Concerned at 35+2 wks

[evp12]

Hello.

Looking for some input... I'm on my third pregnancy - my first two I was diagnosed with pre-e. Both delivered vaginally at term, so I'm very lucky in that respect. I've been very concerned after my last two experiences that I'll develop pre-e again, so I've been very diligent this entire pregnancy ensuring that I monitor my bp and any new symptoms. To date, this pregnancy has been a bit harder than the last two - I've been on modified bed rest since 32 weeks for pre-term labor and in general have just felt blah this entire time. The good news is that my bp has been great... even LOW (100-110's / 60-70's). My OB also has told me since this baby is with a new partner, that my risk for developing pre-e a third time is lower.

Well... over the past week and a half I've have a terrible headache. In the evenings I get really nauseous. My lower back has been aching and I have terrible heartburn. I attributed most of these symptoms to normal pregnancy woes, and attributed the headache with my lack of sleep recently. Last night, however, it was the worst it has been. I vomited twice and even Tylenol with Codeine wouldn't help the headache. I took a shower and tried to get some sleep, convinced I would call my OB today.

This morning I took my blood pressure and to my surprise got the following readings: 129/92, 145/90, 130/70, and 142/96. A little all over the place, but MUCH higher than I typically get, ESPECIALLY after just waking up. As a result, I called my OB... BUT he wasn't in the office and won't be back until Monday. The nurse spoke to the other OB in the practice who told me to continue taking Tylenol and rest. She said I "could go into L&D to be monitored if my bp readings came back at 150+/100+."

I would really like to hear from others on what to do in this situation. I'd like to avoid a hospital trip (my next scheduled OB appt is Monday), maybe I'm overreacting? But then again, maybe the other OB is under reacting. I really don't know. Your input is greatly appreciated.

[blythe]

Our experts have called third trimester nausea an "'underappreciated symptom". You could just have a migraine or a flu, or you could be developing HELLP, an especially severe and fast-moving form of PE. The only way to tell for sure is bloodwork. Could you call or go in to L&D and explain your symptoms and history and ask if bloodwork would be appropriate? I say "ask" because medical folks often respond better when we're asking instead of insisting or seeming like we're telling them how to do their jobs... but in your shoes I'd really want bloodwork today. HELLP is more common in subsequent pregnancies and doesn't always need protein or high blood pressure. Please let us know what L&D says.

How is baby moving?

Oh - and the paternity research swings back and forth, but I think the most recent understanding is that a new partner increases your risk, or at the very least isn't considered especially protective.

[tree]

I agree with Heather. It would be a really good idea to ask your OB or L&D to do some bloodwork today. It is a simple, cheap test that could save your life if you are developing HELLP. I delivered my daughter at 35 weeks with symptoms that sound very similar to yours. The terrible heartburn, nausea, and back pain can be signs that your liver is in trouble. I never had high BPs, and I developed a severe case of HELLP anyway. I wouldn't wait for your BP to increase. It is possible to be very sick without having high BP. The headache, nausea, pain, and vomiting should be more than enough reason for L&D to see you and check your bloodwork. In this situation, I would rather overreact that try to wait it out. This is the one time in your life that you really hope for the flu and migraines. It could be something like that, but you want to rule out HELLP before you assume that it is.

[JB]

I agree with the others that you should at least call labor & delivery and speak with their on-call nurse. It may be inconvenient if they have you come in, but better safe than sorry. I was just in our hospital birth center on Tuesday getting checked out and the discharge paperwork they gave me specifically said to come back if I had a headache that did not go away with Tylenol. I had headaches like that for about two weeks before I was diagnosed with PE last year. I didn't call my doctor because I thought they were hormone-related like the kind I was used to getting before I got pregnant. I really wish I had been more proactive about my symptoms.

[evp12]

Thanks for the feedback. I wanted to go in yesterday, but my new husband thought it was too premature. It's so frustrating, since he's never experienced what could happen by waiting. Against my better judgement, I waited. Today my headache is still there, my back is still aching, I vomited again twice last night, and I had to sit in the middle of my kitchen floor earlier this afternoon when I started seeing bright lights (I thought I was about to pass out). As a result of that, I decided to check my bp again and it was 149/103 and 145/98 -- still not terribly high, but high for me. I told my husband that he'll be taking me into L&D today to be monitored, and his response was "what are they really going to do, besides keep you the weekend and send you home?" UGH. I'm very close to calling a cab or driving myself.

Thanks for letting me vent a bit. I'll provide an update once I have one. Hopefully it IS nothing and they send me home, but I really don't want to regret not being seen.

[angieb]

Thanks for the feedback. I wanted to go in yesterday, but my new husband thought it was too premature. It's so frustrating, since he's never experienced what could happen by waiting. Against my better judgement, I waited. Today my headache is still there, my back is still aching, I vomited again twice last night, and I had to sit in the middle of my kitchen floor earlier this afternoon when I started seeing bright lights (I thought I was about to pass out). As a result of that, I decided to check my bp again and it was 149/103 and 145/98 -- still not terribly high, but high for me. I told my husband that he'll be taking me into L&D today to be monitored, and his response was "what are they really going to do, besides keep you the weekend and send you home?" UGH. I'm very close to calling a cab or driving myself.

Thanks for letting me vent a bit. I'll provide an update once I have one. Hopefully it IS nothing and they send me home, but I really don't want to regret not being seen.

Definitely go. Keep us updated.

[tree]

I hope you are able to get in soon. You have been through this twice, and you are almost certainly right if your gut tells you it is bad this time. We were in the opposite situation when I got sick. I refused when my husband wanted me to go in. He ended up printing out the "signs and symptoms" checklist and forcing me to acknowledge that I had all of them before I would agree to it. You can find that list here if you think it will help convince him:
http://www.preeclampsia.org/symptoms.asp

[evp12]

So I went into L&D and was monitored this afternoon. I'm happy I did - puts my mind a little at ease. My bp while there didn't go below 178/106! That said, all my blood work and urine labs came back PERFECT. No traces of anything, liver enzymes good. So the high bp is a bit disconcerting and definitely will need to be monitored, but at least it's not looking like pre-e or HELLP as of right now. The on call doctor thinks that maybe my headache is the cause of the high bp and other symptoms, versus the headache being one of my symptoms. Interesting, but possible. I'm still a little concerned, as up through 4 days ago my bp has been GREAT, and each day thereafter it keeps going UP. That said, my regular OB appointment is Monday morning, so as long as I can deal with my headache and other symptoms until then hopefully I'll get some answers on how to get rid of it once and for all. (What's another few days when I've had this pain for over 1.5 weeks?)

It's a bit funny, though -- while there my contractions were coming every 2 minutes and were pretty strong. It's like my body figured out where it was. Now I'm back at home trying to get my uterus to calm down a bit. If after all of this I end up going into labor, I would find it a bit ironic...

I hope everyone is enjoying the weekend. Thanks again for the feedback.

[MomTimesThree]

Glad you got checked out- ugh on those pressures! Glad labs came back and that you'll be able to monitor from home.

I had to laugh about the contractions, the same happens to me! It's like my uterus knows... oooh in L&D... NST... let me show off a lil' bit! I hope things quiet down for you and you have a peaceful last few weeks!

[tree]

I am glad that you got checked out and even happier to hear that your labs came back perfect! I hope everything calms down and that you get some answers at your appointment on Monday. Hang in there... It seems like your uterus disagrees with your doctors about how long this pregnancy should last Maybe it knows something. It would be nice if it let you get some sleep.