High Blood Pressure 22 Weeks

[sasha]

Hello, I am a 29-year-old female teacher who is having her first baby in April. I have had high marks in my blood pressure since my first obgyn appt. Normally, my blood pressure is 120/70. Since pregnancy, my blood pressure has ranged from 144/80 to 140/85 to 130/77 and finally to 148/98. I was told to lie down and my bp was taken again and measured 140/90. I had had a previous level 11 ultrasound that came back normal and a 24 hour urine test that came back fine. All blood work has checked out too.

At the last appt. my dr. said I might have to go to the hospital for observation until my pressure went down and prescribed Methyldopa. I didn't get a chance to say much else or ask my questions or anything. Also, Now, I have to retake the urine test, get more blood work, and come in for another appt. I am also getting another ultrasound.

I decided not to take the medication immediately without gathering more data. I bought a blood pressure monitor that fits the upper arm. It matches closely with the nurses reading. Here is the information from the last few days:
Systolic Diastolic
135 86
134 81
128 79
124 76
132 92*
133 74
137 77
134 82
126 73*
137 80
127 82
138 88*
137 77
136 80




Do I need to take this medication immediately or what? It it harmful to wait until I have continuous high marks? Are there specific questions I should ask my obgyn?

Thanks!!!!!!!!!!!!

[annegarrett]

First--I would highly recommend you follow your doctor's advice and take your prescription. That doesn't mean stop asking questions but this is not a disease you want to mess with and the theory behind antihypertensive therapy is that it will reduce or slow the damage that the hypertension is causing the placenta and your vasculature. Your BPs qualify as high because a) they are and b) you are in the second trimester and your BP SHOULD be going down during the second trimester--not "even" or worse (as yours is) "up". BP in pregnancy dips in the 2nd trimester and returns to your "normal" (in a healthy pregnancy) during the 3rd trimester.

Second--I would encourage you to do a search of the posts here (use the above right search engine) for high blood pressure in the 2nd trimester.

Third--your doctor is an OB and has years of medical school under their belt--if you do not trust your doctor's care--then either that is because your doctor is not making you feel safe, or you are not allowing yourself to trust him or her. You need to be with a doctor who you trust. Personally, your doctor sounds like he or she is providing good care but I am not you--I just worry when I hear women making medical decisions like not taking medication--VERY VERY few doctors overmedicate this disease. My personal opinion (not a doctor, though) is that you should trust him or her and DO WHAT HE SAYS. If you choose not to--you need to be very clear with the doctor about that choice so that s/he provide you with the best possible care. It is definitely your choice...but you should bring the doctor into the loop. Without good communication--you cannot count on good care.



Anne Garrett
Executive Director
Preeclampsia Foundation

[sasha]

My concern with taking the medication before my blood pressure goes up higher is low blood pressure induced by the medications. Lower blood pressure appears to be much worse than high blood pressure. I have a very stressful job. I teach 115 7th graders in a rural school. I have numerous frustrations and a commute. I work very hard through the week and go to graduate school one night per week. A typical day has me going from 6:00 am until 10:00 pm with solid work. Not to mention the typical ups & downs of the classroom: fights, disrespect, frustrations, failure, and kids who are not taken care off by their parents or abused. After a day like some I have, I am not surprised that my bp is up when I get to the dr. after work. I have not had my bp tested by my obgyn without spending the majority of the day at school with my little angels.

After reading several articles on the research database Lexis-Nexis and Eric, I have come to the conclusion that no long term studies have been done on how medicines affect the baby.

I am not a person who sees medicine as a fix to problems. However, I am not one to jeapordize my health or my baby's health. I prefer to take a dietary and lifestyle change accompanied with raw bp data for atleast two weeks until my scheduled growth scan/ultrasound.

I have no symptoms associated with high bp aside from high marks on occassion. I am simply looking for concrete data before I start taking a medication that will alter my body's cardiovascular functioning. I mean, I consider the side effects of the medicine as almost worse than high blood pressure and I really don't want to take anything that I need to be "weened" off of.

But still, I will....if i show concrete data. I have read this forum and researched medical articles on realiable online academic databases - it seems a majority of the experts won't prescribe until atleast 160/100. Am I wrong? Is it too dangerour to wait?

As far as trusting my OBGYN goes, I do trust her. But there are about 4 OBs that rotate. The one I met the day my pressure was so high really struck me as a "I am scared I am going to get sued, so here take this" kind of Dr. She hadn't known me but two minutes and was ready to send me off to the hospital and then said well, just take this medicine. NO WAY! I will not take it based on four meetings where a nurse practioner has taken my bp.

