Low Blood Pressure in Pregnancy

Premise

La low pressure, or more properly hypotension, is the condition in which resting blood pressure values ​​are lower than normal.
In numerical terms, if normal blood pressure falls within a range of values ​​ranging from 90/60 mmHg to 129/84 mmHg, those suffering from low blood pressure have resting blood pressure less than 90/60 mmHg (NB: the first value is the so-called systolic pressure o maxim, while the second value is the so-called diastolic pressure o minima).

What is Low Blood Pressure in Pregnancy?

La low blood pressure in pregnancy it is a very common phenomenon, which is strictly dependent on the characteristic hormonal changes of this particular period of a woman's life.

Causes

Who is the real creator of Low Blood Pressure in Pregnancy?

Low blood pressure in pregnancy is determined by peripheral vasodilation, which derives from the natural increased production of the hormone progesterone and has the task of ensuring the supply of blood necessary for his correct development of the fetus. In essence, therefore, low blood pressure in pregnancy is the result of an absolutely physiological mechanism, without which adequate fetal development could not take place.

To learn more about the functions of progesterone during pregnancy, read: Hormones and pregnancy

Readers are reminded that the factors affecting blood pressure also include so-called peripheral resistors, that is the resistances opposed to the blood circulation by the state of constriction of the small arterial vessels. Faced with a drop in such resistance - a drop that can occur as a result of peripheral vasodilation - blood pressure decreases.

When does low blood pressure in pregnancy start and how serious is it?

In the pregnant woman, blood pressure tends to drop progressively since very first settimane of pregnancy.
At the 24th week of gestation, the magnitude of the blood pressure drop is, according to statistical averages, approximately 5-10 points, for systolic blood pressure, and just over 10 points, for diastolic blood pressure. In essence, therefore, it is almost always a reduction in blood pressure of mild degree.

How long does low blood pressure last in pregnancy?

In pregnant women, low blood pressure is a condition that is usually maintained until the end of the second trimester of pregnancy. After this period, in fact, blood pressure values ​​gradually begin to rise, until returning, when the birth is near, to pre-pregnancy levels (ie before pregnancy).

Risk Factors of Low Blood Pressure in Pregnancy

The drop in blood pressure during pregnancy is in itself a highly probable phenomenon.
However, there are circumstances that make it even more practical and that a woman and her gynecologist must consider at the time of a possible gestation.
Among the aforementioned circumstances, the main ones are:

• The presence of aconstitutional hypotension, that is the tendency to always have a low blood pressure of a mild degree;
• The presence of hormonal diseases, such as Addison's disease or diabetes;
• The presence of heart ailments, such as bradycardia or read arrhythmia;
• The tendency to suffer from anemia;
• The low intake of folate e Vitamin B12 through diet.

Consequences

What are the Consequences of Low Blood Pressure in Pregnancy?

While low blood pressure during pregnancy can be valuable for chronically hypertensive women, for many normotensive women and for most women with symptoms of hypotension even before the happy event, the drop in blood pressure associated with gestation can be a source of problems.
Among these problems, the most common are: weakness, dizziness, dizziness, feeling of fainting, blurred vision, nausea, headache e fatigue.
A peculiarity of the symptoms ranging from weakness to blurred vision is that they manifest themselves especially during the transition from a sitting / lying position to an upright position.

Other Symptoms of Low Blood Pressure in Pregnancy?

• Palpitations
• Difficulty concentrating
• Increased sense of thirst

What Behaviors Can Aggravate Pregnancy Low Blood Pressure Symptoms?

A series of bad behavioral habits can aggravate the symptoms of low blood pressure in pregnancy.
Among these behavioral habits, the following are reported in detail:

