It is quite possible for the BP to be causing harm to you and the baby at 140/90 and even below that, it all really just depends on what is truely going on, which the doctor can't tell you with any certainty.

Don't ignore or be comfertable with a reading of 140/90, while in a non pregnant person doctors may think this reading is okay and boarderline high BP, a pregnant woman is much different.

The BP that docs want you to have is 120/60, 140/90 is the guise for hypertension.

Regarding the blurry vision. Any swelling to the cranial area around the eyes will cause your eyes shape to change. Your vision is based on where the light hits the retnia along the back of the eye. If your farsighted it hits to short, if your near sighted it hits to long. When you have swelling and the shape of your eye changes even slightly, this causes the light to now hit in a different spot then previously, thus it actually changes how well you can/cannot see. People that wear contacts or glasses more readily notice this because suddenly their corrected 20/20 vision isn't that anymore.

I can always tell when I am going to have allergy problems a few days in advanced because my vision gets blurry from the swelling in my sinuses. I had the same problems when I had PE. I did find that wearing my glasses alleviated it some (because there is a difference in the way your prescription works in glasses and in contact lenses) in my second pregnancy. In my first pregnancy nothing made it better.

Erin

Mommy to Alex and Mason

Just want to echo what Laura is saying--good advice on talking with your doctor.

Hypertension and preeclampsia are both concerning--they impact the blood flow to the uterus and so can compromise getting nutrients to the baby. Either of them is cause for concern and "expectant management". Because of pressures on doctors (time, HMOs, costs, etc) many doctors will not overdiagnose and will adopt a "wait and see". I am heartened that the doctor at least realizes there is something to watch for--but I would still be a pushy patient.

Laura also makes an excellent point about second trimester pressures--this is not a well-known fact among doctors so you should remind them of that.

And finally--ANY BP that is elevated 15 diastolic (lower) and 30 systolic (upper) bears watching. With proteinuria--it could be defined as preeclampsia and the National Institute of Health cautions that such elevations require careful monitoring.

MY point is that your doctor sounds more educated than many but not as educated as some--which is pretty common. My experience is that doctors do not appreciate patients trying to tell them how to do their job--so tact is essential--that and just being firm on what you know and backing it up. I would read through some of the older posts on the forum and see some of the links suggested. This forum is a goldmine of information and I would strongly encourage you read up!

Take care and keep us in the know--

Anne Garrett
Executive Director
Preeclampsia Foundation

Don't let this stress you!!! You're going to be ok, and the baby is going to be ok!!! One of the problems we run into with this whole thing is that the doctors don't want to freak us out, and don't always tell us the whole plan, so it's hard to tell whether they're blowing it off, or they're just not telling you everything to keep from scaring you. What I'm trying to get at is that if you have a doc that's not going to be able to be sensitive to the issues that may end up effecting your pregnancy, then I want you to have enough time to find another one!

At your stage, 23 weeks, you'd want ultrasounds for growth, and probably wouldn't start NST's until 28 weeks. Most docs wouldn't treat your BP at this point, so that's not a huge issue. What you want to see is that they're watching closely for development of problems. You want a doctor that is sensitive to the fact that hypertension does cause problems (other than preeclampsia) that they need to watch for.

I'm not a doc...but my guess is that it's essential hypertension you're seeing. But even among my doctors, they called it different things. Most women's BP does down during the 2nd trimester before 28 weeks- if it doesn't, it's a sign to watch closely.

Here's what I'd do, to test the waters. Go in, and say, I know my hypertension is not severe, but in light of my blood pressure and for my peace of mind, I'd like to adopt expectant management with this pregnancy. I'd like serial ultrasounds for growth, and Non-stress testing beginning at 28 weeks. If I develop any protein, I'd like a 24 hour urine- and in fact, I'd like one right now to establish a baseline.

These things are all standard care for hypertension. If he's insulted or makes light of your request- he's probably not the best fellow to manage a hypertensive pregnancy. If he says- well that's what we had in mind- you know you have a keeper.[:)]

Expectant management just means- I may not develop problems, but because I am at risk, we will act as though I will. Nobody loses anything by being cautious!

Don't worry about the jumps from baseline- that's a guide for women who normally have normal or low pressures to determine that they are developing a problem- like -hey- my Bp is normally 90/60. Now it's 138/85, is it hypertension?

Hypertension is technically 140/90. They've developed a new pre-hypertensive category which is anything above 130/80. The ideal bp is 120/70.

Hang in there- you're doing the best you can to have a healthy baby, and that's all anyone can expect!

Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/

That is about the normal time to start antihypertensive meds but you should continue to pay attention and call if you have any symptoms. BE SURE to mention any blurred vision. Let the doctor be the doctor and tell him or her everything.

And one more thing! Worrying is not increasing your blood pressure. DO not worry about that--this is scary--you are worried--that is normal. Keep asking questions--that is the best way to find out the things you need to know!



Anne Garrett
Executive Director
Preeclampsia Foundation

I do think my dr is taking steps to see what this is because Im getting the blood test but..... if my blood pressure is considered " hypertension" than I want to make sure my baby is safe. I want to make sure they are doing the ultrasounds and makind sure he is growing properly.

Let me ask you this...

Since my blood pressure before pregnancy was around 130 + over 80 + you would assume i have chronic hypertension right?
My mother has high blood pressure she developed when she was 29 years old from an unknown cause. She has since ( 14 years ) been on high blood pressure meds.

I am sooooo worried about this and I know worrying makes my blood pressure just go up and up and up.

if my blood pressure before pregnancy was 130/80 and not its around 135/80 to 140/90 I read thats not considered hypertension because it didnt jump 30 points.

