when should I get worried? high bp, nausea, headac

[expert@preeclampsia.org]

I have always had low blood pressure and the last month, my blood pressure has been between 140/80 and 148/90. I have been throwing up and have a constant headache. I am in my 34th week. My doctor feels that I am fine and do not have preeclampsia because there is no protein in my urine. Is this possible? Should I seek a second opinion?

[expert@preeclampsia.org]

Preeclampsia is a condition that evolves over time. Fluid weight gain and swelling are frequently followed by elevations in blood pressure and then the development of proteinurua. All cases do not follow this sequence. Symptoms of headache and vomiting are common symptoms of preeclampsia. But, not all women with these symptoms have preeclampsia.

You clearly have gestational hypertension (elevated BP). Women who develop gestational hypertension preterm have a high rate of developing preeclampsia and severe preeclampsia. Your symptoms are very concerning.

Have you had a 12 or 24 hour urine collection for protein? How is the baby doing? Is it moving every day? Are NST's of the baby normal? Is the baby's growth on ultrasound normal?

You should have a very low threshold to return for BP checks. The progression from gestational hypertension to preeclampsia to sever preeclampsia and HELLP{ can be very rapid. It is never wrong to be seen again or to go into L&D if you are worried.