PIH Diagnosis 32weeks-What next?

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Re: PIH Diagnosis 32weeks-What next?

Postby kellyo19 » Sat Aug 16, 639259 4:56 pm

I was diagnosed PIH at about 32 wks too. I had weekly US/BPP/NST until about 36 wks and then it was twice wkly. I was also at L&D every other wk until 36 wks when I was in 2-3 times a wk due to BPs not coming down with bedrest. I was never medicated. My BPs were usually 140-150s/90-110s, and during delivery I had some 160s/115s that had the mag on standby (but never needed that). I would tell the dr that for ease of mind and to help my anxiety and worry, request weekly 24-hr urine catches and weekly NST/BPP. It reassured me to have the NST and BPPs to make sure baby was doing fine. My OB however refused to do the 24-hr weekly but if I was at L&D and got another OB, they always agreed to my requests. =)

If you feel the OB isn't taking you seriously, bring a friend, mom, sister, husband along and have them affirm your concerns... sometimes the OB listened to my hubs more than me. :roll:

Good luck, and for what its worth, I made it to term.
2005: PE/IUGR pregnancy with Daughter, born 40+2 induction. Diagnosed with Sensory Processing Disorder (or Sensory Integration Dysfunction) in 2010. Diagnosed with ADHD in 2011. It's getting better with OT and treatment!
2009: PIH pregnancy with Son, born 38+5. Diagnosed in 2011 as Developmental Language Delays, Social-Emotional-Communication Delays. More testing Nov. 2011.
2011: I'm undergoing neurological testing. Praying for the best!

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Re: PIH Diagnosis 32weeks-What next?

Postby trish » Wed Aug 06, 639259 2:14 am

Sorry for not seeing this sooner! Welcome back. :) With my 3rd, on BP meds for CHT I had either a growth scan/BPP or an NST every week after about 28/30 weeks. Also, my Dr. didn't get concerned at all with 140/90's - at 160's/110 she'd just say I guess we need to up your meds. In my 1st pregnancy that BP earned me a same day delivery (well that and URQ pain!). Maybe they are considering you chronic and generally they are "allowed" to run a little higher.

I would just plan to ask your Dr. for weekly NST's and/or BPP's to ease your mind. Don't be afraid to push for the care you need/deserve. Hang in there!!!
Trish: mama to my 3 PE Princesses:
Elizabeth 11/6/03 induced at 37 weeks for PE
Katie 4/13/05 induced at 38 weeks for PE
Allison 12/27/07 induced at 36 weeks for PE then PP PE & BP issues for over a year

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PIH Diagnosis 32weeks-What next?

Postby Jessa » Mon Jul 14, 639259 9:55 am

Hi Ladies,
I haven't visited the forum in a while. I had to change my login with the new site, but I used to post as jfindley. Anyway, a quick history. I had my son at 26weeks in 2008 due to severe PE and HELLP. He is perfectly healthy now. After lots of testing and research we found that I had an underlying condition, an adrenal tumor, that contributed to my severe early onset case. All my docs were sure that since the tumor had been removed that I had a very slim to none chance of PE or HELLP again and so we decided to have another child.

I am now 32weeks along. All has been very smooth sailing so far, just a little low function thyroid, so some meds, but just a borderline case. I haven't really been treated as high risk since they think my last pregnancy drama was due to this tumor. I have only been followed by an OB-GYN and consulted 2x with an MFM. My pressures have been 110s/60s the whole pregnancy until the last two weeks. I started getting a couple of readings a day 130s/80s and eventually as high as 150/93 this past Monday. My doc immediately ordered PE labs (all normal),put me on 100mg of labetalol 2x a day, offered to pull me out of work to start bed rest and diagnosed me with PIH this week. He has declined my request to see the MFM again to have her do an us and instead offered to do a growth scan himself next week to reassure me. I feel that he is being very proactive, but here is my question. Last pregnancy, things got so out of control so fast, there was not time to monitor baby and manage my case, so this time, I don't know how closely the baby and I should be monitored and how frequently. If I had not asked for the growth scan, I don't think he would be doing one until another 3 weeks out. I feel like 3 weeks is way too long to wait to check things out.

So, for you ladies, during the early stages of PIH or PE, how frequently are you/were you monitored? What types of tests were done? Did you have NST and what would constitute requesting a NST? I have never had one and my doc has not mentioned needing one, but I feel like I will need to be a hardcore advocate to get what i need done in this situation. BTW-even on the labetalol, I am getting at least one reading a day 130s/90s. He told me to let him know if I got to 180/105 and we would deliver, but otherwise, he wasn't concerned about 140/90s etc. This also seem crazy to me. Isn't there an in-between stage where additional monitoring and management is prudent? I know the risks of IUGR, abruption, stillbirth etc. and that all of these things can happen during the risky management stage. How high does my BP need to be to become at risk for these types of outcomes?

Any wisdom from you gals would be greatly appreciated. This is new territory to me. I know all about severe disease and having a 26weeker, but being this far along with mild PIH just starting, I am lost and don't know what type of care is best.


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