To reduce chronic hypertension, the choice of antihypertensive medication is determined based on safety for the fetus. Therapy should be initiated in consultation with a doctor, as untreated hypertension carries high risks.
Pregnant women with hypertension should be closely monitored and advised to limit excessive activity, avoid alcohol consumption or smoking, and limit salt/sodium intake to 100 mmol/day. Weight loss is not necessary, even for obese pregnant women, as it can reduce fetal weight.
If complications occur, mothers with chronic hypertension are at increased risk of superimposed preeclampsia and placental abruption. Placental abruption is the premature separation of a normally positioned placenta from the uterine wall, which occurs during pregnancy rather than during delivery. Babies born to mothers with severe hypertension generally have a very poor outcome, with a high risk of death.
Mothers with hypertension can safely breastfeed, but should still discuss breastfeeding options with their doctor, as most antihypertensive medications are excreted in breast milk in low concentrations. If the mother has stage I hypertension (diastolic blood pressure <100 mmHg), antihypertensive medications can be discontinued for several months while blood pressure is continuously monitored.
