New With Questions

[mllewellyn]

Hello! I developed HELLP in my 1st pregnancy at 23 weeks. I delivered a stillborn daughter at 24 weeks. In my 2nd pregnancy, I developed high blood pressure in the 20th week, but progressed without too many issues. Mt son was born at 38.5 weeks, healthy. I am now pregnant again and will be 30 weeks tomorrow. I started with HBP at 25 weeks and give RX of aldomet, increased my dosage of aldomet (500mg/2x day) at 26 weeks. Things were going fine until this week. Then, my BPs got out fo wack (avg 140/90). I went to L&D triages at the hospital yesterday. My doc increased my aldoment to 3x/day of 500 mg. I am curious as to how long it will take for the aldomet to lower my BP. Your experiences would be greatly appreciated. I also wonder if this dosage will stick and my BPs will normalize out. It seems odd that my 3rd has more problems than my 2nd. From my reading and research, I thought this one would be an easier pregnancy than my 2nd. I should mention that I am 39 yo and this one was a surprise. I was exercising often during this pregnancy (a difference) and also very hard before I got pregnant. I am now on bedrest. I really tried to do everything I could to avoid HELLP or pre-e. So far, I have been Dx with PIH only since I do not have protein in my urine and my blood work is all normal. I am just trying to understand. Thanks for anything you have to offer me.
Mistie

[flori]

Hi Mistie-

When my pressures soared at 21ish weeks, I was on 500mg of aldomet twice a day but my bp stayed up around 150/100. My MFM made the call for me to switch to Labetalol 200mg twice a day along with amlodipine. That combo finally held my bp to around 140/90, but I ended up with HELLP at 25 weeks. When I consulted with an MFM the other day I told him about my experience with aldomet and he said that it does take longer for it to start working in some women.

I'd keep a close eye on things until your bp gets closer to your baseline. Do you have a cuff you can use to monitor your bp at home?

[mllewellyn]

Flori,
Thanks for responding. I do have a cuff and I probably take my BP too much. The aldomet has brought me down to 130s/80s on average. I am on bedrest and when I am down resting, my numbers tend to be lower.
I just don't understand pre-e and HELLP. I thought this pregnancy would be better than my 2nd. However, it seems to be a little worse. I checked my chart from my 2nd and 1st pregnancies. Obviously, in my 1st the HELLP progressed too rapidly for treatment. In my 2nd, I made it to 38.5 weeks and was induced only because I was on heparin and they wanted to control the birth process. I was on 500mg aldomet 2x day. Y+That was the highest I went. But, I am on the same dosage 3x day now. I am worried about making it to 36 weeks. I do not have protein in my urine and so this is a relief. I also do not have elevated liver enzymes or low platelets. At this point, my OB thinks it might jsut be PIH. I just remember with my 1st, I was hospitalized on Tuesday and in L&D on Thursday. So, I know how quickly HELLP can progress.
Anyway, thanks for your response!
Mistie

[angieb]

Unfortunately, there are quite a few women on these forums who have pretty normal second pregnancies and then get sick again for the third. I'm only 15 weeks right now in my 3rd pregnancy so can't speak from experience yet on that (though I have a similar history to you except my second was born at 36 weeks due to my classical incision from my first pregnancy- even though i developed gestational diabetes that time, I never did get sick.) My doctors consider me just as high risk this pregnancy as I was for the last one, although I did talk my MFM into cutting my lovenox dose in half this time.

As early as you got HELLP in your first pregnancy, you may have higher odds of getting hellp again vs. someone who had it much later in the first pregnancy, but still, the odds of HELLP recurring are pretty low. While your blood pressures aren't great, they aren't *that* bad either. Hopefully you can get by with just some meds for your blood pressure and not any other drama. Also feel free to join us in the "pregnant again" section of the forum.