Im confused too as to why my drs office isnt concerned with my blood pressure being 140/90 as much as yall say they should be. From what I was told... " many women each day have those pressure readings " and that unless it gets to 150/100 will they start giving meds.

OH im confused.

hmm, that's an interesting remark your doc made about the 140/90....

Some of us will develop preeclampsia because we have underlying essential hypertension that we inherited genetically, and will emerge fully as we age. If you have a strong family history of hypertension, or if your pressures were borderline before pregnancy, that may mean that essential or chronic hypertension is your 'thing'.

The good news about that is that people with essential hypertension or chronic hypertension have a 25% chance of going on to develop preeclampsia. The BAD news is that when people with chronic hypertension do develop preeclampsia, the superimposed preeclampsia can get terribly severe terribly fast. Superimposed preeclampsia is very dangerous.

Hypertension blasts your blood vessels and end organs, like the kidneys and liver (that's why they frequently check for protein, to see if the hypertension has damaged your kidneys to the point that they're not filtering properly)

Another end organ that can get blasted by this pressure is the placenta, the source of all good things for your baby.

High blood pressure in the mama=low blood pressure in the baby... or in other words, can cause low oxygen and nutrients to the baby, causing a whole host of problems, including interuterine growth restriction and oligohydramnios (low amniotic fluid)

That's the problem I had. I never ventured too far above 140/90, yet the problems with placental perfusion chronically restricted the oxygen to my baby. As a result, her body diverted all available oxygen to her brain, and the rest of her body sort of hibernated- including, but not limited to her kidneys, and she quit peeing, and her amniotic fluid dwindled to nothing by 36 weeks, when I had to deliver.

So, like Catherine, I wasn't through the roof with BP. I didn't go too far above 140/90, for that matter, yet my pregnancy was deeply effected by it.

I'm absolutely not saying that your doc is wrong, but what I would hope to hear from him, were that me- is- hmmm, Chances are you'll be fine. But women with hypertension can develop complications, so we're going to watch you closely, including visits more frequently than usual, frequent monitoring of your BP, Non-stress testing at least once a week, monthly growth ultrasounds, to make sure baby's growth remains on target.

My first providers with my second pregnancy didn't take that course. They did my routine u/s at 18 weeks, and called it all good-- had no plans to follow up on it. I wasn't satisfied, so I got a second opinion and a second ultrasound. In the 4-5 weeks between ultrasounds, my amniotic fluid had halved, and the baby's growth had slowed down, and we would have never caught it unless they had that subsequent ultrasound.

So- if you ever get the inkling that your doc doesn't take the effects of hypertension on pregnancy seriously, get a second opinion. Just having hypertension alone puts you in perinatologist territory, it's always a good idea to get a consult. Peris that specialize in hypertensive pregnancies are available at http://www.nasshp.org and general peris are available at http://www.smfm.org

Best of luck, and please let us know how you're doing!

Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/

http://www.preeclampsia.org/symptoms.asp

But check also the whole site
http://www.preeclampsia.org

Good luck to you!


Ileana 33
Angel stillborn 24w p-e 2/17/03

WHERE IS THE SIGNS AND SIMPTOMS PAGE? I CANNOT FIND IT..

THANKS IN ADVANCE!

Thank you for your quick response.

I just verified that there has been NO protein in any of my urine samples.

The doctor seems to think that my hypertension was pre-pregnancy since my mother has high blood pressure.

I will make myself familiar with the signs and simptoms and I hope to hear from many of you about this.

My doctor did say that he sees blood pressures of 140/90 all day long and not to be alarmed that it is not hurting the baby right now.

I hope that he is going to stay on top of this and I will be monitoring my blood pressure daily at home from now on. I will do anything I can to keep myself and my baby healthy. this pregnancy has not been easy for me and its extremely upsetting to hear that I may deal with this for the next 17 weeks.

I hope that my high blood pressure was just " white coat syndrome" and that when I get home to check it it will be back down to normal.

Any other imput will be greatly appreciated on this because like I said before I dont know anything about any of this.

p.s. akemt you had said that your high blood pressure was reducing blood flow to your placenta. Can this harm the baby? Should I be concerned about this now?

What harm can this do to my baby?

Christy,

140/90 is not normal...120/80 is. And preeclampsia is diagnosed by a bp of 140/90 and protein. (can't remember if it's 1+ or 2+?) This blood pressure may be an indicator of things to come and should definately be watched closely since it is possible for things to change VERY quickly. That said, I had high bp in pregnancy (PIH) from 28 wks on and my labs never came back abnormal. Though in my case, the blood pressure was affecting blood flow to the placenta. Why am I telling you about me? lol [:I]

ANYWAY,

Your doctor should be monitoring your blood pressure, nst's (monitoring the baby) and labs closely now that you've hit the hypertensive mark. It is early in your pregnancy and they want the best possible outcome for you...that requires close attention. Definately keep us posted on how you are doing and feel free to ask as many questions as you need to! I'm sure others will come chime in...I'm not the most knowledgeable on here and tend to ramble. Definately check out the "signs and symptoms" page and make sure you are well aquainted with those...and tell our doctor about any you may be having. The blurred vision sounds to me to be more of a pregnancy fluid thing...but, it doesn't hurt to let your doctor know that either! lol The women on here who have had the "vision disturbances" they are talking about describe it more like flashing, moving lights.

The best things you can do for you and your baby is to become educated about your condition, RELAX (yah, hard to do, I know), and make sure you are getting the care you both need.

Hope this helps! Good luck!

Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo