Help?

[afaiz]

Hey ladies
Hope everyone is doing well, I had severe hellp & preeclampsia in my first pregnancy at 25 weeks I started having problems with elevated liver enzymes and itching around 16-17 weeks. I am now 15 weeks and 2 days pregnant again. I am on lovenox, baby aspirin, pre-natal, 2 frolic acid and 1 vitamin d daily. I have been taking my blood pressure about twice a day since 4 weeks, and it has been around 90/60 to 100/70 ish until recently I just started taking my blood pressure sitting up since the beginning I was always taking it laying down on my left side and so about 3-4 days ago its been about 110-114 over 65-75...and today I have had a really stressful day and my pressure I have been taking every 5 min for the past 1 hr and didn't go below 120/90.. What should I do I had a huge fight with my spouse and it won't go down... Past that should I go to the hospital or should I call my dr right now? Sorry I'm just so stressed out now. I don't have an appointment till march 8th what should I do?!

Thanks for listening

[gratiana]

Context: w/baby #1 I delivered with PE and HELLP at 25.6 weeks; with baby #2 I am now 36.3, although I've had quite a few scares this time around... My experience has been that stress has a HUGE effect, and the more I freak out about it, the more it stays elevated. Two examples: when my mother and mother-in-law were visiting and being annoying over Thanksgiving (right about 24 weeks!), my BP started going up, and as soon as I started worrying about it ("Oh God, this is it, here we go again"), it went up further—but as soon as they left, it went right back down. (I almost couldn't believe it, but I swear it happened. This was a difference of like 100/60 up to 130/85.) Likewise, last week, I was in the hospital for my weekly NST, and everything seemed fine: BP running about 115/75. Then they noticed I was having contractions (BAD, since I have a classical incision from last time), and by the time they got me down to L&D triage in a wheelchair 20 minutes later, it was up to 135/95. As soon as they figured things out and I calmed down, it was right back down again.

So it really could just be the stress! My advice would be: find something to distract yourself; stop taking your BP every five minutes (I've been there, I know the temptation, but I'm convinced it makes things worse); and check it again tomorrow. If it's still high then, call the doctor. You're not in diagnostic range yet, and even once you are, they'll want consistently high BP readings taken several hours apart (often 12!) before they'll decide it's PE. So rely on that: you have time to figure out whether this is PE or a false alarm. Meanwhile, breathe! Sorry about your worries! I hope this helps.

[MomTimesThree]

Hi There-

I'm sorry you're having a difficult time right now- I'm sure especially nerve wraking for you since you're at a similar gestation as with your previous pregnancy. If I understand correctly you were previously taking your BP lying down and recently started taking it sitting- if that's the case you can't compare the pressures- it's expected that they would be different and would be for anyone.

Now step away from the BP cuff. Put it in a drawer... in another room (I say this from experience I had to do this!). Your pressures are a little higher than usual which given the day you are having is to be expected. Put on your favorite show, pick up your favorite book and breathe.

This was my favorite quote throughout my pregnancies- "Worrying does not empty tomorrow of its troubles- it's robs today of its strength"

You can always call and request an earlier appointment to give you peace of mind- right now though focus on finding a peaceful space.

I'm keeping you in my thoughts- I know how scary pregnancy after loss is.
Lauren

[afaiz]

Thanks ladies I took my pressure about 2 hours later and it was 100/70 but I was wondering about movement if I put my cuff on & then move around it comes out higher like if I reach for something even with my other hand is that normal? And if its a little high I re-take it right away & it usually comes lower? I am pretty sure it's my emotional stress but the only way I used to get rid of stress is working out but my dr has only okayed pre-natal yoga which doesn't do anything for my stress levels.. Lol and I'm only aware of 1 studio that offers it & I have a friend whose going there so I don't know what to do...I can't get out of my head and I don't want to hurt my baby ... We lost our first little baby and it I can't stop thinking about everything that happened

[MomTimesThree]

Glad it went down and ya have some breathing room. My total non-doc understanding is that makes sense for you BP to go up a bit if you're moving around while taking it. Just like if you take it while doing an activity it would be differently because the body is needing different things. I also think encouraging that it goes lower when you retake, probably a sign it was higher because it was stress related, and resting brings it back down to where it normally wants to be.

For my second pregnancy after my first ended with my daughter being born prematurely and ultimately dying, I saw a psychologist that specialized in medial trauma. It sounds so hokey, and I never thought it would be something I would do, but we did hypnosis and made personalized guided relaxation CDs that I could do at home- I swear it it what allowed me to make it through my pregnancy someone sane!

