Treatment Options for Gestational Hypertension

Pregnant woman laying on bed

Camille Tokerud / /Getty Images

The treatment of gestational hypertension, in which blood pressure levels spike about halfway through pregnancy, follows a different set of guidelines than the treatment of general high blood pressure. The main goal of treatment is to prevent the development of more serious conditions. Pregnant parents can develop seizures or placental abruption, while their babies can be harmed by fetal growth restriction, pre-term delivery, or stillbirth.

Treatments for Pregnancy-Induced Hypertension

There are several strategies to treat hypertension that develops during pregnancy. These strategies are similar to those used to treat preeclampia, which is when a pregnant person has gestational hypertension as well as increased levels of protein in their urine. Up to half of people with gestational hypertension go on to develop preeclampsia or symptoms consistent with it.

In choosing a specific treatment plan, details such as blood pressure levels, how far along the pregnancy is, and how well the baby is doing will all be considered. It used to be common for doctors to prescribe bed rest to control gestational hypertension, but the American College of Obstetricians and Gynecologists (ACOG) no longer recommend it, citing a lack of evidence to back up its effectiveness. Now, primary treatments for gestational hypertension include medications and prenatal monitoring.

Medications

Drug therapy is an effective, proven way to moderate blood pressure during pregnancy, though care must be used in selecting and administering drugs. Because drug therapy during pregnancy can carry risks for both the mother and the baby, it is usually reserved for use only in cases where the blood pressure is very high.

According to ACOG recommendations, medications should be started as quickly as possible if your blood pressure is 160 mm Hg or more (or diastolic blood pressure of 110 mm Hg or more) for 15 minutes or longer. Drugs to treat spiking high blood pressure in pregnancy include:

  • Labetalol: a beta-blocker, which helps to slow your heart rate
  • Hydralazine: a vasodilator, which relaxes blood vessels to promote blood flow
  • Nifedipine: a calcium-channel blocker, which also eases the blood vessels to prevent the heart from needing to pump so hard

Short-term, emergency-use medications are often given intravenously to be as effective as possible quickly. If medication is needed for a longer-term period, oral versions of some common hypertensive drugs are used.

Maternal and Fetal Evaluation

If you have high-blood pressure during pregnancy, ACOG recommends regular prenatal check-ups for both you and your baby. Doctors are likely to perform the following tests to monitor your gestational hypertension:

For the pregnant parent:

  • Weekly evaluations of your platelet count, serum creatinine, and liver enzyme levels
  • Weekly assessment of protein in the urine (indicating preeclampsia)
  • Regular blood-pressure checks, either by a doctor or at home (after receiving medical guidance and the proper supplies)

For the baby:

  • Weekly amniotic fluid assessment
  • Ultrasound to determine fetal growth every 3 to 4 weeks of gestation

If your hypertension has become severe enough to put you or your baby's health at immediate risk, or getting to regular check-ups is hard, your doctor might recommend hospitalization during certain phases of pregnancy to ensure that you and your child are well cared for.

Labor and Delivery With Hypertension

Almost all people with uncomplicated gestational hypertension will go on to have a normal, uneventful deliveries. These people typically have successful vaginal deliveries and no other serious problems.

In cases where the blood pressure is severely elevated, or in cases of preeclampsia, early delivery is often considered. In cases of serious problems, like eclampsia, early delivery is usually attempted to avoid the development of potentially life-threatening complications.

A Word From Verywell

It can be a shock to learn that your blood pressure has become a problem midway through your pregnancy, especially if you've never dealt with hypertension before. In general, however, it's important to remember that the vast majority of people with gestational hypertension go on to have a successful, full-term pregnancy and deliver healthy infants.

The good healthcare that led you to discover your gestational hypertension should continue to serve you and your child well throughout the prenatal period. With regular checks to monitor your blood pressure and your baby's growth, you and your doctor can work together to ensure you're doing everything you can to maintain a healthy pregnancy.

Loading shell for quizzesApp1 vue props component in Globe.
Was this page helpful?
Article Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222. Obstetrics and Gynecology. 2020;135(6):e237-e260. doi:10.1097/AOG.0000000000003891.

Additional Reading