March 11, 2026 • 12 mins
Women who are pregnant can develop high blood pressure, even if they didn't have it prior to pregnancy. This condition is called preeclampsia and develops after the 20th week of pregnancy. Preeclampsia can threaten the life of the fetus and the mother. My guest is Dr. Kjersti Aagard, a renowned maternal fetal medicine specialist, specializing in preterm birth and congenital anomalies and pregnancies complicated by diabetes, hypertension and infectious diseases. Dr. Aagard explains ways the high blood pressure develops, the warning signs and what needs to be addressed.
Preeclampsia causes high blood pressure and can damage organs, leading to symptoms like severe headaches, vision changes, and swelling, potentially progressing to dangerous complications like seizures (eclampsia), liver/kidney damage, stroke, premature birth, or placental abruption, with delivery being the only cure, requiring close monitoring and management.
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Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
For nearly seventy years, the March of Dimes has worked
to improve birth outcomes, lower birth effects, and improve mortality rates.
It started in nineteen thirty eight as a nonprofit to
raise money to care for polio victims and find a cure. Today,
the March of Dimes is focusing attention on a medical
condition that only twenty percent of Americans say they know
anything about. It's high blood pressure or pre eclampsia during pregnancy,
(00:24):
a condition that threws millions of people saying they've used
artificial Guest today is doctor Chirsty Agarist guest today especially
doctor Nancy Patchers from the Lender Center of the Mental
Health Experience Inclusional Psychology Pregnant women share where humans AI
chats intersect and what the March of Dimes and she
Help Care is doing to target the problem, educate and
(00:47):
prevent it. For so many years, March of Dimes has
been working on this. I remember kind of joining back
in in the eighties and nineties when you were really
focusing on premature.
Speaker 2 (00:58):
Birth for babies. Yeah, tribniture birth absolutely.
Speaker 1 (01:01):
And kind of worked on that, and now you guys
are pivoting tackling on other serious issues for women. Tell me,
first of all, doctor, how can we have the highest
rate of women who died during pregnancy or childbirth in
developed countries? How can we be the highest? I thought
we had the best of everything here in the US.
Speaker 2 (01:22):
So let me kind of put that in a little
bit of context and kind of a hope for the futures.
So we know that there are a number of different
things that can contribute to higher rates of both mom
or maternal as well as infant morbidity and mortality. And
(01:43):
some of that can just be numbers of births that happened.
Some of that can be the healthcare burden overall of
the society, and some of that can be the burden
that we carry during pregnancy. And what we're really focused
on with HCA Healthcare in our partnership with March of Dimes.
Want preface this by saying that we have a longstanding
(02:03):
history of partnering with marchadims with HTA Healthcare, ranging from
years ago when we did the thirty nine week delivery
initiative to reduce the burden a preterm birth to now
our low dose big benefits. So it's important that when
we tease apart what contributes to these higher rates of
(02:23):
maternal and child morbidity and mortality that we recognize where
we have things we can do and step in and
make a difference, and so one of those ends up
being preeclampsia. Now, some people haven't heard about preeclampsia before,
and some people have heard a lot about it, so
maybe to get us all on the same page. Preeclampsia's
(02:45):
when there is new onset, high blood pressure, and having
one or more organ systems affected during pregnancy. And so
for example, it could be your kidneys and you're leaking
protein in your urine. It can be your liver and
it can be disrupted and cause very serious complications. It
can be your brain and swelling in your brain causing
(03:07):
clampsy or seizures in pregnancy. Or it can be your
blood cells, specifically your platelets that are like the glue
that enable you to have blood clots. All of those
are examples of things that can be affected by preeclampsia
and can lend to that high risk of complications in moms.
On the baby side, we can also see babies that
(03:29):
become growth restricted when that pre eclampsia is early onset
during the pregnancy and when we have moms that become
really sick and we have to deliver them early, what
we can see as those babies suffer with prematurity. And
so by focusing in on this one problem around pre eclampsia,
we aim to reduce some maternal morbidity immortality. Unfortunately, we
(03:53):
have an evidence based solution that working in hand in
hand with the marchadimes we're implementing out through the low
Dose Big Benefits campaign.
Speaker 1 (04:03):
We're talking about people that often have normal blood pressure
before they're pregnant and how it becomes high. What are
the triggers.
