Postpartum PIH

[ccake79]

I had pre-eclampsia with my first baby, who was delivered at 36+2. Luckily she was perfectly healthy and only had a short stay in special care. My bp took 6 months to return to normal after reaching 220/110 at one point 5 days after having her.

This time round I had completely normal (in fact a bit low) bp readings throughout my pregnancy (115/80), but suffered with gestational diabetes and polyhydramnios. They delivered early at 37 weeks. Again, my son is perfectly healthy and was able to come straight home. Me, on the other hand, I developed a headache a day after giving birth, but was discharged from hospital 2 days after the c-section. On day 3 and 4 I started noticing my knees and ankles swelling, as well as a continuing headache. Obviously it totally freaked me out and I went into hospital to get checked out. I was admitted as I also had chest pain (something I'd had with my first), which they thought was caused by a lung clot (scans showed it wasn't, thank goodness). My bp was a bit high on admission (150/90), but slowly went up over the next few days and I was put on labetalol. Last time the only thing that controlled it was nifedipine, which I told doctors repeatedly when the labetalol didn't bring my bp down enough. Unfortunately no one listened at first and I ended up on enalapril, which completely messed up my bp - it's supposed to work over 24 hours, but by 6 hours my bp was already up and by 16 hours it was 184/114! A day later they upped the enalapril, much to my horror, and predictably, it did nothing. Finally - 8 days after readmission - they put me on nifedipine and my bp's been normal since (now almost 3 weeks pp).

I just wondered how many others have experienced normal bp during a pregnancy after pre-eclampsia and then gone on to develop PIH? I'm really hoping it's not made me permanently hypertensive. I'd be interested in other people's stories.

[sam10]

It seems that the doctors took your elevated pressures as a sign to deliver, just before your BP got out of control. Were you diagnosed with postpartum PE or just PIH? It seems to me it could have been postpartum PE. Once the PE gets going, it does not always abruptly stop with delivery. It may take a while for your body to return to normal, which then shows as BP issues in the postpartum period.

I had a similar scenario the second time around. However, my BP started rising 2 weeks before birth, but then got very messy postpartum. Labetalol did nothing; then we found out that I was allergic to Nifedapine. Funny enough Enalapril was helping my BP to stabilize. For me it took about 3 weeks to return to normal. It can take a while to find the right kind of medication, and it can be quite nerve racking and a messy undertaking. I remember calling the MFM team almost daily for an adjustment of my medication. I also saw an internal specialist to keep an eye during the first few weeks postpartum.
Some women take a while to regain their normal BP (up to several months), while others spring back quickly. Some remain on BP and are considered hypertensive.

In general having experienced preeclampsia in your pregnancies does put you at higher risk for developing hypertension later in life. Hope you will stabilize soon.

[ccake79]

Thanks for your reply. They delivered early this time round due to the diabetes and polyhydramnios. My bp was perfect all the way through this last pregnancy, just spiked 5 days pp for some reason. They did check that it wasn't pp pre-e and it definitely wasn't, although I must admit the swelling really bothered me, even though my knees only swelled to a fraction of the size they did last time.

BP seems to be ok on nifedipine - I have a GP appointment next Friday and hopefully it'll be settled by then (I'll be 4 weeks pp then).

[sam10]

Oh, I misread why you were delivered. How did your appointment go today?

[ccake79]

It went well thanks. BP is good. I have to stay on nifedipine for a couple of months, reducing the dose after a month and seeing how things go. Doctor seems hopeful that I won't need long-term medication.

[sam10]

There are posters on here who had to take medications for a few months, but then could get off of them. Let us know how it goes.

[ccake79]

Well I was able to come off my medication at the end of last month! Yay! I'm keeping an eye on everything as my bp is a bit higher than it was before but it's within the normal range.