> - Thank you for having me Susan.
38.638 -> - So why is high blood pressure also known as hypertension?
42.46 -> Why is it on the rise during pregnancy?
45.9 -> - That's a good question.
46.8 -> I think we have been seeing a rise on comorbidities
52.63 -> prior to pregnancy.
53.64 -> So chronic health issues are on the rise
55.71 -> such as obesity, baseline hypertension
58.31 -> or essential hypertension or diabetes
60.73 -> and these lead to an increased risk
62.91 -> for development of hypertension or high blood pressure
65.49 -> in pregnancy.
67.4 -> - And so what are the symptoms of high blood pressure?
69.8 -> - Typically the symptoms are headache,
71.55 -> visual disturbances, epigastric pain,
74.4 -> pain in the upper right region of the abdomen
77.26 -> underneath your right rib cage for example,
79.76 -> swelling, excessive weight gain.
82.67 -> Those are typically the symptoms.
84.67 -> - And how does it put the mom and her unborn baby at risk?
88.6 -> - Well, with mom, you know,
89.72 -> this is patients that have severe high blood pressure.
92.13 -> I think about the brain, they could have
94.23 -> something called eclampsia, which is seizure disorder.
97.01 -> They could have a stroke.
98.01 -> Think about the lungs, they could go into fluid overload.
100.27 -> Think about the heart,
101.14 -> myocardial infarction or heart attack.
103.37 -> Think about kidney failure.
105.13 -> You know, with babies, we think about growth restriction.
107.38 -> The babies are not growing as well.
109.01 -> They could have something called placental abruption
111.26 -> where the placenta separates from the uterine wall.
113.78 -> Babies can pass away from this.
115.64 -> It really is depends on how severe the blood pressure is
119.36 -> and how quickly we can address
121.2 -> the elevation of the blood pressure
122.52 -> and other organ damages for example.
125.29 -> - Can you just go into a little bit more detail
128.46 -> what is preeclampsia?
131.26 -> - So preeclampsia is an elevation in blood pressure
135.1 -> in association with spillage of protein.
137.25 -> Remember proteins are macromolecules, right?
139.32 -> We usually don't spill them.
140.92 -> But in pregnancy, there's damage to these vessels.
143.54 -> So mom starts getting more protein.
145.8 -> There's also a condition called gestational hypertension
148.42 -> where it's elevation in the blood pressure
150.62 -> without evidence of proteinuria or any spillage of protein.
153.61 -> This typically happens after 20 weeks of gestation
156.48 -> and typically resolves by about six to 12 weeks
158.97 -> after delivery.
160.37 -> - So how can you control high blood pressure
162.52 -> during pregnancy?
163.968 -> - Unfortunately, the treatment for preeclampsia is delivery
167.66 -> but it depends on again,
169.63 -> what kind of a risk are we willing to take on mom's health
172.37 -> and obviously with baby,
173.59 -> how early do we want to deliver this baby?
175.44 -> So typically again,
177.63 -> if a patient has high pressure or preeclampsia in pregnancy,
180.72 -> we'd like to push the pregnancy as far along as we can
184.3 -> typically up until about 37 weeks of gestation
187.16 -> if the patient has preeclampsia without severe features.
190.45 -> Those are for example,
192.28 -> the patient doesn't have any neurologic abnormalities,
194.37 -> is not experiencing any headaches that don't resolve
196.47 -> with taking a pain medication for example,
198.78 -> or does not have any significant laboratory abnormalities.
201.68 -> If a patient has any of those
203.23 -> and also has severe range blood pressures which are
207.35 -> systolic blood pressure 160
209.35 -> and diastolic blood pressure of 110 equal or above.
212.55 -> These patients are typically delivered at 34 weeks
214.88 -> or earlier.
215.713 -> Preeclampsia typically Susan happens
217.42 -> in the latter stages of the pregnancy,
218.67 -> in the latter stages of third trimester,
221.11 -> but it can happen at any time.
222.52 -> I've delivered babies at 23 weeks, at 24 weeks,
224.88 -> at 20 weeks with preeclampsia unfortunately.
227.63 -> - In terms of hypertension, high blood pressure,
230.04 -> is this really a conversation you should have
232.23 -> with your doctor before you get pregnant?
234.97 -> - Again, the time where we can make
237.07 -> the most amount of difference in a patient's care
239.37 -> is really preconception.
240.98 -> So before you get pregnant,
242.31 -> seek care with your obstetrician gynecologist,
245.55 -> with your family medicine doctor,
247.11 -> and because you're not only doing,
249 -> do you wanna make sure you find tune the elevations,
251.9 -> the blood pressure,
252.733 -> but also make sure that you're taking medications
254.22 -> that are safe in pregnancy.
256.56 -> - And what if you had high blood pressure
258.22 -> before you got pregnant?
259.75 -> What steps should you be taking?
262.13 -> - So again, addressing your health prior to pregnancy,
264.55 -> if there are any comorbid issues such as obesity or diabetes
268.07 -> and making sure again, you address those
270.14 -> as much as possible,
272.03 -> you know, making sure again
272.863 -> you're on the right type of medication.