Speaker 2 (04:11):
It's a great question. So there are some risk factors
that can put people at risk for this new onset
high blood pressure or preclamsy and pregnancy. Now, one thing
you're kind of alluding to is what about people who
have chronic hypertension or high blood pressure out of pregnancy. Unfortunately,
we've had answers about treating blood pressure to keep it
(04:31):
low gives better outcomes for moms and babies, but they
can also have superimposed preeclampsia or pre acclamsia on top
of their already high blood pressure. That's where using eighty
one milligrams of low dose aspirin throughout pregnancy can reduce
that occurrence of preclamps Yet there are other clinical risk factors.
Diabetes is a major risk factor. Having multiples like twins
(04:55):
or triplets is a risk factor for preclampsiat Having an
autoimmune des like lupus or rheumaturreed arthritis is a risk
factor for developing preeclampsia, and other more moderate risk factors that,
when coming together, provide risk. Being a mom whose age
is over thirty five, or having ten years since your
last pregnancy, having had a mom or a sister who
(05:17):
had preclamsia puts you at higher risk yourself. Having had
preeclampsia in a prior pregnancy puts you at risk. Having
a pregnancy that results from in vitro fertilization puts you
at higher risk for preeclampsia. And experiencing chronic stress from
social disparities of help puts you at higher risk for preeclampsia.
Speaker 1 (05:37):
So it's so important for women to have prenatal care
all throughout their pregnancy. The minute you figure out you're expecting,
you need to get to a doctor and monitor that
because that can come up later in the pregnancy, Isn't
that right?
Speaker 2 (05:51):
That is absolutely correct, So preaclamsy is really a disease
of the latter second and third trimester of pregnancies. Correct
that pre pregnancy or preconception care is important, and early
pregnancy care so finding a physician in your community that
you really bond with and feel comfortable about is important.
(06:13):
Or midwife. So obstetricians, family physicians, and midwives are all
people who provide prenatal care and can be fundamentally important
in reducing that risk of significant maternal morbidity immortality as
well as newborn.
Speaker 1 (06:28):
What kind of warning signs can folks look for for
this preeclampsy and whether it's in their own pregnancy or
maybe a family member.
Speaker 2 (06:37):
Great question. So there are certain clinical signs that are
common to pregnancy and not necessarily unique to preclamsy, but
are still warning signs. Those include swelling in the hands,
the face, and the feet, and so partners can look
out for that because sometimes we don't necessarily notice when
our faith is getting a little bit more swollen, So
(06:57):
that's an important thing look out for. That gold standard
that we look for is seeing your blood pressure elevated
So one of the things that I do with my
patients and we encourage in our Marchadim's toolkit that's available
on marchadimes dot org is monitoring your blood pressure. So
what are we looking for. We're looking for when that
systolic or top number is more than one thirty to
(07:20):
one forty and that diastolic or that bottom number is
more than eighty to ninety. You can pick up a
blood pressure cup or have one prescribed at your local
pharmacy and just keeping a log of your blood pressure,
bringing it into your prenatal visits, or when it's high
more than one thirty to one forty over more than
eighty to ninety, let your physician or your midwife know
(07:45):
and work one on one to figure out whether or
not you have pre acclamcy it by getting additional lab
values and monitoring your blood pressure, including in the hospital,
will be the right answer to keep you and the
ones you love the safest.
Speaker 1 (07:59):
My guest today is doctor Shirse Agard. She is a
maternal fetal medicine specialist who cares for high risk pregnancies
and specializes in pre term birth and congenital anomalies and
pregnancies that are complicated by hypertension, diabetes, and infectious diseases.
Doctor Agard leads the HCA Healthcare Perinatal Research at the
(08:22):
national level with the HCA Healthcare Women's Research Advisory Board
and the HCA Healthcare Research Institute. Talking today about hypertension
during pregnancy or preeclamsia. So, doctor, how do you treat
a preeclampsia Once you realize that a woman's love pressure
is up? How is it treated?
Speaker 2 (08:42):
So this is where we and maternal fetal medicine sometimes
we're called high risk pregnancy doctors oftentimes get tapped and
really lend a hand in this care. So it depends.
It depends upon where you are in your pregnancy. Can
we kind of watch it carefully as long as there's
not really bad liver problems or those plate lit problems.
