High blood pressure, no pre e...hoping to connect

This section is for discussions with other women who have probably been through the same signs/symptoms that you may be experiencing. Please note, we cannot offer medical advice and encourage members to discuss their concerns with their doctors. New members, come on in and introduce yourself!
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caryn
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Re: High blood pressure, no pre e...hoping to connect

Postby caryn » Wed May 30, 2012 05:07 pm

The way to think about this is to remember that we don't get to choose between the no-risk scenario and something riskier. There are known statistical risks associated with all of these things, and if you ask your docs, they will be able to tell you (at least rough!) numbers. And you'll probably want the less-risky of the two options, whichever it is. After all, the reason for "choosing natural birth" is that arguably evidence says it's the less risky option given a normal pregnancy, all other things being equal.

Since these pregnancies aren't normal, the umbrella of options that constitute "natural birth" aren't necessarily the least risky options, any more. It's hard to wrap our heads around this, because we were generally low-risk for complications at the beginning of our first pregnancies, when we read popular pregnancy books and blogs. But on this board, women aren't at low risk for complications - they're *already having medically complicated pregnancies*. We already have hypertension, or a history of preeclampsia. And women in those populations have a different risk profile from normal pregnant women.

Induction with pitocin at 37 weeks is the lowest risk scenario in some cases. Emergent Caesarean with a NICU team in the room is the lowest risk scenario in some cases (raises hand). Amnio to check for fetal lung maturity followed by a scheduled Caesarean is the lowest-risk scenario in some cases.

Some women value some things more highly than choosing the lowest risk scenario, in which case they may choose the riskier of the available options. But sometimes there are no options, medically speaking - and that's probably okay with everyone who posts here, because we want to get to raise our babies.
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)
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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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aajatwins
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Re: High blood pressure, no pre e...hoping to connect

Postby aajatwins » Wed May 30, 2012 02:29 pm

I absolutely agree, induction is preferable to being cut open and sections are definitely major surgery. And I've actually seen a couple of posters here who said they were able to deliver during/after having seizures - which is crazy to me! - but evidently it happens.
Anna (28) - endometriosis
Hubby (27)
Aidan & Jordan - 7.2.09 at 36 weeks. Induction turned emergency c-section due to eclampsia. big healthy toddlers today!
Asa - 10.23.11 at 39 weeks. NO hypertensive issues!! successful VBAC :)

jenh
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Re: High blood pressure, no pre e...hoping to connect

Postby jenh » Wed May 30, 2012 09:35 am

Aajatwins, that sounds like a very scary experience. I'm sorry you went through that. When I was induced with severe PE, borderline HELLP, at 35 weeks with my first, the MFM told me I was so sick a c-section would kill me. It's my understanding major surgery (which is what a section is, even though it's so common and routine today) is much more stressful on the body than an induction, so induction is the preferred option. (Unless the research has changed since I last looked at it?) Of course, there are situations where a vaginal birth is impossible or something (like your seizures or fetal distress) comes up that requires faster delivery, and then thank God for modern medicine and c-sections, but I personally would prefer an induction over a section if it were possible.
Jen
Wife to Brett 6/30/02
Mom to Ethne Joy 10/12/03, 35 weeks, severe PE
Mom to Catie Grace 12/8/06, 37 weeks, mild PE
Mom to Riley Faith and Gavin Arthur 7/7/09, 36 weeks, PIH 22 weeks, PE 31 weeks, severe post partum PE
Mom to three angels Grace (12/15/05), Ian (7/28/08), and Declan (5/23/15)

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aajatwins
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Re: High blood pressure, no pre e...hoping to connect

Postby aajatwins » Tue May 29, 2012 03:48 pm

I should correct myself - pitocin can raise your BP, for sure. I don't know if it really can change the course of PE or PIH during an induction or not. My experience was bad, in that I was induced with already-too-high BP and I seized after being started on pitocin, having my epidural, and having my water broken. So for me, I count pitocin as bad! :D But I seriously do not know about how it affects PE/PIH, just BP. And I have been reminded that doing major surgery on a sick pregnant mama is also not a great option! Maybe there's not a great option... just options! Sorry about that. That earlier post was a little too much experience talking.
Anna (28) - endometriosis
Hubby (27)
Aidan & Jordan - 7.2.09 at 36 weeks. Induction turned emergency c-section due to eclampsia. big healthy toddlers today!
Asa - 10.23.11 at 39 weeks. NO hypertensive issues!! successful VBAC :)

mom29
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Re: High blood pressure, no pre e...hoping to connect

Postby mom29 » Tue May 29, 2012 03:36 pm

With my last delivery, they gave me magnesium to prevent seizures so a vag. delivery was still an option for me.