• Getting up too quickly from a sitting or lying position.
  The sudden passage from the sitting / lying position to the upright one involves, due to the force of gravity, a sudden recall of blood to the lower limbs (therefore to the legs).
  If, as happens in the presence of hypotension, the venous system of the legs is unable to immediately return all the blood seized and thus oppose blood stagnation in the lower limbs, there is an inevitable reduction in blood return to the heart and the consequent appearance of weakness, dizziness, blurred vision and fainting.
• Lie on your back (back).
  Especially in the last two trimesters of pregnancy, the enlargement of the uterus can lead to occlusion of the inferior vena cava and pelvic veins.
  This problem is particularly evident when the pregnant woman assumes or is in the supine position, so much so that about 1/3 of pregnant women develop a condition known as "hypotensive syndrome from supine position"; Supine hypotensive syndrome includes a wide range of symptoms - including tachycardia, hypotension, anxiety, nausea, and dizziness - all of which can be traced back to lying on the stomach.
• Not providing the right amount of liquids and / or food.
  Hypoglycemia and dehydration are two factors that trigger and aggravate the condition of hypotension, as they lead to a lowering of the total volume of blood circulating in the body (hypovolemia).
  Readers are reminded that the circumstances affecting blood pressure include blood volume, that is, the aforementioned total volume of blood circulating in the body.
• Eating too large meals.
  After meals, blood pressure undergoes a physiological reduction, thanks to the greater flow of blood to the digestive system and the lower blood perfusion to the other organs of the body.
  The consumption of too large meals accentuates the aforementioned reduction, particularly in people prone to low blood pressure, such as pregnant women.
• Drinking alcoholic beverages.
  Besides having deleterious effects on the psycho-physical development of the fetus, alcohol contributes to aggravate hypotension and the resulting disorders, due to its known vasodilating effect.
• Maintain an upright position for a long time, especially if it is static.
  The static maintenance of the upright position for long periods of time involves, due to gravity, the stagnation of blood in the lower limbs. All this, in a person suffering from low blood pressure, has the effect of aggravating the symptoms of hypotension, as there is no adequate blood return to the heart.

Other Circumstances That May Aggravate Low Blood Pressure in Pregnancy

In addition to the behaviors described above, the following may contribute to further aggravating low blood pressure in pregnancy:

• The presence of iron deficiency anemia, i.e. the pathological decrease in hemoglobin in the blood (anemia) due to an iron deficiency (sideropenic).
  In addition to being in itself a fairly common condition in the female population, iron deficiency anemia is an even more concrete possibility for pregnant women, as pregnancy involves an increase in iron requirements.
• L'high temperature.
  The heat promotes peripheral vasodilation and blood sequestration in the lower limbs; as seen in other circumstances, these two factors contribute to the drop in blood pressure, especially in people already prone to the problem, such as pregnant women.

Complications of Low Blood Pressure in Pregnancy

In the pregnant woman, if the pressure drop during pregnancy is severe higher than mild - very rare situation - significantly increases the risk of damage to key organs for human health.
Furthermore, scientific studies have shown that, in such situations, there is also a greater inclination to ectopic pregnancy.

Is Low Blood Pressure in Pregnancy Harmful to the Fetus?

So far, no doctors, researchers, etc. has conducted adequate research into the precise effects on the fetus of low blood pressure in pregnancy.
In the past, however, some experts had advanced the hypothesis, never satisfactorily demonstrated, that the drop in the pregnant woman's blood pressure could lead to a higher risk of low birth weight, learning difficulties and even fetal death for the future unborn child.

When to see a doctor immediately?

Low blood pressure in pregnancy requires the pregnant woman to contact her doctor immediately or to go to the nearest hospital when it causes:

• Repeated fainting
• Severe headaches;
• Protracted vomiting
• Dyspnea;
• Extremely rapid pulse;
• Chest pain;
• Numbness in some part of the body.

Remedies

What is the Treatment of Low Blood Pressure in Pregnancy?

In most cases, low blood pressure in pregnancy does not require specific care and treatment (therefore no drugs), but it only requires a few tricks, useful for controlling the symptoms of hypotension and preventing it from excessively disturbing the mother's quality of life.
The measures in question include countermeasures to circumstances that aggravate hypotension in pregnancy and other remedies.
In detail, here is what these countermeasures and remedies consist of:

• Switch from sitting / lying position to standing position gradually, rather than suddenly;
• Lie down on your left side, rather than from the back. In this way, the blood return to the heart is favored even in a lying position. To make the position more comfortable, a pillow can be stowed under the thighs or along the back.
  It is particularly important to adhere to this countermeasure starting from the 16th week of gestation;
• To consume small and frequent meals, and hire generous amounts of liquids;
• Avoid the consumption of alcoholic beverages;
• When the upright position is expected to be maintained for long periods of time, stimulate blood circulation along the lower limbs, through the periodic movement of the leg muscles. It is useful, for example, to raise yourself up on your toes from time to time, as this movement involves alternating contractions and relaxation that acts as a "pump effect" on the blood;
• Avoid staying in excessively hot and humid environments;
• Integrate your iron intake coming from the diet through specific supplements, as prescribed by the doctor;
• Avoid the consumption of coffee, especially in the evening or before going to bed. Coffee has hypotensive effects;
• Avoid physical activities that are too intense. After engaging in vigorous physical activity, blood pressure tends to drop;
• Wear compression stockings. This type of stockings promotes the return of venous blood from the lower limbs to the heart and is an excellent remedy for low blood pressure in pregnancy and beyond.

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