Mom still has high BP five days after delivery

[kevin811]

Mom went in for a routine check-up for the baby and her blood pressure was high (150/90). She had been retaining a lot of fluid and was ideally just trying to go on rest as work was becoming a bear. Doctor evaluated and decided to have an emergency C-section last Thursday because of high blood pressure. Protein in blood was low but BP was approximately 155/95 steady. Baby girl was delivered last Thursday and was sent to ICU. Difficulty breathing for baby girl and was placed on respirator for first 21 hours of life. She has since been off respirator and is doing great. However, currently being treated for jaundice.

Mom has continued to have high blood pressure since delivery. There were some up and downs but not it has continued to remain high (150/90 range). Yesterday we tried Procardia (sp?) and it only made matters worse. Mom had serious heart racing upwards to 160 per minute. She has since stopped taking ProCardi and we are awaiting the doctor to come in today. Unfortunately her blood pressure was just taken and it is 155/93.

Are there any medications that people have had success for their blood pressure and have had minimal heart rate increases?

What are some of the post partium BP's for women who have had late stages of PE?

Any suggestions would help at this time as we are still in the hospital.

Thanks,
Kevin

[alexza]

HI,
I can't give you too much advice, other then watch for blood clots. I had an emergency C due to high blood pressure and after the birth, my blood pressure actually rose higher (into the stroke range 200+/100+) for the next 24h hours.

I don't know in the end what they gave me to lower the pressure... I haven't even got to look at my file since the event. I did get a blood clot in my lung from all the events though. (It feels like a stitch from running that won't go away.) Please have her watched for those and don't let it get as bad as it did for me. (I wasn't diagnosed until the 5th day, when I couldn't breathe without severe pain.)

Write in when you get the chance again and tell us how she's doing.
God Bless,
Alexza

[missgamecock]

Ziac is what I am on now. I don't know if it is used as a pp drug. But I havn't had problems with it. It actually lowers your heart rate. It lowered mine to as low as 50 but has evened out now. My heartrate is around 60-75bpm now. On Procardia, it put me in Tachacardia. It didn't do a thing for my bp and gave me terrible headaches. The ziac was prescribed to me by my family dr. She did run it through my OBGYN in case of an ooopsie. They both said it was safe for pregnancy. Not sure about breastfeeding though.

With the bp, mine never went back as high as it was during labor. But it was up and down for a couple of months. I hit a new high 3 mos pp and my obgyn transferred me to my family dr for treatment. She brought me into the office immediately. Started me on Ziac that night. My bp dropped within 3 hours to normal. Now it runs about 110-115/60-70. I havn't had a problem with it since.

[caryn]

Hi Kevin, glad you've found us.

It's not uncommon for bp to stay elevated postpartum in preeclamptics. Often it comes down after a few weeks or months as the body repairs the damage, and sometimes it stays up. The stress of pregnancy, in suceptible women, "nmasks" a tendency towards chronic hypertension, and we develop PIH or PE, and sometimes have chronic hypertension remain after the pregnancy. Here's some quotes from the Working Group Report on High Blood Pressure in Pregnancy:

Blood pressure normalizes postpartum, usually within the first few days of the puerperium, but may take as long as 2 to 4 weeks, especially in severe cases.

and

Resolution of hypertension is more rapid in patients with gestational hypertension and may lag in those with preeclampsia, especially those with longer duration of preeclampsia and greater extent of renal impairment. This delay in resolution may reflect the time needed for endothelial recovery.

Here's a link to the full report, in case you or your wife are like me and will want to read the whole thing [:D] :

http://www.nhlbi.nih.gov/health/prof/heart/hbp/hbp_preg.htm

Anecdotally, my bp was 220/116 two days postpartum, on IV mag sulfate and labetalol. I was discharged on labetalol (it's safe for breastfeeding) five days postpartum. It was something like 160/100 at my two week followup, and 140/90 at my six week followup, and I was weaned off of the medication about 4-5 months postpartum when I presented with a bp of 90/60. These days it mostly hovers in the 100-110/65-70 range, and although I am likely to need bp medication as I age, I have definitely recovered.

The medications I see mentioned most often on the boards are labetalol, procardia, atenolol, and aldomet.

Congratulations on the birth of your daughter, and my best wishes for a speedy recovery to your wife! Please keep us posted as she and baby heal -- you (and she) are very welcome here.

[heather j]

I was originally on labetalol which had no affect on my high pressures. At my doctor's recommendation, I agreed to forgo breastfeeding and move on to some more powerful drugs. I ended up on Cardizem and Indural, and my pressures were normalized within four months. Congratulations on the new baby!

[gordon k]

Congratulations on the birth of your daughter

My wife and I have a great doctor that is very well versed in dealing with preeclampsia and pregnancy induced hypertension. The first thing that he did was measure my wife's cardiac output using an UltraCOM (a doppler device that measures blood flow) to determine whether she had high cardiac output (the heart pumps too hard) or vasoconstriction. He also, of course, looked at the pulse rate. Once he had evaluated the elements that can cause high blood pressure he then chose what medicine to use after he had determined the root cause of the problem.

During the worst of it (which was post-partum), my wife was on increased atenelol, lisinopril, lasix (IV & pill), and nifedipine. However, since her problem is primarily high cardiac output she has remained on a perscription of atenelol.

I am not recommending any specific medicine over the forum, that is between you and your doctor. If I were you, I would, however, ask the doctor to determine the root cause of the high blood pressure and how the medication is going to specifically help your wife.

Hope this helps and the best of luck to you, your wife, and your new baby girl.

[emersons mom]

i was on aldomet for 6 weeks post partum, they slowly weaned my dosage down and am now bp med free!!!