by catherine (2832 Posts), Wed Dec 27, 2006 05:59 pm
Test or no test, new or old, the treatment of a woman with a hypertensive disorder during pregnancy does come down to the prior experience and expertise of the particular doctor that treats her. While there are distinct guidelines, eg. woman @36 weeks gestation and a "bad" blood test is a "no-brainer" for immediate delivery, in many cases where the pregnancy is not so advanced, disease is milder or not progressing very rapidly then spotting the moment to deliver becomes less obvious, particularly for the woman who is experiencing it. Even if there was a test that said, "no matter how sick you/your wife appears, she's not getting preeclampsia", would you believe it? Especially if you were experiencing signs or symptoms that had raised your level of concern? I certainly wouldn't and I think that you've done the only thing that anyone in your situation can do which is to find OBs with the best level of experience and expertise that you can. I have to point out too that even a 24 hour quantitative analysis may not be relevent in the context of your wife's current condition. They are monitoring her and your baby by multiple methods. I suspect, and lord knows I'm no doctor, that perhaps they plan to deliver at the first sign of fetal distress, or if your wife shows defintive signs of a rapidly worsening problem, like an insanely high BP that doesn't come down, or a bad blood test but absent that, they want her to get as close to the finish line as possible, limping or or perhaps even crawling. Identifying the "sweet spot" where you can deliver a baby who will not need NICU time, to a mom in good enough shape is what high risk obstetrics is all about. Babies that are born early are at risk for complications and that is a concern that is always paramount with OBs, even if our parental instincts are to "cut and run" to use a horribly over-worked phrase. In saying this, I hope that you don't think that I'm indifferent to poor care, I'm not; I just want to emphasise that no matter how frustrated you feel, you have a safety net, all the monitoring and access that you've already had means that a signifcant change for the worse will be recognized and responded to.