Postpartum hypertension

[MissingMolly]

Hi, all,

I asked this question as part of another thread but haven't received any responses yet.

I recently went to see my PCP about getting on an antidepressant, and at my appointment, my blood pressure was 168/110 and my pulse was in the 120s. I'm really confused as to what is going on with my body. I'm almost 10 weeks out from when I developed HELLP syndrome, and at first, my body seemed to recover extremely quickly once I was no longer pregnant. But in the weeks following, my BP has continued to bounce around a lot and my pulse is staying elevated.

I understand that the pregnancy probably uncovered my genetic tendency for hypertension, but for my pressure and pulse to go that high? Those are extremes, even in my family of hypertensives, and I personally have never had a bp that high in my life before I got pregnant. I was put on 50 mg daily of metoprolol--it was working really well, but I felt severely fatigued so I decreased my dose to 25 mg and I feel better.

My question is, is the likely explanation just chronic hypertension, or could something else be going on here? Thoughts? I appreciate any feedback!

[sam10]

Has your doc said anything about your pressure, or suggested medication/monitoring? My BP went down quickly post-partum, but would swing into quite some heights once in a while, especially when I went to see my doc (memories can do a "number" on my BP!) . I was told that non-pregnant BP has different thresholds than when you are pregnant. Back then I monitored my BP for a while (not daily, but perhaps once a week), and when the highs did not return, I stopped all-together.

[kerisue]

My pe unmasked chronic hypertension too and I have maintained medication for it after pregnancy. However, my bp went down rapidly after delivery and has never been that high while not pregnant. I would definitely talk to the doctor about it.

[caryn]

*Technically* you're still in the recovery stage. They used to say it would all reverse after delivery. Now they say that three quarters of patients are normotensive by 6 months postpartum. (IIRC that came up at the CME in New York before Saving Grace and is somewhere in my tweets from November, but I think I also have a Powerpoint slide, somewhere, with that stat in it. It's new.)

I know you had a section and general, so you won't remember the details - but check your records and see if they did a D&C postpartum to remove as much placental tissue as possible. If they didn't, there's a slight possibility that there are still fragments (especially if there's any bleeding still) that are jacking your pressures.

Stupid placenta.

[mychaelelaine]

I'm having the same problem, I'm 12 weeks postpartum. I had chronic hypertension for 5 years before though, that's the difference with my case and yours. An ER doctor told me something similiar to what caryn posted. He said his wife was sick for 6 months postpartum and the doctors initially diagosed her as having fibromyalgia. Eventually, they determined there was retained placenta. I just had an ultra sound to check my kidneys and gave blood to do some tests. I think they are checking my adrenal glands. I went to a nephrologist/hypertension specialist a couple weeks ago. He is the doctor who ordered the ultra scan and blood work. I'm hoping to get some answers. I know this can be frustrating. Today is the second day in a long time that I'm not seeing really high numbers (200s over 140s), so, I'm happy. I'm hoping maybe after I created a thread about the same subject as yours that my blood pressure is now normalizing. I am taking 1800 mgs of Labetelol daily and 120 mgs of Procardia. A lot of meds! I want to have a baby ASAP. This is very frustrating. I hope you get some answers soon. Please keep us updated.

[p1nklemonade]

My highest in the hospital before delivery was 190/120, and I was released on procardia and labetalol. Numbers were ok as I was weaned off of both, but at a checkup two weeks after complete weaning, I was up to 150/100, and was put back on medication. I'm on 75 mg of Metoprolol daily, and it's mostly held my pressures in check. (120-130/70-80) I am almost ten months out from delivery. My PCP and OB have both said that pregnancy unmasks chronic hypertension, and that is almost certainly what happened with me. I had kidney ultrasounds and a full cardiac workup to rule out any contributing factors, everything checked out normal. I'm sure my anxiety does nothing to help the pressure go down, but the high bp and horrible delivery experience make me more anxious and probably raise the pressure more. It's a horrible cycle.