I would definitely prefer to be in a hospital.

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aajatwins
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Re: High blood pressure, no pre e...hoping to connect

Postby aajatwins » Tue May 29, 2012 02:32 pm

It is good to hear that you are 30 weeks! So not too much longer for a safe delivery.
In light of what you've said about your care, I would only caution you to prepare for a hospital delivery because of the chance of seizures (which can cause you to become unresponsive, i.e. unable to birth your baby) and stroke at high BPs. You would not want to be in the middle of a homebirth and have either of those happen and no safe way to get baby out or administer necessary drugs to you, Mama! You would also want to choose carefully if given the option of induction vs. section. Pitocin can cause BP to rise, making seizures & stroke much more likely. So the safer option there would be a section. I really hate both of those options (for anyone), so I understand that is a terribly difficult situation. But safety of mama & baby are obviously top priority (I'm sure you agree) :)
Anna (28) - endometriosis
Hubby (27)
Aidan & Jordan - 7.2.09 at 36 weeks. Induction turned emergency c-section due to eclampsia. big healthy toddlers today!
Asa - 10.23.11 at 39 weeks. NO hypertensive issues!! successful VBAC :)

mom29
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Re: High blood pressure, no pre e...hoping to connect

Postby mom29 » Tue May 29, 2012 12:16 am

intime0 wrote:
Mom29, what were some things they did to help you through the full term pregnancy? And were you able to deliver non medicinally...meaning, did they let it come when it was ready? What were the safe guards in place concerning your bp at that time? But no pre e, correct?

I've definitely gotten to the point where I'm pretty nervous about GETTING to keep my baby and will agree to just about anything at this point. Well maybe not. They'd really have to convince me I needed a csection. I"m actually quite grateful to be over here for this. This doctor is so knowledgeable and helpful and I feel so blessed.

Anyway, do comment and offer more suggestions and your stories, as time permits. THank you so much.


It was my 10th baby that I had the post partum pre-e with. The OB did absolutely nothing. I was admitted overnight and put on mag. when another OB was covering for him. Then I was supposed to monitor my bp at home and I was also seen by a peri. for growth ultrasounds. When the peri. saw my bp log she wanted me delivered immediately and called the OB to tell him. I went straight over to the hospital where my reg. OB was on staff and the house OB got one good bp reading by having me lay on my left side and told me I was fine to go home (boy was I confused!). When I went to my appointment the next day, the OB casually said he had been waiting to get a call that I was there. I was induced the following day 10 days before my due date. I was sent home 24 hours later with high bp despite the nurse expressing concern.

There were no safe guards regarding my bp. They had me call in the numbers and the nurse would say they were breathtakingly high, but nothing was done. It felt like a waste of time calling the numbers in. He thought I had PIH, but I had actually developed chronic hypertension and he didn't want to mask pre-e by treating the high bp. Even though I hadn't developed pre-e, I was still at risk for seizures with my bp so high and I felt absolutely terrible. Just unloading the dishwasher or switching over laundry left me feeling breathless.

The next pregnancy, I was already on bp meds. so I felt so much better. I did develop gestational diabetes and was seen by a mfm also. When my bp went up at 38 weeks, the mfm told the OB I needed to be delivered "today" and the OB agreed. Bp went too high after delivery and again the OB just wanted to ignore it. He didn't answer the nurse's numerous pages so she had a house dr. cancel the discharge. I never saw the OB again and he wouldn't increase my labatelol. One nurse whispered to me "Call that MFM as soon as you get home." I called him and he tripled the bp meds. and added a third dose the following week.

