Trying to understand what a baseline implies

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Trying to understand what a baseline implies

Postby blue143 » Mon Jan 14, 2013 09:43 am

I could use some help trying to understand what the baseline 24-hour urine I did means for my current pregnancy. I am currently 13 weeks and BP is steady at my normal 110/62. I did a baseline 24-hour urine at 9 weeks and it came back 210.

Here is my history from my first pregnancy. At 28 weeks, I complained of some pretty significant foot swelling. My midwife ordered a 24-hour and it came back 546. My BP was 135/80. I was put on immediate strict bedrest without any up time except bathroom and shower (maybe a little severe?). From 28 weeks and on, my protein went 765. 492, 506, 928, 624, 468, 555, 525 (last reading was just before 37 week induction). During this time the highest my BP was was 126/72 and that was just one reading. It floated mostly around 105/65 after starting bedrest. It was 106/61 the day before I was induced. No headaches ever, or any RUQ pain. Liver and kidney function tested always tested normal. My BP was great during labor and I never needed mag. I had a 5 lb healthy girl who didn't need any assistance after birth.

About 1 year post-postpartum and before becoming pregnant again, I did a thrombophilia panel (negative all around) and a non-pregnant 24 hour. The results of the 24 hour still bug me. Apparently they dip it with a special dipstick (different from what's in an OB office) and it was negative. Because of that, they don't run the entire sample as a 24 hour test. The results were negative < 5. I would feel more confident with these results if they had actually run the entire sample. So all I have to go off is that my non-pregnant sample is negative.

I am currently at an OB practice since I am now high risk. My OB mentioned that I could have some sort of underlying kidney problem or that my first pregnancy may have damaged my kidneys. Is this something serious that I would need to have evaluated by a specialist? I also do not have an MFM... I never thought my experience with pre-e was bad enough to warrant one, but any advice or suggestions would be appreciated.

This time around I am taking better prenatal vitamin with DHA + EPA and a baby aspirin. That's about all that is different. The prenatal I took during my first pregnancy was a weird one from Whole Foods and required me to take 6 / day and 3 different times.... which basically meant I only ever took 2 and never got enough vitamins.

Just like everyone who is pregnant again, I am terrified. I have no family nearby and very little budget to bring in outside child care help for my daughter. I'm so worried about bed rest again.
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Re: Trying to understand what a baseline implies

Postby Raposa » Mon Jan 14, 2013 01:25 pm

All my urine dips when I'm not pregnant come up zero, but as soon as my baby got established and my body started gearing up, my blood pressure spiked and I started leaking protein. I did see a specialist, who ruled out any other causes, and he said I did probably have some kidney damage from my previous pregnancy, but that it's not enough to cause me trouble under a normal load. Instead, it might have crept up on me as I got older.

So, the baseline tells my OB when to start worrying that things are getting too bad too fast. Since I have some leaking in early pregnancy, there's some issue that needs to be accounted for when measuring for preeclampsia.

As for fixing the problem, no doctor is going to work on that until I finish this pregnancy. There's just too much that changes during pregnancy, so only perinatologists are really qualified on what the new 'normal' might be. So, I had to stick it out. I might try a low protein diet once this is over to try to heal the damage, but not while growing a baby.
1st son, induced at 37 weeks due to pre-e, born 6/18/10.
2nd son, c-section at 37 weeks due to hypertension, born 1/15/13.
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Re: Trying to understand what a baseline implies

Postby blue143 » Tue Jan 22, 2013 12:41 am

Just wonder if anyone has ever had a baseline around 200 in the first trimester that didn't go on to get pre-e?
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