BP reading of 178/110... go to ER or okay to wait till tmw?

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GeorgiaGirl
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Re: BP reading of 178/110... go to ER or okay to wait till t

Postby GeorgiaGirl » Thu Feb 09, 2012 08:47 pm

Still in hospital... Diastolic BP has been around 80 last few times - awesome! MFM may release me to home bed rest tmw if nothing worsens. Praying it doesn't turn severe for weeks (does it ever progress that slowly?!). Thanks as always for your info and advice.
Julia, age 40
six first-trimester miscarriages
expecting a miracle baby May 3, 2012
diagnosed with chronic hypertension at 22 weeks; high risk of PE (extremely low PAPP-A, bilateral uterine artery notching and other risk factors)
diagnosed with pre-eclampsia at 27w5d
delivered my miracle baby, John Jr. ("Jack") at 29w1d, 2 pounds 8 ounces of absolute perfection

GeorgiaGirl
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Joined: Sat Dec 24, 2011 10:41 pm
Location: Atlanta, GA

Re: BP reading of 178/110... go to ER or okay to wait till t

Postby GeorgiaGirl » Thu Feb 09, 2012 04:25 am

Thank you... funny how I've been expecting this since week 13, so I shouldn't be surprised, yet I'm siting here stunned that it finally happened. Wish it had held off until week 34 or 37, but glad it didn't happen at week 22 or 24.

I am prepared to stay in the hospital until delivery, although I'm hoping they will let me go home briefly first to gather things I need for the long haul first (stuff my husband nor anyone else would possibly be able to find).

Really hoping to beat that average of 2 weeks from dx to delivery... 30 weeks is still way too early. This kid is prone to be a genius and I don't want him having brain delays forced on him. :) if it stays slow progressing, is there any shot at making it to 37 or even 34 from here (28 weeks today) on hospital bed rest/close monitoring?

Eta: I'm in a great hospital with an excellent level III NICU. My OB recently saved a 23-seeker who is doing great. I know my baby and I are in good hands here; just hoped this stage wouldn't have happened this soon. I'm ashamed to say I'm envious of those who don't develop PE until week 35 or beyond (I know -- pathetic).
Julia, age 40
six first-trimester miscarriages
expecting a miracle baby May 3, 2012
diagnosed with chronic hypertension at 22 weeks; high risk of PE (extremely low PAPP-A, bilateral uterine artery notching and other risk factors)
diagnosed with pre-eclampsia at 27w5d
delivered my miracle baby, John Jr. ("Jack") at 29w1d, 2 pounds 8 ounces of absolute perfection

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caryn
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Re: BP reading of 178/110... go to ER or okay to wait till t

Postby caryn » Wed Feb 08, 2012 11:34 pm

The proteinuria isn't really a big deal - it can go waaaaay higher - except that it plus the numbers you're scoring on those bp checks mean you're officially a severe preeclamptic according to the diagnostic criteria. Those are linked in the News forum in the NIH Working Group Report. (We had a representative - Anne Garrett - contributing to the Working Group a decade ago, and while it's so old it's been archived, that does mean docs should be very comfortable with it by now.) IIRC it says you should stay put with close monitoring once you score a 300 and *one* reading of either of 160/100, preferably in a tertiary facility with a NICU.

So I'm hoping they do *not* send you home. At the hospital they have the equipment and skills to push you and babe farther safely.

This bit is no fun whatsoever. I'm sorry. And we're all crossing our fingers. Let us know how you get on, as convenient, please!
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

sam10
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Re: BP reading of 178/110... go to ER or okay to wait till t

Postby sam10 » Wed Feb 08, 2012 09:07 pm

I am glad that you are in good hands and being monitored so closely. Also good news is that your labs are good. I'll keep my fingers crossed that they will let you go home tomorrow!
~Julija (42)
MC 3/2009 and 3/2011
H (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
M (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/

GeorgiaGirl
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Joined: Sat Dec 24, 2011 10:41 pm
Location: Atlanta, GA

Re: BP reading of 178/110... go to ER or okay to wait till t

Postby GeorgiaGirl » Wed Feb 08, 2012 08:57 pm

Wow... Long day. Still in hospital; just found out my 24hr result was 336. Nurse said it like it was good news, but that's freaking PE!!!! BPs finally back down to 140-150/90ish with the new med doses.

MFM did not have urine result back when I met with him. Bloodwork looked good again, no HELLP or anything.

The good news: had ultrasound and baby looks great, practicing breathing and weighs 2lb12oz, great for 28 weeks(still no IUGR, hooray!!!!!!).