(09:04):
Sometimes we can get away with watching these pregnancies until
they're thirty four to thirty seven weeks. But in general,
as a general rule, the treatment for preaclamsya is going
to be delivery and using safe in pregnancy blood pressure
medicines to lower your blood pressure. But we are more
interested in how do we stop this before the whole
(09:25):
crisis and chaos of pre eclampsias steps in and that's
where that low dose aspirin comes into play. We have
almost thirty years of evidence that suggests that low dose
aspins started at around twelve to fifteen weeks, so the
early part of that second trimester, and continuing through pregnancy
at eighty one milligrams once a day reduces that risk
(09:48):
of preeclampsia or a small furgestational age baby by twenty
five percent. That's an important thing. In other words, if
four women were destined to develop preeclamsya or have small
for gestational age baby, only three of those would end
up having in one would not if all of them
took a asprind Now you ask another important question, what
(10:11):
about that seventy five percent that don't appear to benefit
and have preclams, You are prevented well Again at March
of Dimes and with HCA Healthcare, we're dedicated to solving
that problem in the other seventy five percent, and so
we're engaged in state of the art research initiatives. We
built a very large database with our HCA Healthcare Research
(10:34):
Institute to dive into what can we do to prevent
it in the other seventy five percent, so that our
women are healthier and our families start off in the
best shape possible.
Speaker 1 (10:46):
So many things to be concerned about when you're pregnant,
and it's a very exciting and kind of frightening time,
and it's good to know that there are doctors like you,
HCA Healthcare and the March of Dimes that are doing
everything they can to make sure that women have all
the information and support or that they need in order
to deliver babies healthy and they survive it themselves, because
it's something that we still don't have a complete handle
(11:10):
on here in the US, and we're trying to do
that with your health. So thank you so much, Shirsty Agar,
thank you so much for your time. And where can
we go from more information? We've got the March of.
Speaker 2 (11:20):
Dimes absolutely so, marchidimes dot org backslash low Dose, Big Benefits.
But on that Marchodimes dot org website, boy, is there
a lot of wonderful information for families and for those
that are in the country where we're proud to serve
in HCA Healthcare, come by and see us. We got
(11:41):
warm hearts and knowledgeable minds, and we want to take
care of you and your pregnancy and take care of
your family so you can have the best start possible.
So please come see us and we will welcome you.
And thanks for your dedication to pregnancy health. We really
appreciate it.
Speaker 3 (12:00):
Coming up. As mental health practitioners, I really think we
need to learn about this and be aware of how
to use it in a helpful way so that it
doesn't take our patients off into an unhealthy line of thinking.
Speaker 1 (12:14):
AI for therapy, Good idea or NAH. That's coming up
on iHeart Sinsey next.
For nearly seventy years, the March of Dimes has worked
to improve birth outcomes, lower birth effects, and improve mortality rates.
It started in nineteen thirty eight as a nonprofit to
raise money to care for polio victims and find a cure. Today,
the March of Dimes is focusing attention on a medical
condition that only twenty percent of Americans say they know
anything about. It's high blood pressure or pre eclampsia during pregnancy,
(00:24):
a condition that threws millions of people saying they've used
artificial Guest today is doctor Chirsty Agarist guest today especially
doctor Nancy Patchers from the Lender Center of the Mental
Health Experience Inclusional Psychology Pregnant women share where humans AI
chats intersect and what the March of Dimes and she
Help Care is doing to target the problem, educate and
(00:47):
prevent it. For so many years, March of Dimes has
been working on this. I remember kind of joining back
in in the eighties and nineties when you were really
focusing on premature.
Speaker 2 (00:58):
Birth for babies. Yeah, tribniture birth absolutely.
Speaker 1 (01:01):
And kind of worked on that, and now you guys
are pivoting tackling on other serious issues for women. Tell me,
first of all, doctor, how can we have the highest
rate of women who died during pregnancy or childbirth in
developed countries? How can we be the highest? I thought
we had the best of everything here in the US.
Speaker 2 (01:22):
So let me kind of put that in a little
bit of context and kind of a hope for the futures.
So we know that there are a number of different
things that can contribute to higher rates of both mom
or maternal as well as infant morbidity and mortality. And
(01:43):
some of that can just be numbers of births that happened.
Some of that can be the healthcare burden overall of
the society, and some of that can be the burden
that we carry during pregnancy. And what we're really focused
on with HCA Healthcare in our partnership with March of Dimes.
