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How to proceed with changing symptoms?

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How to proceed with changing symptoms?

Postby expert@preeclampsia.org » Wed May 12, 2010 11:27 am

by expert@preeclampsia.org (322 Posts), Wed May 12, 2010 11:27 am

My blood pressure was slightly elevated at the beginning of my pregnancy and due to my past PE with 2nd child, my doctor has had me also consulting with a high risk doctor. The blood pressures seemed to drop in the 2nd trimester, but increased quickly at the beginning of my third trimester. I had readings over 150/100 which prompted the doctor to admit me to the hospital for screening (at 31 weeks).

Fortunately, blood work came back fine and baby shows no distress. They placed me on Labetelol 100mg 2x day (which has kept my BP's lower) However, 24 hour urine came back at 328 which they called mild PE. Told me to start bedrest, then retested 24 hour urine again, with a result coming back at 182 (at week 32). Now, bedrest not necessary. But I am continuing with fetal testing two times a week. Doing another repeat 24 hour urine this Sunday for them to test Monday.

My question is, why/how could the result all of a sudden be good, and should I expect the bad results to return? And would this or would it not be diagnosed as PE? The last week and a half has been so stressful. I just wish I knew how to proceed.
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Re : How to proceed with changing symptoms?

Postby expert@preeclampsia.org » Wed May 12, 2010 11:29 am

by expert@preeclampsia.org (322 Posts), Wed May 12, 2010 11:29 am

As usual the data here are sparse. This is a chronic hypertensive but how long she has been hypertensive(meaning does she have a degree of focal glomerular sclerosis or otehr renal changes of chronic hypertension when not pregnant etc etc?. That is she did not mention what her baseline values were at the beginning of pregnancy (which should be sought for all high risk women.)

At any rate the amount of proteinuria she had manifested is borderline and since proteinuria in every one normally increases in the second half of pregnancy variations should have little influence on management if the remainder of the clinical picture is stable,

The major things her doctor will focus on are control of blood pressure, no evidence of progressing renal dysfunction (such as creatinine rising), no evidence for superimposed preeclampsia showing ominous signs such as falling platelet counts, appearance and/or worsening of liver enzyme abnormalities, symptoms of concern such as headache abdominal pain etc.

Finally, having been both a chronic hypertensive and supposedly a previous preeclampsia gives her ~30% chance of superimposed preeclampsia, but no one can predict if it will less or more severe.
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