when to deliver

[expert@preeclampsia.org]

Good afternoon...I am 36 weeks and 6 days pregnant with our fifth child. I experienced pre-eclampsia with my 2nd child and after weeks of bed rest she was delivered via emergency c-section at 39 weeks. None of my other pregnancies caused any BP trouble. However, this week I have experienced 3 episodes of blurred vision and headaches but I have only shown trace or 1+ protein in my urine. My BP does not alarm most caregivers because by normal standards it is not that high. The problem is that my normal BP is 90/60 to 100/70. My current BP (on hospital bed rest) has been between about 123-144/70-92 with one reading of 154/82. I am currently in the hospital completing a 24 hour urine collection but I will most likely be sent home when it is complete. I've asked for my Dr to go ahead with delivery but he refuses because of hospital regulation forbidding delivery before 39 weeks without more serious risk.

I am very worried and feel that the risk is already great enough but I am no expert...so I am wondering at what point should I worry and when should I push for delivery to ensure the safety of my daughter and myself? What result from the 24 hour collection should raise concern?

Thank you for your time.

[expert@preeclampsia.org]

This may be resolved tomorrow at 37 weeks gestation when a diagnosis of mild gestational hypertension-preeclampsia is best served by delivery, not carrying the pregnancy further (ACOG recommendations from its Task Force on Hypertensive Complications of Pregnancy). This is one exception to waiting to 39 weeks to deliver in the absence of a valid indication, such as the one this patient appears to have.