So, I am getting a second opinion and keeping a running record, and
deciding to take the medicine if:

Something is wrong with the growth scan.
There is protein in my urine.
My Bp goes over 150/100

I want a natural childbirth. I don't want to treat something unless it really needs to be treated. I am not in denial, I am just being pro-active in my medical needs. I might not completely trust drs in general. Mainly because I am an educated person who can read and discern medical journals enough to know that bandwagoning of medicines for various ailments is a problem in this country.

Well, that is enough for now. Comments?

[ileana]

These are great points. You should talk with your doctor about them and get your answers.

My comments are: The blood work and urine tests that you had do not show that there is no disease, just that it's not advanced enough to have either you or your baby die soon. They show that your kidneys and liver are not affected yet.
Something is wrong, because your blood pressures are going up.
Your doctor is trying to slow down the process and buy you and your child more time.
She probably did not explain all these things, but she appears to be doing the right thing.

The only other comment I have is that your aim should be to have a healthy baby and a healthy mom in April, no matter how they get there!

Take it easy and take care!



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

PS: Oh, and BTW, I avoid medicine as much as possible too, and Anne is like this as well. If this did not convince us there might be something in there.

[newmommymar04]

Sasha-

Your story sounds quite like mine.

I am 24 and pregnant with my first baby . At around 22 weeks my bp started slowly rising. Your readings are very very close to mine and at my dr visits my bp is alwasy 140/90 or a bit higher.

I did a 24 hour urine, blood work etc and everthing came back fine. My doctor has ruled out pre-eclampsia at this point and instead has just diagnosed me with chronic hypertension.

I have learned so much from the ladies on this board and have decided that I may be one of the few ( as you may be ) who just develop high blood pressure as a result of pregnancy and will never develop any other simptoms.
You are doing the right thing by taking your blood pressure daily. I take mine 2 times per day am/pm.

My doctor has been WONDERFUL and has told me that he will not perscribe me medication until the following 2 things occur.

1. 2 week bedrest does not lower my diastolic pressure
2. my blood pressure stays consistant at 150/100 for longer than 3 days.

I would hate for your doctor to just throw you on bp meds if you do not need them.
Please talk tohim about your options. Try bedrest first.
ask for no stress tests and ultrasounds of your baby to make sure everything is fine there.

Stay off the caffene and sugar. This will help and lower your salt intake. Drink LOTS OF WATER! this helped me with swelling.


Thats all the advice I can give you,because I am very new to this. These ladies on this board are GREAT and will help you all the way thru.

I am now 28 weeks and have been doing good. My bp has not gotten above 140/90 and has started to level off. Now that I am in my 3rd trimester I am on weekly visits to watch very closely any changes.

Your situation seems very close to mine and I hope yours turns out as mine has so far.
All I have to do is make it to 36weeks and I am home free!!

Good luck and keep us posted!!

Christy
EDD 3/5/04

[sasha]

My doctor called today. She says that she respects my views on the medicine and wants me to come in weekly for bp checks along with the scheduled urine test & ultrasound. She believes I have mild hypertension. I really like her and respect her advice. However, I don't know how to tell her that I do not wish to see the dr. that instantly prescribed the bp drugs to me again. I guess I will just ask if it is an option. The main reason I don't want to see that dr. again is because she was too quick to say "stroke" around someone with "whitecoat" and needle fright. We'll see.

I really have enjoyed reading a variety of responses. I am not convinced that I need to start those meds right now. I WILL take them if the bp ever goes over 150/100. I have been eating salty foods, sugary foods, and for some reasons soda -which I never drink! I am going to eat healthier and take the bp at home and work. I am lucky that we have a school nurse who had a similiar situation and offers caring advice.

I have an ultrasound scheduled for friday and then two weeks off of work. I am anxious to see if rest at home lowers my bp and how much my healthy diet will affect it to.

My husband felt baby move today for the first time. It is such a joyous time that I hate to be so focused on my bp.

Can anyone share a positive experience with bp meds that involved natural childbirth and breastfeeding? I am focused on natural childbirth and use of the Bradley Method.

[julie f]

Sasha,

My reply is not meant to scare you but, as someone whose bp did rise instead of drop in the 2nd trimester, I just wanted to share a bit.

