Potential Complication: Gestational Hypertension with Twins

When you're pregnant with twins, it's common to develop high blood pressure. If this first develops when you're expecting, it's called gestational hypertension or pregnancy induced hypertension. As a mom-to-be of twins, you're more than twice as likely to have this condition as women who are having only one baby.

Before you become too alarmed, however, know this: most women with gestational hypertension have healthy pregnancies and healthy babies. Still, it's important to also know that high blood pressure during pregnancy can be a sign of other, more harmful conditions. That's one reason seeing your doctor early and often is so helpful in keeping you and your babies healthy.

What Is Gestational Hypertension?

Gestational hypertension occurs when your blood pressure rises in the second half of your pregnancy. This can happen even sooner when you're expecting twins.

Blood pressure is the force of blood pushing against artery walls through blood vessels. When this force measures more than 140/90 mm Hg, doctors consider your blood pressure to be high.

The good news is that, if you develop high blood pressure during pregnancy, your blood pressure should go back to normal about 6 weeks after you give birth.

How Can It Affect My Babies and Me?

High blood pressure can hurt you and your babies. The effects can be mild to severe. It may cause no problems. Or it may:

  • Damage your kidneys and other organs
  • Reduce blood flow to the placenta, which means your babies receive less oxygen and fewer nutrients
  • Cause your babies to be born too small or too soon
  • Put you at risk for having heart disease or high blood pressure when you get older

Gestational hypertension can be more severe when you're having twins. In severe cases, gestational hypertension may lead to preeclampsia, also known as toxemia. It can harm the placenta as well as your brain, liver, and kidneys. With twins, there's a greater chance the placenta will become unattached.

Preeclampsia can lead to eclampsia, a rare and serious condition that can cause seizures and coma -- even death.



Who Is at Risk for Gestational Hypertension?

You are at greater risk because you are having twins. You are also at greater risk for gestational hypertension if:

  • This is your first pregnancy
  • You were overweight or obese before you became pregnant
  • You are age 40 or older
  • You are African-American
  • Have a history of PIH or preeclampsia


Is There a Test for Gestational Hypertension?

Your doctor will test your blood pressure throughout your pregnancy. It's important to get tested because high blood pressure causes no symptoms unless it is extremely high. If your pressure is higher than normal, you may have gestational hypertension.

If you happen to develop gestational hypertension, your doctor will check you closely for other changes, too. For example, protein in urine can be a sign of kidney problems from preeclampsia.

What's the Treatment?

No treatment may be necessary for gestational hypertension, although sometimes blood pressure medicine may be prescribed. Your doctor will keep an eye on your blood pressure throughout your pregnancy. Working closely with your doctor can help ensure the health of both you and your babies -- whether or not you develop gestational hypertension.

Be sure to go to all your prenatal appointments to help your doctor keep tabs on your blood pressure and your overall health. You may need extra visits the closer you get to your due date.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on January 17, 2019



American Academy of Family Physicians: "Pregnancy-induced Hypertension."

CDC: "Births: Final Data for 2009."

Johns Hopkins Medicine: "Complications of Multiple Pregnancy."

Krotz, S. Twin Res, Feb 2002; vol 5: pp 8–14.

March of Dimes: "Pregnancy and the overweight woman."

Medscape: "Hypertension and Pregnancy."

National Heart, Lung, and Blood Institute: "High Blood Pressure in Pregnancy."

ACOG: "High Blood Pressure During Pregnancy."

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