How much of a concern is this?

[melissaa]

How bad is a BP of 130/80 when your normal bp is 90-110/50-60 and a 24 hour urine protein of 185? I've had pre-e twice, 6 and almost 4 years ago and Im pregnant again, 27 weeks and starting to have headaches daily with flashing spots once about a week and a half ago. I have a gut feeling that we're headed in that direction again. This didnt start with my other two until about 30-31 weeks and they were 35 and 36 weekers with the first having IUGR. Im very concened that If it is headed in that direction that I wont get to the 35-36 week mark this time

[caryn]

Any time there's a rise of 30/15 above your baseline, you tip into the "worrisome" category. Usually, with someone like you who's got a history, that just means you're in for closer monitoring.

However, have you told the docs about the headaches and visual disturbances? Those worry me more; some women are just more likely to develop that as a first symptom, and unfortunately those are also the seizure symptoms. I'm guessing from your account that in your last pregnancy, those symptoms also appeared a few weeks prior to delivery? Did you deliver for maternal or for fetal indicators?

[melissaa]

Headaches were the first indicator along with bp creeping up with my son... but I didnt start having.symptoms at all until about 30 weeks. At 34 weeks i had a 24 hr come back at 500 but bp wasnt super terrible and i had no other symptoms except headaches and occasional spots in vision. i washospitalized but the next day my 24 hr came down to 300 so they let me go home and decided to monitor me but a week later asked if I would like to havean amnio to check lung development for delivery instead of letting things progress and I agreed and he was delivered at 36 weeks, when i went infor my csec prep, my bp was 150s/100s. with my dd, it was trickier... i developed headaches, spots, high bp that went up and down, tachycardia (which I still have today, i actually had to ave a cardiac ablation in dec. but it didnt work) and a persistent cough due to my rapid heartrate. My dr wouldnt do a 24 hr urine and never even told me what my dip showed...dd's movement slowed at 35 weeks and when I demanded an nst, she was showing signs of distress and i was hospitalized..it was determined that she had iugr and was in the 4th percentile and was delivered by emergency csection when her hr dropped to 60 and didnt recover. I was told later that if I hadnt gone with my gut and spoke when I did, she would have been stillborn in a week or two.

[melissaa]

I have mentioned the headaches.. they ordered bloodwork which came back fine so I was toldjust to watch it and report any changes or more disturbances. Ive had a headache the entire day today dispitetaking tylenol along with nausea. the last few weeks Ive also had these flat red dots all over my belly that come and go..they dont itch at all.. it doesnt really look like the pupps rash....but I never had it with my other two so im not sure what it is.

[caryn]

I'm glad the bloodwork came back good. That rash sounds like it could be petechiae, which can pop up when your blood vessels are being damaged by the chemicals released by the placenta. That's another worrisome symptom. And of course headache is always hard to work with - headache that will not go away with Tylenol is a symptom to report to the doc, even if you just did that yesterday, because they assume if you're not reporting it that it's gone away. Persistent headache is one of the only reliable symptoms for seizure, so they need to know if it persists or worsens. Nausea can be an indication that your liver enzymes are elevating, so if that persists or worsens I'd definitely report it as well.

Are you scheduled for another check on Monday morning? In your shoes I'd want to be seen quite frequently. I'd also head back in for another check in L&D over the weekend if symptoms worsen.

[melissaa]

Could the rash be petechiae even if it blanches? Some of it does blanch and some of it doesnt, its very random and mostly above my belly button all the way upto my bra line and on around both sides of my belly... kind of like a rainbow shape.
The headache thing is always the worst part for me it seems. Its a very dull annoying ache behind my eyes and on the top of my head that is constant. It does seem to wax and wayne some but is always there from first thing when I wake up in the morning until I go to bed at night (the past few days anyway). I keep tellin the OB and nurse about it and they just say to call back if the headache persists even when taking tylenol.. so I do, and then they just tell me the very same thing again. Its frustrating not knowing when to call and whento just watch it. My bp's this morning were 142/77, 120/82 and 135/72.. which is higher than it has been but it was somewhat of a stressful morning too with my daughter's school drop off.
The nausea is just like it was in the beginning, I feel like im going to hurl when I get the slightest bit hungry. I told the nurse about this too and she said to call back if I was vomiting... which Im not thank goodness!
They called today to remind me of my growth scan next Wednesday and I mentioned the headaches not going awa with tylenol and BP again and the fact that we were going out of town this weekend for a funeral, and she spoke wih the dr and said that "everything looked re-assuring and that it was ok to travel but to keep an eye on the BP and to let them know if the headache doesnt go away with tylenol" Its like a broken record...

The one thing that IS reassuring at this point to me is that the baby seems to be moving around pretty good. I do worry a lot when shes not moving though.

[melissaa]

I guess what im wondering is.. if the headache persists.. is it still considered very dangerous if my bp isnt any higher than it has been?

[blythe]

Darnit, just lost my long reply to you!!

Let me summarize - these symptoms are hard because they can be signs of serious sickness - eclampsia, HELLP - or just being pregnant. Bloodwork is the only way to know for sure.

PE / HELLP can move really slow, or rarely, within hours. The "hours" cases stick in my head and make me awfully twitchy.

I hope you have a safe and uneventful trip, but do you have a plan for where to go just in case you get worse when you're traveling this weekend?

[melissaa]

Thanks for your replies! I dont currently know where the nearest triage would be but i plan on scoping it out when we get there just incase. my feet are starting to swell some tonight.. which I know is normal for pregnancy too but considering I never swelled at all with my other two it concerns me a little too :/ And yeah, those " hours" or even "days or weeks" cases terrify me at this point!