Want preface this by saying that we have a longstanding
(02:03):
history of partnering with marchadims with HTA Healthcare, ranging from
years ago when we did the thirty nine week delivery
initiative to reduce the burden a preterm birth to now
our low dose big benefits. So it's important that when
we tease apart what contributes to these higher rates of
(02:23):
maternal and child morbidity and mortality that we recognize where
we have things we can do and step in and
make a difference, and so one of those ends up
being preeclampsia. Now, some people haven't heard about preeclampsia before,
and some people have heard a lot about it, so
maybe to get us all on the same page. Preeclampsia's
(02:45):
when there is new onset, high blood pressure, and having
one or more organ systems affected during pregnancy. And so
for example, it could be your kidneys and you're leaking
protein in your urine. It can be your liver and
it can be disrupted and cause very serious complications. It
can be your brain and swelling in your brain causing
(03:07):
clampsy or seizures in pregnancy. Or it can be your
blood cells, specifically your platelets that are like the glue
that enable you to have blood clots. All of those
are examples of things that can be affected by preeclampsia
and can lend to that high risk of complications in moms.
On the baby side, we can also see babies that
(03:29):
become growth restricted when that pre eclampsia is early onset
during the pregnancy and when we have moms that become
really sick and we have to deliver them early, what
we can see as those babies suffer with prematurity. And
so by focusing in on this one problem around pre eclampsia,
we aim to reduce some maternal morbidity immortality. Unfortunately, we
(03:53):
have an evidence based solution that working in hand in
hand with the marchadimes we're implementing out through the low
Dose Big Benefits campaign.
Speaker 1 (04:03):
We're talking about people that often have normal blood pressure
before they're pregnant and how it becomes high. What are
the triggers.
Speaker 2 (04:11):
It's a great question. So there are some risk factors
that can put people at risk for this new onset
high blood pressure or preclamsy and pregnancy. Now, one thing
you're kind of alluding to is what about people who
have chronic hypertension or high blood pressure out of pregnancy. Unfortunately,
we've had answers about treating blood pressure to keep it
(04:31):
low gives better outcomes for moms and babies, but they
can also have superimposed preeclampsia or pre acclamsia on top
of their already high blood pressure. That's where using eighty
one milligrams of low dose aspirin throughout pregnancy can reduce
that occurrence of preclamps Yet there are other clinical risk factors.
Diabetes is a major risk factor. Having multiples like twins
(04:55):
or triplets is a risk factor for preclampsiat Having an
autoimmune des like lupus or rheumaturreed arthritis is a risk
factor for developing preeclampsia, and other more moderate risk factors that,
when coming together, provide risk. Being a mom whose age
is over thirty five, or having ten years since your
last pregnancy, having had a mom or a sister who
(05:17):
had preclamsia puts you at higher risk yourself. Having had
preeclampsia in a prior pregnancy puts you at risk. Having
a pregnancy that results from in vitro fertilization puts you
at higher risk for preeclampsia. And experiencing chronic stress from
social disparities of help puts you at higher risk for preeclampsia.
Speaker 1 (05:37):
So it's so important for women to have prenatal care
all throughout their pregnancy. The minute you figure out you're expecting,
you need to get to a doctor and monitor that
because that can come up later in the pregnancy, Isn't
that right?
Speaker 2 (05:51):
That is absolutely correct, So preaclamsy is really a disease
of the latter second and third trimester of pregnancies. Correct
that pre pregnancy or preconception care is important, and early
pregnancy care so finding a physician in your community that
you really bond with and feel comfortable about is important.
(06:13):
Or midwife. So obstetricians, family physicians, and midwives are all
people who provide prenatal care and can be fundamentally important
in reducing that risk of significant maternal morbidity immortality as
well as newborn.
Speaker 1 (06:28):
What kind of warning signs can folks look for for
this preeclampsy and whether it's in their own pregnancy or
maybe a family member.
