My last pregnancy had low BPs at first appt, 100/60 on average and slowly rose to 130/80 by 31 weeks. At 32 weeks, it was confirmed I had proteinuria but kept getting the run-around on whether or not I had preeclampsia since my BPs were not hypertensive. By 35 weeks, my daughter was IUGR (growth rate over 3 week period was less than 3rd percentile) and proteinuria went up, even though BPs were still around 110-120/70-80. I was diagnosed with severe preeclampsia (according to the hospital records) even though it seemed very atypical! I have some unilateral renal scarring, but kidney function is not impaired during pregnancy or post pregnancy. They did a baseline during that pregnancy and protein was under 100mg so any increase was considered significant.
Fast forward to THIS PREGNANCY... Has been pretty identical except this baby is more average sized than my last (always kind of small but not IUGR until that 35 week ultrasound). My BP at my first appt (4 weeks to confirm + HPT) was 100/60. Prior to pregnancy my BP was around 110/70. BP stayed around 100/60 until my 16 week appt when I was back to 110/70. They also did a 24hour and it came back under 100mg. I am now 22w5d and have had a few readings each day around 130/80. I am somewhat nervous since I delivered with these pressure readings, even though my BPs are completely normal. My new Dr office doesn't seem to do anything until BPs are hypertensive and/or I dip + for protein. I never had a + spot protein with my last pregnancy because I have polyuria and the urine is always diluted. The only reason they requested a 24 hour urine before was because the protein/creatinine ratio was above normal...my spot urine was always negative.
I read that BPs were suppose to stay normal in the 1st trimester, drop in the 2nd, and rise back to normal in the 3rd. I also read that the body/placenta/baby adjust to the 1st trimester BPs and any significant increase might create a problem. Maybe I am understanding this wrong, I'm somewhat confused! Is it possible that my renal scarring has left me "sensitive" to any BP increase and I am more likely to spill protein, despite normal (although elevated) BPs? I'm not sure how to approach my Dr about this, especially because the clinic seems somewhat "lazy" already. I had to request a baseline 24hour and HELLP labs at 16 weeks! Part of the reason I am nervous too, is because my daughter pretty much stopped growing after that 32 week ultrasound and preeclampsia diagnosis. I don't have normal symptoms so I am unsure of how my body might be reacting! Maybe I'm just being anxious but any input on my questions is greatly appreciated.
Sorry if I was all over the place!
And request a 24hr and PIH labs. Hopefully everything comes back right where it should... at the same time, your peace of mind is worth it. With a history of IUGR I'd also be wondering about closer u/s monitoring at least every 4 weeks (20w, 24w, 32w) if not doing so already...
