6 Pruebas Rutinarias Durante el Embarazo que son Importantes para el Bebé (y para la Salud Cardíaca de la Madre)

Una ginecóloga que mide la presión arterial de su paciente embarazada que está sentada en la cama de un hospital

Cómo los exámenes preventivos que se realizan habitualmente durante el embarazo pueden vislumbrar la salud cardiovascular de una mujer embarazada, tanto a corto como a largo plazo

Durante todo el embarazo, su equipo de atención médica le realizará una serie de controles y pruebas de rutina para supervisar su estado de salud y el de su bebé. Estos exámenes preventivos son importantes para realizar un seguimiento del desarrollo de su bebé, pero ¿ha pensado en lo que cada prueba puede indicarle también sobre su propia salud y su corazón?

Las enfermedades cardiovasculares son la principal causa de la mortalidad materna. Además, ciertas afecciones relacionadas con el embarazo pueden influir en el riesgo de desarrollar problemas cardiovasculares más adelante en la vida de la madre y del bebé. Es fundamental cuidar la salud cardíaca durante el embarazo.

A continuación, se indican algunas pruebas frecuentes que pueden proporcionarle más información sobre su salud cardiovascular durante el embarazo y mucho después del parto.

1. Blood Pressure

When: Every visit

Why It’s Important During Pregnancy: Checking your blood pressure is an easy, routine part of every prenatal visit, but it’s crucial in caring for both you and your developing child. Your health care professional will use a blood pressure cuff to check your blood pressure and track two numbers:

  • Systolic mmHg (millimeters of mercury). This is a blood pressure reading’s upper or first number, which measures how much pressure your blood is exerting against your artery walls when the heart beats.
  • Diastolic mmHg. This is the lower or second number, which indicates how much pressure your blood is exerting against your artery walls while the heart rests between

A healthy blood pressure reading is less than 120/80 (“120 over 80”).

High blood pressure (also called hypertension) is when your blood pressure is consistently too high. When high blood pressure is left untreated, the damage caused to your circulatory system is a significant contributing factor to heart attack, stroke and other health threats.

Rates of high blood pressure before and after pregnancy have increased in recent years, making it important for every woman to monitor her blood pressure throughout pregnancy and in the months after birth.

Why It’s Important for Mom: High blood pressure is a key risk factor for maternal death and increased risk for cardiovascular disease later in life. In fact, high blood pressure during pregnancy is associated with a 67% higher risk of later cardiovascular disease. And preeclampsia, a form of severe high blood pressure plus the presence of protein in urine, has been associated with a 75% higher risk of later death from cardiovascular disease.

What to Discuss With Your Health Care Team:

  • What your reading is during each visit and whether it’s within a normal range
  • If you or family members have a history of high blood pressure, preeclampsia or eclampsia
  • Whether you should monitor your blood pressure at home — and if so, how often? And what should you do with the results?
  • What to do if you record a reading that’s really high

2. Weight

When: Every visit

Why It’s Important During Pregnancy: Your health care team will weigh you and record your weight at each appointment to track changes throughout your pregnancy. It’s normal to gain weight during pregnancy, but your team can help you understand how much weight is healthy for you based on your pre-pregnancy weight and any unique risk factors.

Why It’s Important for Mom: Weight is a key risk factor for maternal death and developing heart disease, making it important for women to manage their weight before, during and after pregnancy. Research has shown that women who enter pregnancy overweight or obese are at a greater risk for gestational hypertension (high blood pressure while pregnant), preeclampsia, gestational diabetes, pre-term childbirth, and delivering a baby who is small for gestational age.

What to Discuss With Your Health Care Team:

  • How much weight you should gain during pregnancy
  • How many more calories per day you should consume during pregnancy
  • What types of foods you should eat
  • Healthy ways to manage your weight during pregnancy and after delivery

3. Blood Glucose Screening

When: Between 24 and 28 weeks. If you have a history of gestational diabetes or other risk factors, your health care team might test your blood glucose early in pregnancy, too.

Why It’s Important During Pregnancy: A blood glucose screening is a simple test that measures the level of sugar, or glucose, in your blood over the course of a set time. In one type of blood glucose screening, you’ll drink a sugary liquid, then have your blood drawn one hour later to test the amount of sugar in your blood. A three-hour version of the test may also be required to further diagnose based on your results from the initial screening.

Your body naturally produces insulin, a hormone that controls blood sugar. But pregnancy can interfere with the process, causing blood sugar levels to increase and passing excess sugar to the fetus.

