BP going up

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SeattleMom
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Re: BP going up

Postby SeattleMom » Sun Mar 20, 639250 12:37 am

Thanks for weighing in on the subject. I saw my Dr. today. Bp was 168/77 on 200mg labetalol BID, no protein in my urine. He did more PIH labs and bumped me to 300mg BID and told me to come back tomorrow afternoon. He said he'll call my MFM Dr. and talk about an earlier delivery. He said if my BP's don't come down he doesn't see the benefit to keep going up on my meds but is leaning towards just delivering. So I'll update tomorrow.

Angela

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caryn
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Re: BP going up

Postby caryn » Sat Mar 19, 639250 10:47 pm

There's ... sort of... a distinction. :D How's that for helpful?

Gestational hypertension gets mixed up with chronics in the cases where pressures rise, but not to the diagnostic, somewhere in pregnancy and then recovery takes more than 6 weeks. I'm a case of this; my pressures rose before 20 weeks gestation - chronic! - but only to 130/80 - not hypertensive! - but then spiked to 220/116 - preeclamptic! - but not in my index pregnancy (two prior early losses) - superimposed preeclamptic! - and then didn't drop postpartum - chronic!

So, yeah. It's too messy for them to have carefully excluded chronics, kwim? It's a research definition, and I'm sure they tried, and that's why they're running the new trial.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

alexis
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Re: BP going up

Postby alexis » Sat Mar 19, 639250 9:29 pm

This description of HYPITAT says "pregnancy induced hypertension or preeclampsia." I know doctors who are applying it to chronics, but I'm not sure it's clear they were included in the original trial. I thought there was a distinction between chronic HTN (diagnosed prior to 20 weeks) and gestational (onset after 20)? I'm not trying to be too difficult :) I'm just interested because this potentially applies to me.

HYPITAT-II includes chronic hypertensives, though: http://www.trialregister.nl/trialreg/ad ... sp?TC=1792
Chronic hypertension
Aliza - 01/05/2007 - Severe preeclampsia, emergency CS 37 weeks
Isaac - 09/26/2011 - controlled on 150mg Toprol, NO PE, 39 weeks!

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caryn
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Re: BP going up

Postby caryn » Sat Mar 19, 639250 6:45 pm

Gestational hypertension just means that your pressures are above 140/90 when pregnant - whether you're chronic or not. So I don't think they broke the chronics out separately.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

SeattleMom
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Re: BP going up

Postby SeattleMom » Sat Mar 19, 639250 10:39 am

Do you know if it matters that I have chronic HTN and not mild PE or gestational HTN? What are the outcomes for us chronics?

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caryn
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Re: BP going up

Postby caryn » Sat Mar 19, 639250 5:35 am

Yes. This is happening more frequently, probably because of the HYPITAT trial.

It found equivalent outcomes in neonates between both groups, and a lower rate of adverse maternal outcomes with induction or Caesarean at 37 weeks with gestational hypertension or miild preeclampsia.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

SeattleMom
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Posts: 67
Joined: Mon Jan 10, 2011 11:23 pm

BP going up

Postby SeattleMom » Sat Mar 19, 639250 2:59 am

I'm 36+6 weeks today. My BP has been creeping up the past week, but I'm still not spilling any protein. My Dr. keeps worrying that I'm starting to get pre-e again but so far nothing is showing that there's any PE. I'm labelled as Chronic Hypertensive and my MFM told me that most likely my BP would creep up at the end (which it is obviously doing). However, my Dr. told me he thinks my "BP will get the better of me" and we'll have to deliver earlier than my scheduled C/S on July 7th. I have another appt. today, but have any of you heard about delivery based on increasing BP without any PE symptoms? Baby is not in distress and my fluid is not low as I am being seen 2-3x weekly now.

Angela
DD born on 4/19/07 at 31 weeks due to severe PE and HELLP and IUGR.
Due 7/13/11 with DD #2 so far PE free but chronic HTN and GD.


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