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Postpartum hypertension

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Postpartum hypertension

Postby MissingMolly » Tue Jan 10, 2012 06:04 pm

by MissingMolly (41 Posts), Tue Jan 10, 2012 06:04 pm

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!
Mommy to Molly, who was born alive on Oct. 29, 2011 at 23+3 weeks due to severe pre-eclampsia/HELLP syndrome and passed away 3 hours later. Loved and missed every minute of every day...."If love could have saved you, you would have lived forever."
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Re: Postpartum hypertension

Postby sam10 » Tue Jan 10, 2012 09:18 pm

by sam10 (1436 Posts), Tue Jan 10, 2012 09:18 pm

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.
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
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Re: Postpartum hypertension

Postby kerisue » Wed Jan 11, 2012 01:32 pm

by kerisue (623 Posts), Wed Jan 11, 2012 01:32 pm

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.
Mama to Millie
born June 2010 @ 24 wks. gestation due to my severe PE and CHF
lived 25 days, loved and missed
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Re: Postpartum hypertension

Postby caryn » Wed Jan 11, 2012 02:24 pm

by caryn (10111 Posts), Wed Jan 11, 2012 02:24 pm

*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.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
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Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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Re: Postpartum hypertension

Postby mychaelelaine » Fri Jan 13, 2012 01:45 pm

by mychaelelaine (195 Posts), Fri Jan 13, 2012 01:45 pm

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.
10/17/2011 ~ Mychael Elaine was born sleeping. We miss and will always love you!
9/16/2012 ~ Michael Leon was born, God is so good! Severe pre-e again, induced at 34 weeks, c-section due to baby's heart decelerating with each contraction. 1 week in NICU. I'm done! :)
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Re: Postpartum hypertension

Postby p1nklemonade » Fri Feb 03, 2012 03:22 pm

by p1nklemonade (2 Posts), Fri Feb 03, 2012 03:22 pm

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.
Paige
Mom to Leah Grace--born at 37w5d via c-section
Diagnosed with pre-e at 37w3d
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