What is normal treatment plan for PIH only?

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growlie
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Re: What is normal treatment plan for PIH only?

Postby growlie » Sat Jul 14, 2012 07:23 am

Well, just had BP of 156 over 110. Never had bottom number nearly that high. Haven't seen dr, but we will see what the plan is from here.

blythe
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Re: What is normal treatment plan for PIH only?

Postby blythe » Fri Jul 13, 2012 10:11 pm

Good to hear you're staying in the hospital and being watched closely! Fingers crossed that you get those 10 more days!
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH

growlie
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Re: What is normal treatment plan for PIH only?

Postby growlie » Fri Jul 13, 2012 12:46 am

Well, labs are all normal but BP readings are very labile. Dr has ordered no visitors except my husband, and plans to induce at 37 weeks. She suspects that I will develop pre-e, but is most concerned with BP's right now. If BP's stop being labile and go up a little nudge more and stay up, baby will be out sooner. 37 weeks is just ten days from now, so we are almost there.

blythe
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Re: What is normal treatment plan for PIH only?

Postby blythe » Thu Jul 12, 2012 11:16 pm

I'm glad "your" OB is back and that your treatment plan is more clear!

I'm not sure about the difference between their 37 or 38 week plans - my understanding is that HYPITAT says 37 weeks for any hypertension in pregnancy. That is definitely a question for your doctors - how the HYPITAT study relates to your case, if at all.

My understanding is that "normal" protein is 0-150, and diagnostic for PE is 300mg. My sense is (and I'm definitely no doc) - is that most docs prefer to have 0 protein, but don't get too worried until the protein gets much higher. Other questions for your docs - how will they monitor your protein from now on, and how will the treatment plan change if you hit diagnostic criteria.

The blood pressure cuff issue - I'm almost positive is correct. That "extra" inflate was actually how I knew that I was about to see a higher reading. Someone else can surely explain this better, but my understanding is that the machine is set to "expect" a similar bp reading as it got previously, so only inflates at first to reach that reading. But if your bp is actually higher, it has to re-inflate to be able to correctly read the higher reading.

Our experts consider readings either 160+ systolic or 100+ diastolic "severe". Even though it may keep you in the hospital longer (whether to get you stabilized on bp meds - ask if they think meds will be appropriate for you, they may not be - or to deliver), I'm glad they're taking your bps and symptoms seriously.

Hang in there and keep asking questions!
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH

growlie
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Re: What is normal treatment plan for PIH only?

Postby growlie » Thu Jul 12, 2012 09:04 pm

My 24 hr urine came back at 154. Nurse said not to get my hopes up about going home even with perfect labs b/c last BP reading was something like 168 over 84.

growlie
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Re: What is normal treatment plan for PIH only?

Postby growlie » Thu Jul 12, 2012 07:52 pm

I'm sorry for the triple post...but I have another question. When an automated BP cuff in the hospital kind of stops mid squeeze, then starts over and squeezes a lot tighter, and then finishes doing its reading....is that really accurate? I had that happen repeatedly in L and D last night, and it just happened again and my reading was 168/82 which is the highest top # I have ever seen.

growlie
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Re: What is normal treatment plan for PIH only?

Postby growlie » Thu Jul 12, 2012 06:52 pm

I also think the big problem was that "my" OB was on vacation and the others in the group that saw me did not take any ownership over managing my condition while she was gone. I saw 4 or more OBs, a midwife and nurse practitioner. I think they all basically just made sure it wasn't an emergency right then and there, and punted the problem down the hall a few days. Until I found this forum (yesterday) I really didn't know how to best advocate for myself. During my appt I did ask why we weren't doing 24 hr urines, labs, etc regularly with the symptoms I've had. The midwife said she would send a message to the maternal fetal medicine dr who was doing my BPP, so I guess she didn't know the answer.

"My" OB came back over here after office hours to check on me today, and will come tmw before she goes to the office to check on the labs and 24 hr urine. I am glad she is back from vacation, because I feel like she is actually watching me carefully.

I'm wondering though based on what I have been reading, what is the argument for and against inducing at 37 weeks for "pih only" versus 38 weeks? I thought I had read recommendations to go ahead at 37 weeks. (There is no debate if I have pre-e I will be induced at 37 or severe pre-e be induced like yesterday).

growlie
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Re: What is normal treatment plan for PIH only?

Postby growlie » Thu Jul 12, 2012 06:46 pm

I just finished my 24 hr at 7:30, and expect it to take a few hours for results. My OB came to visit after office hours and she said they don't like to discharge anyone at night, so we will wait and they will re-draw the labwork (blood) in the morning and use the 24 hr and the blood results to determine whether I can go home on bedrest or have to stay here longer. My labs yesterday were unchanged except uric acid went from a 4.2 to a 5.2. Platelet level good and everything else was good. Haven't seen the actual numbers from yesterday.

I'm in a different room this time with a different bed that is really uncomfortable. For the first 24 hours, they could not give me any of my medicine for some unknown reason, and I have food allergies that the cafeteria has not been able to figure out how to accomodate yet. They also stuck me 3 times before giving up and calling the lab. One of the times they put in a hep lock but they weren't actually in a vein at all. No idea why that was left there, as they couldn't get any blood from it. I know this is for the best, but I am having a much less pleasant experience this time around.

I am grateful to be at 35 + 3 and that on the BPP yesterday the baby looks perfect. Hoping for a couple more weeks.

angieb
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Re: What is normal treatment plan for PIH only?

Postby angieb » Thu Jul 12, 2012 03:57 pm

Sorry you are in the hospital but glad they are keeping a close eye on you. Fingers crossed you can make it several more weeks.

I would want/expect weekly 24 hour urines from here on out. I have a friend who gave a completely clear, not even trace protein, urine sample at the dr, but had several signs of issues (swelling, mildly high bp, etc.) and her protein levels came back at 250. (So not pre-e yet but I was surprised she didn't even have trace protein in-office.) There is another poster here who had a 24 hour urine in the 400's after a normal dip test in office. So yeah, I think with no other signs of pre-e/pih, in office tests are fine for the general population, but once there are issues, they are slightly better than worthless.
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/

alviarin
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Re: What is normal treatment plan for PIH only?

Postby alviarin » Thu Jul 12, 2012 12:19 am

Sorry you are in the hospital, but glad you got a chance to talk to *your* OB and discuss "the plan".

Did you get the results of your 24-hour yet?
Hypothyroid mom to
Connor (severe pre-e at 38 weeks)
Claire ("mild" pre-e at 37 weeks)
Annabelle (chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)


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