by laura (5139 Posts), Wed Nov 05, 2003 09:13 pm
hmm, that's an interesting remark your doc made about the 140/90....
Some of us will develop preeclampsia because we have underlying essential hypertension that we inherited genetically, and will emerge fully as we age. If you have a strong family history of hypertension, or if your pressures were borderline before pregnancy, that may mean that essential or chronic hypertension is your 'thing'.
The good news about that is that people with essential hypertension or chronic hypertension have a 25% chance of going on to develop preeclampsia. The BAD news is that when people with chronic hypertension do develop preeclampsia, the superimposed preeclampsia can get terribly severe terribly fast. Superimposed preeclampsia is very dangerous.
Hypertension blasts your blood vessels and end organs, like the kidneys and liver (that's why they frequently check for protein, to see if the hypertension has damaged your kidneys to the point that they're not filtering properly)
Another end organ that can get blasted by this pressure is the placenta, the source of all good things for your baby.
High blood pressure in the mama=low blood pressure in the baby... or in other words, can cause low oxygen and nutrients to the baby, causing a whole host of problems, including interuterine growth restriction and oligohydramnios (low amniotic fluid)
That's the problem I had. I never ventured too far above 140/90, yet the problems with placental perfusion chronically restricted the oxygen to my baby. As a result, her body diverted all available oxygen to her brain, and the rest of her body sort of hibernated- including, but not limited to her kidneys, and she quit peeing, and her amniotic fluid dwindled to nothing by 36 weeks, when I had to deliver.
So, like Catherine, I wasn't through the roof with BP. I didn't go too far above 140/90, for that matter, yet my pregnancy was deeply effected by it.
I'm absolutely not saying that your doc is wrong, but what I would hope to hear from him, were that me- is- hmmm, Chances are you'll be fine. But women with hypertension can develop complications, so we're going to watch you closely, including visits more frequently than usual, frequent monitoring of your BP, Non-stress testing at least once a week, monthly growth ultrasounds, to make sure baby's growth remains on target.
My first providers with my second pregnancy didn't take that course. They did my routine u/s at 18 weeks, and called it all good-- had no plans to follow up on it. I wasn't satisfied, so I got a second opinion and a second ultrasound. In the 4-5 weeks between ultrasounds, my amniotic fluid had halved, and the baby's growth had slowed down, and we would have never caught it unless they had that subsequent ultrasound.
So- if you ever get the inkling that your doc doesn't take the effects of hypertension on pregnancy seriously, get a second opinion. Just having hypertension alone puts you in perinatologist territory, it's always a good idea to get a consult. Peris that specialize in hypertensive pregnancies are available at http://www.nasshp.org and general peris are available at http://www.smfm.org
Best of luck, and please let us know how you're doing!
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)