Two time PIH veteran & still confused

[steph]

I had elevated blood pressure at 38 weeks with my first child and was put on bed rest at home. I took labetalol and was on a low-sodium diet. I saw the DR every 2-3 days and they monitored my BP and urine carefully. I never had any symptoms but elevated BP and went into labor 4 days after my due date. I gave birth to a beautiful and healthy 8lb 7oz baby boy. My BP returned to normal immediately after delivery. He is now 2yrs old and remains healthy and I had no further problems, either. Then, I became pregnant again 17 months later and was told that I probably would not have to deal with PIH again. But at 36 weeks I had a headache and decided to go in and be checked just in case. I left with a labetalol prescription in hand, to be on bed rest again. I felt fine, like before, but followed all directions meticulously. I was monitored every week this time and all went well. I had non-stress tests and placenta checks via ultrasound with both pregnancies after PIH was discovered. Again, I was fortunate to deliver a healthy 9lb 3oz baby boy. My BP went down when my labor began, on my due date. I was even allowed to walk a little during labor because my BP was back to normal. I had a fast, normal, medication-free delivery. The baby is 5 months old and remains perfectly healthy in every way. I had no idea how serious PIH is or that it can cause death and ongoing health problems. I really would like to have two more children. My DR says that I have an equal chance of not having to struggle with PIH the next time. Is this true? I guess reading other women's stories has me a litle scared. I feel fortunate in the outcomes of my experiences(my PIH seems very mild in comparison to other stories I've been reading). However, I still wonder about my odds next time. I want to have a healthy baby and be alive to enjoy him or her and after reading about PIH I'm feeling the deck is stacked against me. Since I had a mild form that disapears quickly and easily does this mean I should continue that pattern if I have PIH the next time? Any advice or information you could give me would be helpful. Thanks.

[expert on call]

The Expert will respond to your question soon and in more depth but wanted to assure you that maternal death in pregnancy due to preeclampsia (PIH, toxemia, all the same) is very very rare in the United States.

Editor's Note

[expert on call]

Having had preeclampsia in 2 prior pregnancies, you are certainly at risk to have it again. However, you had mild preeclampsia at term. Your babies were very well grown. If you should need to deliver 2 or 3 weeks earlier to avoid a bad maternal outcome, this would not be adverse for a baby.

You of course need to be followed closely as a woman "at risk for preeclampsia." You probably have some tendency to chronic hypertension that may be more evident later in life. If your BP is elevated when not pregnant, it should be treated. Some would treat your BP aggressively in pregnancy. The only significant complication to treatment is a smaller baby - given that you have such healthy sized babies--a somwhat smaller baby--say 7 pounds--would be OK.

Your history need not dissuade you from completing your family. But, you should be watched closely.

Expert on Call

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