BP rising and swelling hands....Pre-e again?

[ross]

I was diagnosed with Post-Partum Toxemia after delivering my first (induced 4 days after EDD because of low amniotic fluid). BP had been around 150/90 and had lots of swelling, water retention, rapid weight gain, shortness of breath, and heart pounding. No protein in urine.
Now 32 wks with #2 and experiencing same symptoms except rapid weight gain and water retention. No protein in urine and blood work looks fine, but BP continues to rise. Was 161/91 and usually 90/60. My hands swelled up so much last night that I couldn't even bend my fingers! Bp was 157/85, but came down within 30 minutes of lying on left with hands elevated above my heart. The doctor has done nothing as of yet and I am frustrated! Advice anyone? Am I nuts or are these signs of pre-e?

Ross
EDD 2/24/04

[akemt]

They may be early signs of PE...but they are DEFINATELY worth testing, etc. They ARE signs of Pregnancy induced hypertension (PIH). I'm glad they ran bloodwork and that you do not have protein in your urine. Are you seeing a maternal fetal specialist/perinatologist? You should ask for a referral if not. Have they checked your fluid level since this rise in Bp? I had oligohydramnios caused by PIH with my first pregnancy and never did have bad bloodwork or proteinuria. Did you call your doctor about the BP and the swelling last night? Make sure you have a good heart to heart chat with your doctor...be sure he/she is taking your symptoms seriously or find another doctor.

Here is a link where you can find a specialist: www.nasshp.org/address.htm

32 weeks is a great place to be. I hope you can make it even farther! Please keep us updated.


Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo
Baby #2 due August 11, 2004

[ross]

Thank you so much for responding. I feel like I have been getting nowhere with my Dr. They keep saying everything looks good. No I have not been to a specialist, or even asked to see one for that matter, and they have not checked my fluid levels. Is that another area of concern? I called the triage nurse at the hospital last night and she told me to raise my arms, lie on my left, and take my BP after 1 hr to see if the bottom # came down below 84. It was 73 when I checked, so I went to bed. I have been in bed all day today, but the BP has gone up in high 140's and 150's over 80's and 90's. I plan on chatting with the Dr. tomorrow and getting some results. I'm also gonna look up PIH since I am not as familiar with that. Thanks again so much and take care.

Ross

[annegarrett]

Ross,

(Someone on the forum help me find the link--please!) There is a discussion on the forum with our medical experts on how to take a BP properly. When we get that posted--please print it out and take it to your doctors (tomorrow!) and tell them that your nurse suggested you put your arm over your head. You need at LEAST an OB and probably a perinatologist. You need a second opinion if you don't get satisfaction tomorrow. (TOMORROW). The biggest risk factor for repeat preeclampsia is having had it before. PIH (what you clearly have) is Pregnancy Induced Hypertension. That just means your blood pressure has risen to hypertensive during pregnancy. About half of such women will develop preeclampsia but even PIH impacts a pregnancy.

I am not trying to frighten you but women die from this. Babies die. We have lost two women in the past month. You need to go in and insist on a 24 hour urine, and REMIND them that your BP has gone up. Please share with them the following paragraph from our main website:

In 1990 the National Institutes of Health, National High Blood Pressure Education Program: Working Group Report on High Blood Pressure in Pregnancy issued the following research guidelines:

In the past it has been recommended that an increase of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure be used as a diagnostic criterion, even when absolute values are below 140/90 mm Hg. This definition has not been included in our criteria because the only available evidence shows that women in this group are not likely to suffer increased adverse outcomes. Nonetheless, it is the collective clinical opinion of this panel that women who have a rise of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure warrant close observation, especially if proteinuria and hyperuricemia (uric acid [UA] greater than or equal to 6 mg/dL) are also present.

It should also be noted that 4 members of the Preeclampsia Foundation Medical Board and our Executive Director participated in this working group. There was significant debate over removing baseline BP as diagnostic which is why the final sentence was included. The Preeclampsia Foundation continues to encourage its women, particularly those with low baseline BPs, to know their baseline and to be aware of significant changes and to make any concerns about those changes known to their health care provider.

Good luck and let us know how everything goes.

Take care,



Anne Garrett
Executive Director
Preeclampsia Foundation

[ileana]

Here's the link Anne

http://www.preeclampsia.org/forum/viewtopic.php?t=321&SearchTerms=hypertension

Ross, you are not nuts, these ARE signs of preeclampsia.

Ileana 33
Angel stillborn 24w p-e 2/17/03

[ross]

Thank you all so much for being so supportive and reassuring. I checked out the link. Educating myself is the least I can do, pressing the issue with my Dr. and insisting something be done is what we will do tomorrow at the appointment. You don't know how relieved I feel to know that I am not nuts and this is what I HAVE to do for my baby and myself. I'll be on tomorrow and let you all know how it went.

Take care,

Esilda Ross
Caitlin 9/13/01
Kiersten EDD 2/24/04

[akemt]

Ross,

While the low amniotic fluid is not common at all, mine was caused by the higher blood pressure. Perhaps that is why you had low fluid with your first pregnancy? My doctor described it quite well by saying the placenta and my internal organs were fighting over blood supply. In my case, the placenta was losing instead of my kidneys/liver like others seem to have problems with. So the placenta caused my bp to rise in order to get more blood flow, but that starts to deteriorate the placenta. Basically, he said it is a vicious cycle. I don't know why I just told you all that? lol HOpefully it atleast made sense.

I'll be looking forward to hearing an update tomorrow then! Best of luck! And btw, I had problems getting the OB nurse to take my bp upright...she was such a pain.

Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo
Baby #2 due August 11, 2004

[aimeejane]

Esilda,

Good for you for taking this into your own hands! My heartrate jumped reading your post. Please continue to press your doctor if he/she continues to ignore your symptoms. If necessary, change doctors, even this late in the pregnancy! I'll be keeping you and your little one in my thoughts.



Aimee - 28
Dh - 30
Ds Nicky - 3/24/00 (28 wks - eclampsia)
Ds Kalen - 7/10/03 (36 weeks - preeclampsia)

[ross]

Just got back from the Dr. appointment. Blood pressure was at 112/73, but they found a trace of protein in my urine. My husband and I spoke with the Dr. for quite a while. He was very helpful and answered all our questions thoroughly. He is concerned that I may be developing pre-e and wants to see me again in 1 week instead of 2. He also told me of the signs to watch for and to go directly to ER. He prescribed Fiorecet for my headaches and told me to call him if it doesn't make the headache go away.
Whew! I feel like a huge weight has been lifted. He was glad to see that my BP is down, but took note of the higher readings and said pre-e is episodic and can come on all at once.
Thanks again for listening and for your comments and advice. It is truly appreciated.

Esilda Ross, 28
DH Jean-Paul, 27
Caitlin 9/13/01
Kiersten EDD 2/24/04

[twolfgram]

Sounds like you've got a good doctor! There is no substitute for that! Good luck for the remainder of your pg! You're almost there!

Therese Mom to
Jonathan - 28 weeks born 10/4/95
Angel in Heaven - Erik 12/20/02