Speaker 2 (06:37):
Great question. So there are certain clinical signs that are
common to pregnancy and not necessarily unique to preclamsy, but
are still warning signs. Those include swelling in the hands,
the face, and the feet, and so partners can look
out for that because sometimes we don't necessarily notice when
our faith is getting a little bit more swollen, So
(06:57):
that's an important thing look out for. That gold standard
that we look for is seeing your blood pressure elevated
So one of the things that I do with my
patients and we encourage in our Marchadim's toolkit that's available
on marchadimes dot org is monitoring your blood pressure. So
what are we looking for. We're looking for when that
systolic or top number is more than one thirty to
(07:20):
one forty and that diastolic or that bottom number is
more than eighty to ninety. You can pick up a
blood pressure cup or have one prescribed at your local
pharmacy and just keeping a log of your blood pressure,
bringing it into your prenatal visits, or when it's high
more than one thirty to one forty over more than
eighty to ninety, let your physician or your midwife know
(07:45):
and work one on one to figure out whether or
not you have pre acclamcy it by getting additional lab
values and monitoring your blood pressure, including in the hospital,
will be the right answer to keep you and the
ones you love the safest.
Speaker 1 (07:59):
My guest today is doctor Shirse Agard. She is a
maternal fetal medicine specialist who cares for high risk pregnancies
and specializes in pre term birth and congenital anomalies and
pregnancies that are complicated by hypertension, diabetes, and infectious diseases.
Doctor Agard leads the HCA Healthcare Perinatal Research at the
(08:22):
national level with the HCA Healthcare Women's Research Advisory Board
and the HCA Healthcare Research Institute. Talking today about hypertension
during pregnancy or preeclamsia. So, doctor, how do you treat
a preeclampsia Once you realize that a woman's love pressure
is up? How is it treated?
Speaker 2 (08:42):
So this is where we and maternal fetal medicine sometimes
we're called high risk pregnancy doctors oftentimes get tapped and
really lend a hand in this care. So it depends.
It depends upon where you are in your pregnancy. Can
we kind of watch it carefully as long as there's
not really bad liver problems or those plate lit problems.
(09:04):
Sometimes we can get away with watching these pregnancies until
they're thirty four to thirty seven weeks. But in general,
as a general rule, the treatment for preaclamsya is going
to be delivery and using safe in pregnancy blood pressure
medicines to lower your blood pressure. But we are more
interested in how do we stop this before the whole
(09:25):
crisis and chaos of pre eclampsias steps in and that's
where that low dose aspirin comes into play. We have
almost thirty years of evidence that suggests that low dose
aspins started at around twelve to fifteen weeks, so the
early part of that second trimester, and continuing through pregnancy
at eighty one milligrams once a day reduces that risk
(09:48):
of preeclampsia or a small furgestational age baby by twenty
five percent. That's an important thing. In other words, if
four women were destined to develop preeclamsya or have small
for gestational age baby, only three of those would end
up having in one would not if all of them
took a asprind Now you ask another important question, what
(10:11):
about that seventy five percent that don't appear to benefit
and have preclams, You are prevented well Again at March
of Dimes and with HCA Healthcare, we're dedicated to solving
that problem in the other seventy five percent, and so
we're engaged in state of the art research initiatives. We
built a very large database with our HCA Healthcare Research
(10:34):
Institute to dive into what can we do to prevent
it in the other seventy five percent, so that our
women are healthier and our families start off in the
best shape possible.
Speaker 1 (10:46):
So many things to be concerned about when you're pregnant,
and it's a very exciting and kind of frightening time,
and it's good to know that there are doctors like you,
HCA Healthcare and the March of Dimes that are doing
everything they can to make sure that women have all
the information and support or that they need in order
to deliver babies healthy and they survive it themselves, because
it's something that we still don't have a complete handle
(11:10):
on here in the US, and we're trying to do
that with your health. So thank you so much, Shirsty Agar,
thank you so much for your time. And where can
we go from more information? We've got the March of.
Speaker 2 (11:20):
Dimes absolutely so, marchidimes dot org backslash low Dose, Big Benefits.
But on that Marchodimes dot org website, boy, is there
a lot of wonderful information for families and for those
that are in the country where we're proud to serve
in HCA Healthcare, come by and see us. We got
(11:41):
warm hearts and knowledgeable minds, and we want to take
care of you and your pregnancy and take care of
your family so you can have the best start possible.
So please come see us and we will welcome you.
And thanks for your dedication to pregnancy health. We really
appreciate it.
Speaker 3 (12:00):
Coming up. As mental health practitioners, I really think we
need to learn about this and be aware of how
to use it in a helpful way so that it
doesn't take our patients off into an unhealthy line of thinking.
Speaker 1 (12:14):
AI for therapy, Good idea or NAH. That's coming up
on iHeart Sinsey next.
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