Not sure if I'm getting Pre-e or worrying about nothing

[liathano]

So I'm 29 weeks pregnant now and having some issues. They started back in early May. May 1st I as in L&D triage because I wasn't feeling right. My vision was blurry, I didn't feel well, a bit dizzy, and juice/ water wasn't making it better. We went in and my BP was in the 150s/ 90s. It was only like that for a couple hours and went down on its own. I had a small headache but not one I would personally have classified as heading to a migraine. However that's what they decided to go with. They made me do a 24hr urine just in case though, and told me it was fine. My BP seemed fine at the next appts and it wasn't something to worry about. Well then this last Sunday I spend the day feeling lightheaded and almost feint, and again I don't feel right. We go to wal-mart to check my BP and it's 154/95. I had also started another 24 hr urine because one of my docs said that while my last 24 hr urine was fine it was slightly elevated so she wanted to test me again just to see. I noticed that I hadn't been peeing as much as normal and it was darker. I know I was drinking plenty of fluids because I had just upped them. The week before I had some intense contractions and they said it was because I was dehydrated. So I was drinking plenty of water and even had added gatorade to help. So with that we decided to make a trip to triage again. I get there and my BP stays around 154/82. It doesn't really go down (occasionally I get a 147, but that was it). They let me go home because I had already started my 24 hr urine. The issue is my normal midwife doesn't think anything is all that wrong because to her my protein wasn't all that elevated before. Either way though the high BP is an issue and I have to see an OB now. I go home I finish the 24 hr urine.

I should explain I see two different people. Originally I was sent to another office to determine if I was high risk and then I kept going for u/s and to see the midwife nutritionist. The midwife nutritionist is the one that ordered the second 24 hr urine just to be on the safe side. My normal midwife saw no issue.

Well I'm worried after Sunday night because my BP didn't go down and I'm wondering whats going on. I go in to meet the OB who will be my new doctor and she says everything is fine. We are just going to treat hypertension but when I went in my BP was 141/84 and she said so long as we keep it around 140/80 (preferably lower) we'll be fine. No meds, no bed rest, no nothing. Just go on with what I'm doing. But that we would also start sending me to an infusion center for my iron because that's low (I was anemic before I got pregnant so this isn't really an issue, I told them this would happen). So I think everything is fine, it's just hypertension, no big deal. Well later that day (Tuesday) I get a phone call from the other place. She tells me my protein did go up and while it's not pre-e levels they will definitely be testing again in a couple weeks. Confused I ask her what my first 24 hr was and what this one was. She says first on was 156, and this one was 232. Then when I told her I was in Triage Sunday for high BP she got really concerned. She said she'll talk with my new OB and they'll see what the plan is but that I should prepare to not go much further than 37-38 weeks.

I'm pissed off. I don't understand at all. I don't know if I need to be concerned, or if I'm even heading towards pre-e. I wish they would get on track though. My question is does it look like this is what's going to happen? Should I be preparing to have issues? Or should I just think it's nothing and not even bother worrying? What should I be doing now?

[MomTimesThree]

In the second pregnancy, I had almost the same progression of protein and BP and our MFM (high risk doc) felt very strongly we were on the road to pre-e and by the next 24 hour (we did them weekly) I was at 300. I was also about 29 weeks... we were on modified bed rest, did twice weekly NSTs and were induced at 37 weeks as is pretty standard protocol for a pre-e momma.

That's just what happened, to us. I don't think anyone can say for sure what your progression will be, but I do think you're right to be concerned and on top of your symptoms. It's especially confusing to have so many people involved in your care. You might want to identify who is going to be your direct point person and what symptoms they want you looking out for as well as what the plan will be to monitor your BP and baby. Often times it's recommended you have a BP cuff at home at take it 2x a day as well as have some extra monitoring of baby.

I hope you get answers soon and your bp and protein levels stabilize.

[aajatwins]

Welcome to the forum
sorry you are going through this - I can see where you'd be frustrated. It does sound a little too confusing to have so many people involved in your care. What would concern me most is the dark colored urine and the lack of it along with the high BPs. With your protein increasing, I'd want it to continue being checked, also.

It sounds like you're in the UK, and I don't totally understand medical care there, BUT I would want to get down to one doctor managing you so that there are no complications from varying thoughts. Things can also get overlooked or missed when there are two different doctors each thinking the other has something covered. It would be preferable for one doctor to have all the info from appts and from L&D trips. Is that possible for you?

An official diagnosis of PE requires 2 BP readings of 140/90 or higher (which you have) and protein of 300 or greater. I would make sure you are well read on the signs and symptoms and report any of those to your doctor, even just a general feeling of something being "off" or "not right". Some women who have BP cuffs at home will be told certain numbers that need to be called into the doctor (which can keep you from running in to L&D triage "unnecessarily", in some cases). 37-38 weeks is normal for PE pregnancies. PE can change quickly and without warning, so delivering as soon as they think baby can handle it is the best option for mama & baby. Because it is a placenta problem, the only cure is to get that placenta out!

[liathano]

thanks so much. I figured I should be worrying and looking out :/ I should be preparing for the early delivery then. I'm not in the UK though I am in the US, I don't know why they have me going to the two different places. I will definitely be discussing it and really it makes me want to just switch to the other place because they seem to be more upfront with me about things and I hate feeling like I'm being lied to, or treated like a 2 year old who is incapable of understanding. I guess for now it's just the wait and see game. We are planning to get a cuff but have to wait until my SO gets paid on Friday and then we'll monitor my BP from there. Any suggestions on best times to do that?

[aajatwins]

Oh ok - the midwives always throw me off My state does not allow them! Yes, definitely get all your care together under one doctor.
I'm not sure what times of day, or if that even matters, but most people are recommended to take 3 readings a day. So early, midday, and evening, I'm sure. You don't want to take it too often because everyone's BP can fluctuate and could cause you to worry when there's no need.