Am I overreacting?

[jason28]

My wife is currently 35 weeks and 4 days pregnant with twins and over the last 2-3 weeks has had many of the symptoms associate with preeclampsia. Being that she has a pre-existing heart condition she is alreay under the care of a high risk OB who is monitoring her weekly, but I'm getting nervous that they are monitoring and not "doing" anything, maybe because no one is really explaining the test results to us. It's possible that my over-active imagination and being a first time dad is getting the best of me, so I thought I'd post and get a "second opinion" :-)

Before her pregnancy, her bp was consistantly in the 100/60 range. Now over the last 3 weeks it has been in the 135-140/85-90 range. The did a 24 hour urine test last week and it was 237mg. Yesterday she had her BP taken by two different physicians about 8 hours apart, the readings were 140/90 and 146/92. We were sent to the hospital(3rd time in two weeks), they did labs monitored her BP(never lower than 138/88) and sent us home with another 24 hour urine collection. She has been vomiting a few times a day, her ankles have doubled in size and she has a headache that won't go away. I have no doubt in the abilities of her OB, and don't want to question his judgement, but is there a point when you shouldn't just monitor the situation?

Any comments are welcome, even if its to tell me I'm crazy. :-) I just want a healthy wife and two healthy babies.

[klynnkopaczrn]

Hi Jason,
I'm not a dad, but if I were in your shoes, I would place a call to her Doc ASAP! Tell them the symptoms, and park yourself at the hospital if you need to. The vomiting as well as the borderline BP has me concerned, as well as the headache.
My preeclampsia started the same way, and quickly snowballed! It's nothing to be taken lightly!

[rebeccac]

Yes, put a call in. If that doesn't help, I wouldn't hesitate going to L&D either just to be safe. There are 3 lives involved here. You are not overreacting! Good luck!!

[laura]

Hi Jason, congratulations on the new babe on the way! I'm guessing that given your wife's preexisting conditions, they're probably taking the PE in stride and trying not to alarm you with progress reports, not realizing that the lack of reporting is more stressful than not!

The diagnostic criteria for preeclampsia is 140/90 with 300mg protenuria in a 24 hour urine- your wife is within spitting distance of the protein and meets the BP requirement. If she were at term, they'd probably go ahead and just induce her. Since she is still 'remote from term' they'll probably wait for her to meet one of the criteria for severe preeclampsia: BP's of 160/100 and/or 5000 mg proteinuria in 24 hour urine, OR other symptoms that things are starting to effect her nervous system: headaches that won't go away, brisk reflexes, visual disturbances.

Next time you see the doc, ask him what his criteria for delivering is, and what symptoms would make him want you guys to call in or go in to L&D. Best wishes and luck!

[for faith]

Glad to hear you are so on top of things, this is a great site to give tons of info about PE and the important things to watch. Her care sounds great, but I would defintely watch those symptoms and make sure the dr is aware of all of them. There were times when I just didn't feel right and went to L&D to make sure things were ok, most times my BP was very high and I was monitored very closely. Glad to hear your wife is so far along. Take care, wishing you both and your 2 babies all the best!

[hfwarner3]

Jason,

Congrads on the twins!

If it was me, I would start with the "help me to help you" approach. I would call the doctor RIGHT NOW and have them paged. When they call you back, I would say, "I know that you are the doctor, not me, but I am confused and scared. My wife is NOT doing well and to me just appears to be getting worse by the day. Her BP just keeps going up. You have found protein in her urine. He ankles are the size of grapefruits. She is throwing up repeatedly and her headache will not go away. This sounds like pre-eclampsia but I am not the doctor, so why do you think it is NOT pre-eclampsia?"

You might be surprised at the answer you get. If that does not start the doctor in the right direction, you can follow-up with, "Well, even if this is not pre-eclampsia, the symptoms alone are scaring the * out of me and making me VERY nervous. I don't feel that I can provide the level of constant care that she needs now. At what point do we talk about getting her in the hospital?"

This will get you a trip to the hospital to "get checked out" and they will likely try to send her home again, so you will have to go through this same routine AGAIN at the hospital until her doctor (or the on-call doctor) decides that the risk of a malpractice suit is greater than the flack they will get from the insurance company for admitting her.

Sorry if this sounds cynical, but a pro-active OB dealing with a mother who is almost 36 weeks with twins, with a heart condition, and with all these symptoms would have induced by now (in my non-expert, non-medical, but been through this same thing 5 times myself opinion).

[dohertyab]

I have to agree with the others. PE can spin out of control very quickly. There are so many more complications with twins and 37 weeks is considered full-term for them, I would keep bugging the doctors. Ask for criteria for when you should come in - headache that lasts longer than 3 hours and won't go away with drugs, weight gain of more than 2lbs in any one day, or whatever the numbers should be. My husband and I were so unaware of the potential issues. Twins usually mature a little faster than singles so at 35 weeks, they're pretty close.

There's so much that's going to happen after they are born, that you want everyone to be as healthy as possible!

Good luck.

[missgamecock]

I totally agree. I am not a dr and this is not a medical opinion. Just perspective of been there done that.

quote:

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Originally posted by hfwarner3

Jason,

Congrads on the twins!

If it was me, I would start with the "help me to help you" approach. I would call the doctor RIGHT NOW and have them paged. When they call you back, I would say, "I know that you are the doctor, not me, but I am confused and scared. My wife is NOT doing well and to me just appears to be getting worse by the day. Her BP just keeps going up. You have found protein in her urine. He ankles are the size of grapefruits. She is throwing up repeatedly and her headache will not go away. This sounds like pre-eclampsia but I am not the doctor, so why do you think it is NOT pre-eclampsia?"

You might be surprised at the answer you get. If that does not start the doctor in the right direction, you can follow-up with, "Well, even if this is not pre-eclampsia, the symptoms alone are scaring the * out of me and making me VERY nervous. I don't feel that I can provide the level of constant care that she needs now. At what point do we talk about getting her in the hospital?"

This will get you a trip to the hospital to "get checked out" and they will likely try to send her home again, so you will have to go through this same routine AGAIN at the hospital until her doctor (or the on-call doctor) decides that the risk of a malpractice suit is greater than the flack they will get from the insurance company for admitting her.

Sorry if this sounds cynical, but a pro-active OB dealing with a mother who is almost 36 weeks with twins, with a heart condition, and with all these symptoms would have induced by now (in my non-expert, non-medical, but been through this same thing 5 times myself opinion).

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[shellbell]

Big congratulations for you both on the twin's.

My option is contact your doctor and really stress your concerns for the health for the three of them.
You need to remember that you are the one that sees your wife all the time and notice's the difference with how big her feet get and how painful the headaches can be.

If you don't get a satisfactory reply from you doc take her to the hospital emergency room and tell them the concerns as this is a serious condition and not to be take lightly also take into consideration her health history.

Better to be safe then sorry.I know from previous experience how frustrating not being totally understood can be.
I was monitored for aprox 5 weeks in hospital on and off till I was blessed that another OB took over and made the ruling my daughter had to be born, I honestly think if my first OB didn't go on holidays we both would not be hear today trying to give others strength and awareness. We are both ok after a very frustrating and trying time.

Good Luck and I pray all is ok..

[hfwarner3]

Any update?