From personal experience and I have learned that preeclampsia can go from bad to worse very quickly. And, while you may not have the disease at one appt, 2 weeks later you can be admitted to the hospital. It sounds as though there are many stressors in your life right now and, I just want to say, please, please watch out for the warning signs. Go to the signs and symptoms page and print a copy and look at it often.

As far as my opinion on the bp meds (just an opinion!)- I have already asked my doctor if she will prescribe them if my pressures start to rise in the 2nd trimester again. (Mine went from 100/60 to 130/70) Of course, she said that we'll cross that bridge when we get there... I realize that this is strictly an emotional opinion but, I will try anything next time.

That's wonderful that your doctor understands your concerns and will be monitoring you so closely. I wish you a very healthy remainder of your pregnancy, please keep us updated.

Julie
Zachary James, 7/22/03-7/27/03, born at 26 weeks due to severe pe

[mada]

sasha,
I was put on BP meds at 34 weeks...I was able to hold out to 36 weeks and was induced..So I did have pitocin but...I had no drugs...A completely natural birth...So, I think the best thing is to try to relax as much as possible, keep doing what you're doing ...checking pressures ect. and then hey, here's to hearing your "natural birth story[:)]"

As for the meds, all the women here are just concerned as we've seen so many times this disease going from barely detectible, to full blown. I believe your other doc was trying to be "preventitive"....Because you are early, we all kind of get nervous. Just keep your appointments and it sounds like your doc is great..Goodluck!

Mada Harpster

Sam 6-29-00 36weeks P.E.
Ben 11-03-01 No P.E.

[akemt]

I just want to add my little bit (sorry, ended up not being so little [;)]):

My bp's were "labile" meaning they were fluctuating and not at a stable high and it was already negatively affecting my placenta. When I was diagnosed and I went in for the ulrasound, my amniotic fluid level had dropped by more than half in about 10 weeks and was now at the "if it doesn't get better, we're flying you to a bigger hospital" stage, and if it got worse I was told to prepare to have my daughter that week. And I also was having no real symptoms other than some swelling. Not having symptoms does not mean you do not have the disease.

Also, I would like to add that I by no means think that low blood pressure is worse than high blood pressure. I can understand your concern considering your place of employment, etc (Hat off to you, I couldn't put up with all that), but I have yet to hear of someone dying of "low bp" or losing a child because of it. And yes, while many doctors wait to give bp meds at higher levels, it is to ward off severe complications like seizures and HELLP syndrome and strokes. I am of the opinion (also not a doctor) that it would be best to take the meds so that you can prolong your pregnancy as long as possible.

What were the stats on gestation reached after diagnosis??? Wasn't it about 2 weeks? Perhaps that was diagnosis of Severe preeclampsia. Not sure.

And, I thought they couldn't "study" medicine on pregnant ladies. Simply question those who have taken it in pregnancy.

That said, I know the decision is up to you and respect your right to do what you please. I would just encourage you to do all you can. I would hate for you to have further complications at all, especially so early and it would be quite difficult to look back and say, "I should have taken those meds" if something does go wrong. I cannot imagine the pain of losing a child and know that the women here who have already suffer from feelings of guilt even when they have done everything conceivably possible.

I hope that the course you choose is the appropriate one for you and that you and your child will get through this pregnancy and be able to have your bradley method delivery! Please keep us updated. I'm glad you are learning what you can.

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

[sherry fisher]

Sasha,
My BP's have been around the ranges of yours in the second trimester, I have had a few high ones. Starting at 8 weeks, I was placed on BP meds. While a BP of 140/80 may not seem high to you, for someone who is normally 120/60 it is! A BP jump like this can be just as dangerous to you and/or your baby as a BP of 150/100. I know your apprehention of BP meds. They make you feel like crap and you will always wonder the outcomes to your baby. I was actually able to get off my meds for a week for being so sick (not due to meds!) During this time my BP's were LOW! I felt like I should not have to go back on my meds. I found out the hard way one night that I did need them! My BP was 175/88. While ultimately this is your decision, And I DO NOT agree that all Dr's know everything, I have had more wrong than I care to say! Just follow your body and your instincts! Alot of these women have lost babies due to similar issues on here. I know sometimes, when I feel like being stubborn about something, its easy to read and change my mind very quickly!

Sherry Fisher (28)
DH: Bill (35)
Proud Mama to:
#1) Alex 1/1/94-PE
#2) Abbie 12/17/97-PIH
#3 Will 08/03/02-PP PE
#4) EDD: 4/27/04
http://www.babiesonline.com/babies/b/babyfish3/