Will they let me leave with over 300 proteinuria???? Guess I have a long night ahead of me wondering....
Julia, age 40
six first-trimester miscarriages
expecting a miracle baby May 3, 2012
diagnosed with chronic hypertension at 22 weeks; high risk of PE (extremely low PAPP-A, bilateral uterine artery notching and other risk factors)
diagnosed with pre-eclampsia at 27w5d
delivered my miracle baby, John Jr. ("Jack") at 29w1d, 2 pounds 8 ounces of absolute perfection

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caryn
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Re: BP reading of 178/110... go to ER or okay to wait till t

Postby caryn » Wed Feb 08, 2012 02:48 pm

You're entirely welcome!

What has your MFM said?
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

alexis
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Re: BP reading of 178/110... go to ER or okay to wait till t

Postby alexis » Tue Feb 07, 2012 10:19 pm

I'm glad they admitted you and are keeping a close eye.
Chronic hypertension
Aliza - 01/05/2007 - Severe preeclampsia, emergency CS 37 weeks
Isaac - 09/26/2011 - controlled on 150mg Toprol, NO PE, 39 weeks!

GeorgiaGirl
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Location: Atlanta, GA

Re: BP reading of 178/110... go to ER or okay to wait till t

Postby GeorgiaGirl » Tue Feb 07, 2012 10:15 pm

Thanks, Trish... At my OB checkup, BP was 165/110... They said I needed to go to triage for a couple of hours for monitoring. Hit some more scary highs while there so I'm having to stay overnight. They bumped up the methyl dopa and gave me another med to bring it down quickly (can't remember the name of that one)...have started steroid shots for baby's lungs, doing another 24-hour UA while here and three NST's. Thankfully no protein in test strip; fingers crossed the 24 hour looks good too. Baby is still kicking away doing great! Latest BP was down to140s/90 so that's good. My MFM is coming by to talk with me in the morning. Hospital food sucks. That's about it for now!
Julia, age 40
six first-trimester miscarriages
expecting a miracle baby May 3, 2012
diagnosed with chronic hypertension at 22 weeks; high risk of PE (extremely low PAPP-A, bilateral uterine artery notching and other risk factors)
diagnosed with pre-eclampsia at 27w5d
delivered my miracle baby, John Jr. ("Jack") at 29w1d, 2 pounds 8 ounces of absolute perfection

trish
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Joined: Sun Jul 22, 2007 05:36 pm

Re: BP reading of 178/110... go to ER or okay to wait till t

Postby trish » Tue Feb 07, 2012 05:24 pm

Just checking in to see how you are doing. Hang in there! (((HUGS)))
Trish: mama to my 3 PE Princesses:
Elizabeth 11/6/03 induced at 37 weeks for PE
Katie 4/13/05 induced at 38 weeks for PE
Allison 12/27/07 induced at 36 weeks for PE then PP PE & BP issues for over a year

GeorgiaGirl
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Posts: 38
Joined: Sat Dec 24, 2011 10:41 pm
Location: Atlanta, GA

Re: BP reading of 178/110... go to ER or okay to wait till t

Postby GeorgiaGirl » Tue Feb 07, 2012 00:05 am

On-call doctor still hasn't called me back... it's after 1am here; if she doesn't call back soon I'm taking another 250mg tablet of methyldopa and going to bed... it seems the BP is coming down, at least (and again, I have no idea how accurate this new monitor is).... (baby is moving and kicking normally, and I'm not experiencing any bleeding, so at least I didn't have a placental abruption when it hit that high earlier)

eta: just got off the phone with the on-call doctor; after she asked me a bunch of questions (hx, symptoms, etc.), she advised me to take the extra 250mg of methyldopa I was considering and lie down and go to sleep... BP seems to be coming down, but as the doctor said, sitting up obsessing about it can only make my BP worse. I'm also going to call the OB's office first thing in the morning and see if I can get in any sooner than my 1:30 appointment (if I have another alarming BP reading, that is).

Grrr, I hate the constant anxiety and panic attacks that come with watching for this condition to catch me.......

eta again: Caryn, thank you for taking time to reply to me at such an absurd hour... you are as kind as you are knowledgeable, and I appreciate both this and all the other helpful replies you've taken time to write in the past.
Julia, age 40
six first-trimester miscarriages
expecting a miracle baby May 3, 2012
diagnosed with chronic hypertension at 22 weeks; high risk of PE (extremely low PAPP-A, bilateral uterine artery notching and other risk factors)
diagnosed with pre-eclampsia at 27w5d
delivered my miracle baby, John Jr. ("Jack") at 29w1d, 2 pounds 8 ounces of absolute perfection


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