274.65 -> When you get pregnant, we do also some baseline labs.
278.44 -> Also we recommend patients to take low dose aspirin
281.25 -> when they're pregnant
282.15 -> because that has shown to reduce
284.783 -> the risk of superimposed preeclampsia,
287.31 -> which means preeclampsia on top of their
289.37 -> already existing hypertension.
291.65 -> And then these patients get monitored much more frequently
294.19 -> as one can imagine.
295.9 -> - And after you've given birth,
297.05 -> if you've had high blood pressure during pregnancy,
300.3 -> what does this put you at risk for?
302.68 -> - That's a very good question.
303.85 -> You know women that have preeclampsia during their pregnancy
307.54 -> have an increased risk for ischemic heart disease.
309.8 -> A lot of times I tell patients
311.039 -> your pregnancy gives you a window as to what your
313.64 -> your health could look like.
314.8 -> So patients who've got preeclampsia,
316.87 -> who also deliver prematurely for example
319.04 -> because of the issues associated with preeclampsia,
321.69 -> have a significant high risk for ischemic heart disease
324.21 -> or heart-related issues, cardiovascular-related issues.
326.66 -> So therefore again, it's very important
329.02 -> to listen to the pregnancy.
330.18 -> We respect pregnancy very much
332.18 -> and make sure that again
333.29 -> you see your primary care physician,
334.78 -> you have frequent checkups,
336.33 -> you check your lipid profile,
338.41 -> you're have a very healthy diet.
339.95 -> Again, exercise,
341.27 -> all the things that go with making sure
342.83 -> that you maintain your health.
345.02 -> - So how do you monitor your blood pressure before,
347.9 -> during and then after pregnancy?
350.27 -> - So you can purchase a blood pressure monitor
352.35 -> and you wanna measure your blood pressure sitting down,
355.82 -> legs not crossed, not talking.
357.54 -> Usually wanna make sure you avoid any caffeine
360.072 -> prior to taking your blood pressure.
362.07 -> I usually do it at a time when you're relaxed,
363.86 -> arm at the level of the heart and you check it.
366.17 -> In pregnancy, we want your systolic blood pressure
368.89 -> to be less than 140 millimeters of mercury
371.12 -> and your diastolic blood pressure to be less than
372.94 -> 90 millimeters of mercury.
375.05 -> - Talk about the Scripps Clinic Perinatology Program
378.63 -> and how it helps these high risk patients.
381.78 -> - I can go on and on forever.
383.35 -> So Scripps Perinatology was started in 2018.
386.47 -> We're very excited.
387.303 -> We're a team of maternal fetal medicine specialists.
389.38 -> We're physicians that have done a residency in OB-GYN
391.96 -> and then did a,
392.793 -> did a three-year fellowship in maternal fetal medicine.
395.62 -> We're part of a team Susan.
396.86 -> We work with our OB-GYNs,
398.77 -> work with our family practitioners,
400.2 -> work with other clinicians that ensuring again,
404.18 -> moms and babies have the best outcome.
406.66 -> We want to provide excellent clinical care
408.66 -> to our high-risk moms
410.27 -> and we also wanna make sure the patients
412.26 -> have the best experience they wanna know.
414.84 -> We want them to know that we care about them.
417.06 -> That's very important to us.
418.21 -> The patient experience also matters significantly
420.65 -> because these are tough times for some of these parents.
423.34 -> A perinatologist is an internal medicine physician
427.27 -> to pregnant moms.
428.17 -> So any kind of complications, whether it's
430.48 -> for example, we talked about hypertension or diabetes
433.23 -> or cancer or a stroke or heart disease or any fetal issues,
438.49 -> we are involved in the care that patient.
440.79 -> And a lot of times we play as the quarterback,
442.6 -> making sure that the patient is seen,
444.35 -> seeing all the specialists,
445.6 -> all that whether it's pediatric or adult.
448.04 -> And again, making sure that we kind of bring in full circle
451.13 -> the care for that mom and child.
453.67 -> - Any final thoughts doctor?
455.47 -> - Pregnancy is a very valuable time in our lives.
457.79 -> It sets the course of our life not only as a newborn
460.16 -> but as an adult.
461.2 -> This is all the study of epigenetics.
463.62 -> We're just very thrilled to be a part of this
465.38 -> and I appreciate you for having me on.
468.88 -> - Thanks so much, doctor.
469.77 -> We really appreciate you being with us.
471.93 -> If you want more information on hypertension,
474.14 -> high blood pressure during pregnancy,
476.02 -> just click on the link or go to scripps.org/videos.
479.72 -> Want more critical information about your health?
482.24 -> Please subscribe to our Scripps Health YouTube channel
484.93 -> and follow us on social media at Scripps Health.
487.94 -> I'm Susan Taylor, thanks for joining us.
491.734 -> (lively music)

Source: https://www.youtube.com/watch?v=C9Fpq4qKw_c