I also blogged/wrote throughout my pregnancy all my worries and fears out. It allowed me to have a place to put all my fear and anger, and I found when I let it out on paper (or the computer) a huge weight was lifted and I could move on with my day instead of circling around in my thoughts whatever I was currently worrying myself about.

This is such a journey- lots of folks here to walk it with you!
Lauren

[afaiz]

Thank you so much for the support I had read through how scary it is to go through a pregnancy after loss but its so so much scarier then I could have imagined. I second guess every appointment and use my Doppler at least 3 times a week bc my husband doesn't let me... Lol
We lost our sweet little girl at 24.5 weeks so Im pretty sure for the next 22 weeks hopefully I make it that far will be like walking on pins & needles. I love the idea of using hypnosis I have never tried it but I think it could help a lot with the stress/anxiety.. Where did you find them? Through a hospital or just online? Also I have read everywhere that there should be a dip in bp in second trimester? Has anyone experienced that and when does it usually happen? I read between 18-28 weeks?

Thanks

[MomTimesThree]

I tell ya, it was awesome for us, and we even focused on it to get me through the labor (which was the scariest part of my daughter's pregnancy), and after our son was born our MFM said that our labor was like a yoga class! Peaceful as could possibly be. The practiced relaxation we did and hypnosis all played into that, I'm still so grateful for it and still practice my breathing. When during pregnancy everything is so out of your control, being able to at least control my breathing really gave me peace of mind.

It was our MFM who made the referral for us- he was at the same hospital our MFM was affiliated with. You might ask your OB or MFM if they have folks that patients have had good experiences with who have also had scary previous pregnancies.

I do remember reading about the 2nd trimester dip... and someone posting an article about pressure throughout pregnancy... sorry I don't have time to search for it... but maybe try in the search box just "dip" or something...

Best,
Lauren

[gratiana]

My BP averaged a few points lower in the second trimester this time around—like 105/62 instead of my normal 110/65—but nothing so dramatic I'd call it a "dip." I was hoping to see something, since I saw someone post here that in the pregnancy where she had PE she never got a dip, whereas with her later, non-PE pregnancy she did notice one, so I was looking for reassurance... I kept thinking, "is this it? is this it?" but nothing dramatic ever happened. But I haven't gotten PE in this pregnancy yet (and I'm full term tomorrow!), so maybe there's no connection. (My BPs have been climbing slowly all through 3rd trimester, to a morning average now of about 120/80, but at this point the docs aren't worried; they can do the c-section any day if necessary. Otherwise I'm scheduled for a week from tomorrow.)

[afaiz]

Thanks for sharing your story so happy that you have made it so far and your still doing great ! Hope your birth experience is amazing. I have been reading through and it seems that the dip comes a little lower so I'm still hoping I will have that and get some breathing room. I am also going to ask my MFM about the hypnosis. Don't know if my husband will go but I definitely will. He always feels he has to be so strong and positive and never seem worried bc he knows I will panic if he gets worried but I def think my emotions are taking a toll on both of us... I appreciate all you ladies replies it soothes me to know its possible and many ladies here have had success..did any of you ladies use at home protien dipsticks? And where did you get them? When did you start getting your uterine artery Doppler? ( hopefully that makes sense) I'm going to ask my dr when I see her? The other question was the Papp-A & HCG in the first trimesters screen? My first pregnancy my pAp-a was higher then average but they still considered me negative yet I know that should have been a warning sign for pre-e based in an article I read here? Was hoping someone might be able to explain it better what are the cutoffs? My dr agreed that its negative, and that even if its a little higher or lower then the normal it would only cue her into watching me more carefully and she is going to do that either way?

I think normal is 1 MoM right? What numbers cause worry I have googled to no end but it seems more related to ppl having issues with the screen bc of Down syndrome and trisomy 21?

Sorry this is so so long

Thanks to anyone that reads this..

[caryn]

Low PAPP-A is correlated to either a higher risk of Down Syndrome and a higher risk of placental diseases like preeclampsia or late miscarriage or HELLP. An elevated PAPP-A can signal coronary artery disease, which if you had it as an underlying issue would raise risk of what they call "superimposed preeclampsia."

So either way they fret a bit because the measurement isn't in the middle of the bell curve. However, given your history they'll be watching you more closely in any case. There's no therapy that alters the way the placenta implants and develops, so what an abnormal test does is track you into the "watchful waiting" category. These pregnancies after preeclampsia are always monitored and I've started to think of the tests as hints that *might* give your doc intuitions about the way in which problems might progress if you were to develop them.

Hope this helps!