early pre-clampsia?

[shuse]

I am 24 weeks pregnant. It is my second pregnancy though my first was lost to miscarriage at 19 weeks after only having developed 8. During this current pregnancy my body attempted to miscarry our little girl at 10 weeks, yet after careful examination doctors informed me I had nothing to worry about my hormone levels were high the cramping had subsided, the pregnancy looked in tact and they saw no concerning cause for the bleeding. They discouraged me from believing rest was necessary and we went on with our life's. At 14 weeks my midwife informed me my blood pressure was a little elevated. Knowing I do not have a history of high blood pressure I purchased a monitor and began tracking it at home. For several weeks all seemed well. My blood pressure was normal 110's to 120's over 60's-70's. Occasional during activity it would rise to 130's and low 140's over 80's at which time I found myself feeling slightly week but good otherwise. Then at 17 weeks I found it necessary to call my husband to bring me home from work as I was feeling week, dizzy, shaking, swelling in hands, nausea, vomiting, and headache. I don't know what my blood pressure was then, but decided to rest over the weekend and return to work the following Monday. Monday came and while preparing a simple breakfast of eggs I suddenly began experiencing these horrible symptoms again. This time taking my blood pressure I was shocked to discover it was 163/110. Calling my Mid-wife she sent me to the lab at the hospital to have an EKG and 24 hour Urin Test for protein. Both tests showed normal results.

Since this time I have been on a leave of absence from work and continued to struggle with my blood pressure. When I have been resting it seems my pressure was still normal, yet even the slightest activity such as taking a shower or clearing the table after breakfast causes it to elevate sky high 150's over 90's and higher. My Midwife told me I have chronic hypertension, explaining that it is impossible that I would have developed preeclampsia at 17 weeks. She referred me to a fetal medicine specialist who told me due to my history of high blood pressure ( a history that I don't have) the only action they could take was to monitor the fetal development and prescribe frequent rest, he suggested there could be a chronic secondary cause and to see my General Practitioner for further examination and to discuss future treatment after pregnancy. Seeing my GP I was told I do not have a history of high blood pressure, There are no secondary causes to be found, and I should be treated for preeclampsi. I feel so confused at this time as none of my doctors seem to agree. Over the past two weeks I am begging to notice that my pressures are rising even more easily and harder to bring down through relaxing. My resting BP's are now in the 140's over 80's-90's, and suspect that a few times during the night I have experienced symptoms of false labor, though didn't realize it until discussing it after with a doctor. I guess my questions are is it possible to show symptoms of preeclampsia earlier then 20 weeks even though 2 of my doctors insist its not? Is my GP acculturate to reassure me not to worry unless my BP becomes consistently 160's over 90's. What signs should I be looking for that I may be in trouble when I am reassured my symptoms are nothing to be concerned about, and elevated pressure is normal for me. Should I transfer from seeing a midwife and find an OB who will see me, or is seeing a midwife regularly in combination with my monthly ultrasounds and visits with the fetal medicine specialist enoupgh. Lastly any encouragement that could be offered would be appreciated as feeling the way my body constantly does now is deeply frustrating.

[MomTimesThree]

Hi There-

I'm so sorry for the loss of your first pregnancy. Totally not doc me, says no matter when your high BP started, those numbers you are having today are high. For an official diagnosis of pre-eclampsia you need the high pressures that you're having as well as protein in your urine, 300 in a 24 hour catch. Though, again, regardless, that's pretty high BP to have and I'm glad to hear they've already tried bed rest and frequent monitoring of baby.

In our 3rd pregnancy our BP spiked early (before 20 weeks) so when protein went over 300 later we were considered "super-imposed" pre-eclampsia since we had high blood pressure earlier than 20 weeks... folks more familiar with all the diagnosing will probably chime in with more detailed information.

With so many people involved with your care you'll probably want to find out who is going to be your go to as well as what your call in numbers are... so for instance, at what BP point do they want you calling or going to L&D. And again, regardless of what label they decide to give you, I think what is important today is you feel comfortable and confident in your plan of action and your team. And trust your mommy gut, if you're not feeling right it doesn't hurt anything to give a call and get peace of mind.

Keep posted when you can,
Lauren

[holly3372@msn.com]

I agree always better safe then sorry. True that preeclampsia is diagnosed after 20 weeks but we have seen many women start very early in their pregnancies with signs and symptoms which eventualy lead to preeclampsia. I believe I had early signs as well but wasnt diagnosed until 25 weeks. In this pregnancy now, I am not seeing a midwife, I see a high risk Ob as well as an MFM so Im glad your midwife was wise enough to point you in the right direction mine did not. I was also wondering,( I apologize if you already wrote this in your post) are you now on any meds for the high bp? Keep us posted, thinking of you.

[honeykovu]

My last pregnancy I developed borderline bp at 17 weeks. At 20 weeks a 24 hr urine showed 200 protein and at 26 weeks it was 430. So I didn't have PE until 25 weeks or so, I had the start of rising bp weeks before that. I also have no bp issues outside of pregnancy. So yes I do believe you can have the start of PE at 17 weeks. I know the books say 20+ weeks, but not everyone follows the rules.

For the record last pregnancy was a twin pregnancy and my son's placenta started failing very early on. He measured 15 weeks at the 18 weeks anatomy scan and died 3 weeks later from the severe iugr. I believe that his failing placenta was what set my PE in motion and made it start and be more severe than it would have ever been. I was also told that since he had iugr before 20 weeks it had to be due to a chromosome problem because placenta issues don't happen until 20 weeks. Nope, he was chromosomal normal and on his autopsy report his placenta was totally infarcted making the cause of death iugr from placenta insufficiency. So you see things that aren't suppose to happen until later pregnancy can and do happen early in the 2nd trimester sometimes unfortunately, though it is very rare, but not impossible.