chronic hypertension vs PIH

[laura]

I'm 27 weeks pregnant currently, and experienced severe preeclampsia with my first pg, which started with raised pressures at 30 weeks and delivery by 35 weeks, due to high urine protein.
This pregnancy my pressures until recently have been normal (110/58 in the first trimester), but an U/S at 25 weeks showed some degree of growth restriction and decreasing amniotic fluid. I had my first 138/92 reading in the ob office yesterday, and my doctor changed my diagnosis from normal pregnancy to chronic hypertension. His theory is that I have underlying hypertension that is "unmasked" so-to-speak by pregnancy, based on the prevalence of (early)heart disease in my family. Regardless of diagnosis, he is following the pregnancy closely with (my)restricted activity, frequent u/s, monthly 24 urines, and office visits every two weeks.

What factors might cause my doctor to conclude that I have underlying illness versus a subsequent pregnancy with PIH? Can you please explain how someone can have chronic hypertension without showing high blood pressures? What are the differences in treatment for chronic hypertension versus PIH? . Thanks!

Laura-28
DH-30
Allie 5-13-98 (35 weeks-pre-e)
EDD 5-12-03

[annegarrett]

Hey there! The difference is really just when the hypertension shows up and if you have proteinuria. As Deerhart pointed out--hypertension with or without proteinuria is a concern. We should probably add something to the site that talks about proteinuria. USUALLY in your second trimester your blood pressure drops slightly so if it hasn't or it has risen, as is your case, then it indicates hypertension (well, especially if you are over 140/90 which you are). I have heard anything from 30%-90% of women with gestational hypertension (what they are saying you have) develop preeclampsia. The difference there is just the protein. I think that protein spilling into the urine is a red flag that the kidneys aren't working properly...but you can have problems with high blood pressure if you start getting swelling, particularly in your face...AND WE ALL KNOW I am NO doctor...but that is what I have read, IMHO...and I do read A WHOLE heck of a lot about this disorder. [;)] Any progress on a trip to see your fellow Anchorite?



Anne

[annegarrett]

Will get the real expert to respond properly ASAP and replace my non-expert response![:D]

Anne