Orthostatic hypotension during pregnancy: understanding and preventing It

During pregnancy, your body undergoes many changes that can sometimes come with unusual sensations, such as dizziness or feeling faint when you stand up too quickly. Why does blood pressure sometimes become too low? What are the risks for you and your baby? How can you prevent these moments of discomfort?

Orthostatic hypotension during pregnancy: let’s take a closer look.

What is orthostatic hypotension during pregnancy?

Orthostatic hypotension is a common phenomenon in pregnant women, causing feelings of dizziness, faintness, or a drop in blood pressure when moving to a standing position.

How does orthostatic hypotension work during pregnancy?

Orthostatic hypotension, or orthostatic low blood pressure, is defined as a sudden drop in blood pressure when you stand up. This rapid change in blood pressure leads to reduced blood flow to your brain, causing dizziness, faintness, and sometimes even falls.

In pregnant women, this phenomenon differs from standard low blood pressure because it mainly occurs during changes in posture. The blood vessels, arteries, and cardiovascular system must then adapt quickly, which can be more difficult during pregnancy.

Why does pregnancy promote orthostatic hypotension?

Pregnancy deeply changes blood circulation and blood pressure regulation. Several factors explain why orthostatic hypotension during pregnancy is common:

• Hormonal changes: progesterone and estrogen cause vasodilation (widening of the blood vessels), making it harder to maintain stable blood pressure during changes in position.
• Increased blood volume: to nourish your baby, your body produces more blood, which can disrupt the usual balance between the heart, arteries, and blood vessels. To meet the fetus’s needs, blood volume increases by 30 to 50%.
• Cardiac adaptation: your heart has to pump more, but the speed of adjustment may be disrupted, leading to a drop in blood pressure during sudden movements.
• Dehydration: common during pregnancy due to nausea and vomiting, it reduces blood volume and increases the risk of a drop in blood pressure.
• Certain medications: antihypertensive treatments or diuretics can also worsen this phenomenon.

These characteristics make orthostatic hypotension more common during pregnancy. Fortunately, the effects are usually mild.

Want to learn more? Feel free to download the May app, where you’ll find plenty of resources to support and guide you throughout your pregnancy.

Symptoms of orthostatic hypotension during pregnancy

Orthostatic hypotension during pregnancy can cause various symptoms that are usually not serious, but it is important to know how to identify them so you can respond appropriately and prevent possible complications.

How does orthostatic hypotension during pregnancy present?

These signs, linked to a sudden drop in blood pressure, are most often mild but can be alarming. Here are the common symptoms to recognize:

• Dizziness: a spinning sensation, loss of balance, or feeling unsteady.
• Faintness: a sudden feeling of weakness, a need to sit or lie down immediately, sometimes accompanied by cold sweats or nausea.
• Vision disturbances: blurred vision, bright spots, or a sensation of a veil over the eyes, appearing during the drop in blood pressure.
• Loss of consciousness (syncope): rarer, but possible if blood pressure becomes too low and blood flow to the brain is insufficient.
• Heart palpitations: the heart rate speeds up to compensate for the drop in blood pressure.

Orthostatic hypotension during pregnancy: when should you seek medical advice?

Although most episodes of orthostatic hypotension during pregnancy are not serious, some signs should lead you to contact your healthcare professional promptly. These situations may reveal a serious underlying cause or expose you to complications. Seek medical advice without delay if:

• Fainting episodes are frequent, severe, or accompanied by loss of consciousness.
• You fall because of an episode of low blood pressure.
• Dizziness persists even at rest, or occurs without any change in posture.
• You develop chest pain.
• You notice unusual shortness of breath, neurological symptoms, or altered consciousness.
• Symptoms are accompanied by repeated vomiting, significant dehydration, or an inability to eat.
• You are taking medications likely to affect blood pressure or blood vessels.

Diagnosing orthostatic hypotension during pregnancy

Diagnosing orthostatic hypotension during pregnancy is based above all on careful attention to your symptoms and an appropriate clinical examination. Your healthcare professional will begin with a detailed assessment by asking about the occurrence of:

• dizziness,
• fainting episodes,
• falls
• or sensations of low blood pressure.

They will also look into:

• your medical history,
• the frequency of episodes,
• the context in which they occur.

The clinical examination is simple. It involves measuring your blood pressure and heart rate while lying down, then again after 1 to 3 minutes in a standing position. This test helps confirm a drop in systolic or diastolic pressure when moving to a standing position.

If needed, additional tests, such as a blood test, may be offered to rule out another cause of low blood pressure or heart problems.

Preventing orthostatic hypotension during pregnancy

Adopting a healthy lifestyle helps prevent episodes of orthostatic hypotension:

• Regular hydration: drink at least 1.5 to 2 liters of water per day, or more in hot weather or if you are physically active. Good hydration helps prevent dehydration, which can worsen low blood pressure and dizziness.
• A balanced diet: choose varied meals rich in fruits, vegetables, whole grains, and protein. Split your meals into smaller portions to avoid energy dips related to digestion, and limit foods that are too salty or too sugary, which can disrupt blood pressure balance.
• Changes in posture: stand up slowly, especially in the morning or after sitting or lying down for a long time. This precaution gives your blood vessels and cardiovascular system time to adjust and reduces the risk of faintness or falls.
• Venous support: if needed, compression stockings can help improve blood return in your legs.

In summary, orthostatic hypotension during pregnancy is a common phenomenon that is usually not serious, but it deserves your attention and may require advice from your healthcare professional. By recognizing its symptoms and adopting a healthy lifestyle, it is possible to prevent it and limit its impact on your daily life.

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Photo credits: snegok1967 | nrradmin | shotprime | africaimages

This text was translated from French by an artificial intelligence. The information, advice, and sources it contains comply with French standards and may therefore not apply to your situation. Make sure to complement this reading by visiting the May US/UK app and consulting the healthcare professionals who are supporting you.