Diabetes, which increases the risk of heart problems, occurs when blood glucose is too high. The main kinds of diabetes are:

  • Type 1 diabetes, also referred to as insulin-dependent diabetes. People with Type 1 diabetes must take insulin or other medications daily. This makes up for the insulin not produced by the body.

  • Type 2 diabetes, the most common form, which arises due to “insulin resistance.” The body can’t efficiently use the insulin it makes, and the pancreas gradually loses its capacity to produce insulin.

  • Gestational diabetes, which develops during pregnancy. It affects about 6 in 100 pregnancies and can impact the health of both a woman and her child short- and long-term.

Why It’s Important for Mom: The risk of heart problems increases with all types of diabetes. If untreated, gestational diabetes can lead to premature delivery and increase the risk of high blood pressure during pregnancy. While gestational diabetes usually goes away after delivery, women who have had the condition face a 68% higher risk of developing cardiovascular disease later.

What to Discuss With Your Health Care Team:

  • When you should worry about developing gestational diabetes
  • Symptoms or risk factors to be aware of
  • How to manage gestational diabetes while pregnant (your health care team may recommend management through lifestyle changes such as healthy eating and exercise or may recommend insulin)
  • How to reduce your risk for developing diabetes after delivery
  • How gestational diabetes impacts your long-term risk for diabetes and cardiovascular disease
  • How to track your home blood glucose readings on a printed log

4. Complete Blood Count (CBC)

When: Early and throughout pregnancy

Why It’s Important During Pregnancy: A complete blood count (sometimes called a panel) is a simple test that can help screen for a variety of conditions. The test takes typically less than a minute and consists of a blood draw, usually from the inner elbow. It can be used to assess general health, diagnose certain medical conditions or monitor existing conditions and treatments.

Why It’s Important for Mom: Results from a complete blood count can give your health care team insight into important aspects of your health during pregnancy, including anemia, blood clotting disorders or occult infection.

Anemia (low hemoglobin) is a condition in which the body lacks enough healthy red blood cells to carry adequate oxygen to its tissues. The condition can cause pregnancy complications and lead to multiple heart problems including heart failure and arrythmia. Prenatal vitamins with iron and folic acid as well as a healthy diet rich in iron, folate, vitamin B-12 and vitamin C can help reduce the risk of anemia.

A blood clotting disorder can be particularly dangerous during pregnancy, when more blood pumps through your body, adding pressure on your blood vessels. Blood clots can lead to serious health problems including stroke and heart attack as well as miscarriage, stillbirth and preeclampsia.

What to Discuss With Your Health Care Team:

  • Your blood test results (and whether everything falls within normal ranges)

5. Urinalysis

When: A urinalysis should be performed both early and later in pregnancy, although some health care professionals might test at every visit.

Why It’s Important During Pregnancy: At your first visit, a urine test can be used to check for the presence of human chorionic gonadotropin to confirm your pregnancy. Urinalysis throughout pregnancy can check for conditions including urinary tract disease, urinary tract infection (UTI) and high levels of glucose or protein.

Why It’s Important for Mom: A urinalysis can help assess your health plus identify signs of more serious conditions. High levels of glucose can indicate gestational diabetes, and high levels of protein can indicate preeclampsia when coupled with high blood pressure. Additional testing may be required.

What to Discuss With Your Health Care Team:

  • Ask for your results during each visit and whether they are within normal ranges

6. Postpartum Depression Screening

Edinburgh Postnatal Depression Scale (EPDS)

When: Postpartum. This screening may be given at visits with your health care team and at your child’s pediatrician appointments. But women should discuss any concerns about depression or anxiety with their health care team anytime — before, during or after delivery. You do not have to wait for a postpartum screening to address any questions.

Why It’s Important During and After Pregnancy: If you’re having prolonged or abnormal feelings of sadness or anxiety, or are concerned about your behavior, talk to your health care team. It's OK to ask. Don't just try to "power through” or "shake it off.”

Why It’s Important for Mom: Women can expect changes in hormones and emotions throughout pregnancy and the postpartum period. The “baby blues,” a temporary form of depression, anxiety or other upset feelings, are common for many women after delivery and typically go away after about two weeks.

Yet some women will experience more intense, lasting or disabling conditions such as postpartum depression, postpartum anxiety or postpartum psychosis. Addressing and managing these conditions is important for both your short- and long-term health. Depression and anxiety are associated with heart disease more frequently and at younger ages in women than in men.

What to Discuss With Your Health Care Team:

  • Any concerns or troubling feelings and any past depression, anxiety or family history of those conditions