With my next pregnancy, I went straight to the MFM. After my previous delivery, the reg. OB had told the pp nurse I was not a diabetic and my blood sugar would be fine when she called him with a high number. Turned out, I was a diabetic and those high numbers didn't "go away" like he said they would. I pretty much lost the trust I had in the reg. OB.

I felt much safer under the MFM's care because he took the increased bp at 30 weeks very seriously. I delivered at 33 weeks.

intime0
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Re: High blood pressure, no pre e...hoping to connect

Postby intime0 » Mon May 28, 2012 08:59 pm

Try to answer all your questions. And thank you all for taking the time to connect with me.

Yes, they've been checking the baby and all is well there. Nothing quite like knowing baby is safe and sound, right?

I'm just about 30 weeks with baby number 6. So TOO EARLY to deliver. That's our biggest concern right now. Fortunately, the doctor is super laid back and hasnt mentioned it at ALL. He just assumes we'll do all we can to keep the baby in. Hasnt even mentioned steroids for lungs or anything.

It's an Ayervedic herb for high blood pressure; very common in Asia. Safer and less harmful over all than the bp meds. But since they arent working this is the route we have to take.

The one great thing about my doctor is that he does homebirths. But I guess I should try to prepare myself mentally to delivering in the hospital. THe Asians do not have power struggles. If I say no to a bed pan they dont force me. LOL. YOu know what I mean. SO I do have that advantage. (Saving face, etc.)

Mom29, what were some things they did to help you through the full term pregnancy? And were you able to deliver non medicinally...meaning, did they let it come when it was ready? What were the safe guards in place concerning your bp at that time? But no pre e, correct?

I've definitely gotten to the point where I'm pretty nervous about GETTING to keep my baby and will agree to just about anything at this point. Well maybe not. They'd really have to convince me I needed a csection. I"m actually quite grateful to be over here for this. This doctor is so knowledgeable and helpful and I feel so blessed.

Anyway, do comment and offer more suggestions and your stories, as time permits. THank you so much.

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aajatwins
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Re: High blood pressure, no pre e...hoping to connect

Postby aajatwins » Mon May 28, 2012 02:36 pm

Welcome to our forum :)
How far along are you? did they do ultrasounds to check out the baby and placenta? Being overseas is obviously different - different meds and resources available... but I have heard some posters say they've had bad reactions to some BP meds (including bad headaches) - can you ask for a different med? Here (US) we have a few choices that work for pregnant women.

I'm sure you realize from your previous experience with PE that the only cure is delivery. And that doctors/hospitals will always act in favor of saving the mother. So I would definitely prepare yourself for a hospital birth at the very least. The high BPs do concern me (and possibly the herb supplement, but we really don't do much of that here in the US), but the bleeding would concern just as much, if not more. I totally understand your desire for the natural birth, though, and it is a hard one to let go! My first delivery was very traumatic, so I was desperate for a vaginal delivery after that c-section and a better experience to heal my emotional wounds. BUT I did have to come to a balance of knowing that whatever is best for both mama and baby will be the right thing, in the end.
Keep us updated as you can!
Anna (28) - endometriosis
Hubby (27)
Aidan & Jordan - 7.2.09 at 36 weeks. Induction turned emergency c-section due to eclampsia. big healthy toddlers today!
Asa - 10.23.11 at 39 weeks. NO hypertensive issues!! successful VBAC :)

mom29
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Re: High blood pressure, no pre e...hoping to connect

Postby mom29 » Mon May 28, 2012 02:11 pm

This is your seventh baby correct? How far along are you right now?

A lot of times bp will become unstable (up & down) before it finally stays high.
If you are still bleeding right now I would call the doctor, you don't want to ignore that.

Does your doctor know you are taking an herb to help keep your bp down?

Between the bleeding and high bp, you should adjust your expectation to delivering in the hospital instead of at home. Things can go south pretty quickly and a fully trained L&D staff, access to an OR if needed, and a nicu team if necessary can be the difference between life & death for you and your baby.

I did make it it full-term with some very very high bp (170's/105+) in one of my pregnancies, but I wound up with post-partum pre-eclampsia and was readmitted to the hospital.

With my oldest I was delivered at 34 weeks and with my youngest I was delivered ay 33 weeks. No c/s, inductions that went well.


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