confusion about pih and preeclampsia

[cindasmom]

I am currently 33 weeks pregnant with my second child. My first pregnancy was wonderful and completely normal.
At about 27 weeks in this pregnancy my doctor noticed that my bp which normally ran about 120/70 was slightly elevated.
At the next appointment it was higher still about 140/95.
My doctor sent me for a non-stress test at the hospital, but everything was normal and I had no protein in my urine. I was told to monitor bp at home.
About two days later my bp kept creeping up when it reached 147/117 one night I went to hospital for another non-stress test again with good results.
My doctor, after consistently high blood pressure and a +1 protein count,extreme headaches and blurry vision sent me for 24 urine catch.
My urine at the hospital showed only a trace of protein so I was put on 10mg of procardia 3 times a day and told to rest.

After one more night at the hospital (bp 166/108), I was sent home again, same meds, told to rest etc.
My doctor sent me to a perinatoligist 2 days later who told me to go to the hospital immediately. He also told me he did not recommend giving meds to someone with pih for risk of masking symptoms of preeclampsia. He stated he wanted to deliver me early even if no protein was found in urine at about 36-37 weeks.

Once again only a trace of protein in urine and blood work normal.
My blood pressure while in the hospital though ranged from 120/90 to 165/104. I was then placed on a higher dosage of procardia. It however did not help so I was given labetalol at 100mg twice a day. I am now on bedrest with only bathroom privleges.

I have to go once a week for non-stress test and blood work. I have to do a 24 hour urine once a week also.

I am very worried. I feel that my perinatologist says one thing and my ob another.
Is this a normal course of treatment for someone with pih?
The labetalol is keeping my bp down for now but so did the procardia at first.
Does pih become preeclampsia only if protein is in urine?
If you could help me with these questions I would be so thankful.

[expert on call]

The definition of preeclampsia depends on protein in the urine. So yes--PIH becomes preeclampsia when sufficient protein in the urine is noted.

Preeclampsia can develop slowly or very quickly, and it is not unusual for someone with high blood pressure to hear a lot of different opinions as to why she is having problems. In addition, there are many different ideas on how to treat preeclampsia. Some doctors treat high blood pressure with medications, others will not. I expect that at some point your blood pressure will become worse and require admission to the hospital, possibly even getting so bad that your doctor will recommend delivery. This is not an unusual course for the disease.

Expert on Call

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