Do these symptoms warrant delivery?

[expert@preeclampsia.org]

At 35 weeks I had severe headaches, swollen ankles, and did not feel right. A trip to the OB indicated my BP was around 150 over 96. However, it came down to normal (124/80) after 5 min on my left side. Was put on modified bedrest at that point.

Four days later, my 24 hour urine test came back at 293, which I understand to be just below concerning. However, my BP while sitting was 170/108. I was admitted to hospital, but after 2 hours by BP was down (130s/80s), baby heart rate/stress test was fine, so I was sent home. They did indicate that my white blood cell count was slightly elevated, but were not concerned with this. I was sent home for more bedrest w/follow up in one week. I am taking another 24 hour urine analysis and will return for 2nd non-stress test this week.

My doctors have not performed an internal exam or an ultrasound. They have indicated I will not be induced until 39 weeks, unless something changes.

Although my BP stays down while on rest, it now seems to be around 145/mid to high 80s according to my at home monitor. Additionally, I have had mild diarrhea over the past week or so. I have also noticed the baby has been extra active the past few days - I'm not sure if that could indicate an issue or not. I am primarily concerned about waiting until 39 weeks to deliver and am questioning if the risk is worth it. Can/should I insist on delivering sooner?

[expert@preeclampsia.org]

You have severe hypertension. The severity of hypertension in pregnancy is defined buy the peak BP's not the lowest. Your BP could be treated with medications.

The level of proteinuria is just below the cut-off for the diagnosis of preeclampsia. At this level, it is concerning. It will rise given the level of your BP.

You and your baby are at risk. With close observation, some benefits to the baby are associated with getting to 37 weeks. It is not important to get to 39 weeks.

When was you last US? Is the baby growing normally?

Call the doctor and go to L&D for:
• headaches
• nausea and vomiting
• decreased fetal movement

I expect that you will get worse over the next few days or weeks. Trust your instincts.