induction for one high bp reading?

[expert@preeclampsia.org]

I am 38 weeks one day pregnant.

Last week I got a blood pressure reading of 140/90 in the office, and was immediately sent to obgyn triage for preeclampsia screening.

My blood pressure was monitored for two hours and was perfectly normal. The baby was also perfectly normal. There was trace prtotein in my urine, slightly elevated kidney functions, and an ALT of 57. My doctor recommended induction. I decided to wait a day and get monitored again.

On day two my blood pressure was again perfectly normal, and so were all the baby's signs. There was no protein in my urine and all the kidney tests were normal. ALT had decreases to 49. I was discharged again from the hospital with instructions to get monitored again next day.

On day three all blood pressure readings were again completely normal , the baby was normal, no protein in the urine, kidney tests normal, ALT was 51. I was again discharged . I am scheduled to see my doctor again monday who believes preeclampsia is inevitable and that I should induce.

I do not want to go the induction route , but my doctor is scaring me to death.

Please comment.

[expert@preeclampsia.org]

Once any obstetric patient reaches term (37 weeks) and has signs and/or symptoms suggestive of preeclampsia, delivery is an option since delivery of the pregnancy including removal of the placenta (the cause of the problems) leads to a return to health. A liver transferase abnormality in the 50s is concerning. If the OBGYN has made a diagnosis of probable preeclampsia at term, that physician is practicing appropriate medicine to recommend delivery.

Hopefully within the next 5 years we will have a readily available and dependable blood test to suggest the diagnosis and estimate risk. Right now blood pressure and proteinuria are often variable and unreliable markers until the disease is well advanced, sometime too late to intervene and avoid morbidity. Once the diagnosis of preeclampsia is considered at term, it is usually in the fetal and maternal best interests to accomplish delivery.