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Is caesarean section risky in women with high BP?

Q: Does high blood pressure in pregnant women make a caesarean section risky for a child and the mother? If yes, what needs to be done in this regard?

A:High blood pressure in most cases is neither a reason to perform nor to avoid a caesarean section. You can have a perfectly normal delivery with high blood pressure, and indeed if caesarean section is required for any medical / obstetric reason, it can be performed in a good centre with reasonable safety. The added risk of the surgery in high BP as compared to a woman with normal BP is of anaesthesia. Special care is required, but is not something an experienced anaesthetist cannot handle. The blood pressure may rise during surgery or may fall to very low levels suddenly. A good experienced anaesthetist would be aware of these eventualities and handle them if and when they arise. The high blood pressure, if it occurs only in late pregnancy in a woman who has normal blood pressure (before pregnancy), is generally associated with protein in the urine and other problems especially in liver and kidneys. These problems if present will have separate risk (as most drugs given during treatment and anaesthesia are processed in the liver or the kidneys). Either way these are rare and a good clinician would handle them as and when they occur. So you do not have to worry whether she has a normal delivery or a caesarean section. You should ensure that delivery is done in a good centre with a good anaesthetist on call.

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