22 Weeks, BP up - any positive experiences

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lornarose
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Re: 22 Weeks, BP up - any positive experiences

Postby lornarose » Mon Nov 01, 639249 12:47 am

Hi Nov Mom,
Thankyou for replying to my post. I just wanted to let you know that I'm sending you good wishes and hope your pregnancy goes well and that your spike in bp will settle. I also hope that PE doesn't kick in at this early stage. I think I recall a few spikes in my bp around 24 or 28 weeks but was not diagnosed until 32 weeks. I too followed that 2 week window between diagnosis of PE to delivery almost to the hour! I'm a bit hazy about my bp figures in the second trimester as I had no concerns really as it was first pregnancy .However,I do remember my doctor having to recheck it a few times. I'm just praying for you that it is your bp misbehaving like mine and that it will settle down. Good luck and best wishes, i'll be rooting for you.
Momma to Emma born 34wplus 3 ,October, 2010,due to severe preeclampsia and IUGR.In NICU due to low birth weight and suspected sepsis, home after nearly 4 weeks.

blythe
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Re: 22 Weeks, BP up - any positive experiences

Postby blythe » Sun Oct 31, 639249 6:00 am

One more thing - if you are lucky enough that you end up to be experiencing "just" hypertension and stay that way for the rest of your pregnancy, a very good recent study suggests that inducing at 37 weeks is best for mom and baby. http://www.ncbi.nlm.nih.gov/pubmed/19656558
(The HYPITAT study).
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH

blythe
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Re: 22 Weeks, BP up - any positive experiences

Postby blythe » Sun Oct 31, 639249 4:55 am

Hi Bianca, I'm sorry to hear that you're having problems this early, especially when you were so hopeful for a home birth this time around!! I don't like the sound of the headaches and visual disturbances, but I'm glad that your labwork came back okay and that you're being monitored more closely now.

When women develop high bp so early in pregnancy - officially the cutoff is "before 20 weeks" - the diagnosis is chronic hypertension, even if you are normotensive outside of pregnancy and at the beginning of your pregnancy. The thinking, as I understand it, is that the physical demands of pregnancy "unmask" a genetic tendency toward chronic htn, in the same way that gaining weight or getting older could "unmask" it.

It is possible that you've got some genetic bad luck in this pregnancy (there is evidence that the particular interaction of mom and dad's genes in each pregnancy leads to the "maternal-fetal conflict" that seems to underlie the development of PE) and that this early rise in bp and your headache and visual disturbances will soon develop into full-blown PE - Jasmin is correct that the average from diagnosis to delivery is two weeks. A reality TV mom in the US recently had her 19th(?) pregnancy complicated by PE and delivered a 24week baby (who did survive), and her only other experience of PE was in a much earlier twin pregnancy, so it is possible to get very sick very fast in a subsequent pregnancy. However, the tragic early losses are much more common in first pregnancies.

It's also possible that - as Caryn said - you have a genetic predisposition to chronic hypertension that is just showing up earlier in this pregnancy. Women with chronic htn have a 25% chance of developing superimposed PE (your doc might be right and in your case it's more likely). "Superimposed" PE is just as dangerous as regular PE and looks the same, but it might be caused by different things and is harder to diagnose because the doctors have to watch your symptoms, bloodwork, protein, and increases in bp to determine when you are getting *really* sick.

As you've heard from a lot of women on the boards, we have a lot of hope for LDA for high-risk women, but as Caryn says, the research shows only small benefit - and they're not sure *who* is likely to be one of the women it helps. Injectables like lovenox and heparin are considered experimental treatments by our experts, and I've only seen them prescribed in women with early losses in their first pregnancy or who have tested as having one of a few specific thrombophillas (blood that clots more than normal). I'm not sure who Jasmin is thinking of who was prescribed meds mid-pregnancy (can you remind me, Jasmin?) but I can't remember anyone, and my absolutely-not-a-doc opinion is that I can't imagine that you'd be a candidate for them even in the US, so please don't worry about your health care system being different!

The research says that BP meds don't slow the progress of the disease, but do help minimize the dangerous effects of high bp on mom. BP meds have to be used carefully so lowering bp too much doesn't impair blood flow to the baby.

About methyldopa, one of our experts said - viewtopic.php?f=19&t=228&p=58287&hilit= ... opa#p58287
Methyl dopa is an old medication with a long record of experience in pregnancy. It is very safe. On the other hand, it is not as potent as more modern drugs. Most of the drugs now used in nonpregnant women were not available when methyl dopa was initially used. Outside pregnancy, methyldopa is rarely used.
If your BP is controlled on methyl dopa and you do not have side effects, there is not a problem. If BP is not controlled, there are many other safe alternatives.


Please keep us updated and let us know what you find out about what the docs think about your predispositions and experience!
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH

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caryn
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Re: 22 Weeks, BP up - any positive experiences

Postby caryn » Thu Oct 21, 639249 3:18 am

Also check Trish's posts - she's a chronic with three pregnancies under her belt who saw an early rise in pressures. And Brandi's - she had crazy pressures and headaches the whole way through her last pregnancy (her third or fourth, I can't remember!), but this one is going better.

The good thing about having these early rises in later pregnancies is that the placental remodeling of the first pregnancy allows later pregnancies to embed more deeply. So superimposed PE can be a problem, but usually - in chronics anyway - the baby is a good size when delivery becomes necessary. Not always, and we've had posters lose their first and third children to PE, but given your history of later deliveries, I'm betting they'll be able to push you a good long way.
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

libby123
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Re: 22 Weeks, BP up - any positive experiences

Postby libby123 » Wed Oct 20, 639249 10:50 pm

During my pregnancy, I first noticed my high BP at my 26 week checkup, where it was 150s/90s up from 130s/70s in early pregnancy. My urine showed only a trace of protein. My high BP stayed in the 150s/90s range until I was 30 weeks pregnant, when it went up to 170/100s. I then went on BP medication called labetalol and bed rest.

I took at 24 hour urine test at 32 weeks, 34 weeks, and 35 weeks. At 32 weeks my protein was less than 100. At 34 it was in the 200s. At 35 weeks it went over 400 and I was officially diagnosed with pre-e. I delivered at 36 weeks by c-section, my daughter was 5 pounds 11 oz and needed no NICU time.

So yes, I developed high BP in the second trimester without protein and it was very stable and slow moving upward. It never went crazy and was always predictable, my proteins climbed steadily.

I hope all goes well for you. This story of mine is meant to be a success story for you.
Mommy to Sailor Ann, born on February 17th 2011 at 36 weeks by c-section due to PIH that slowly turned into preeclampsia.

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tracym
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Re: 22 Weeks, BP up - any positive experiences

Postby tracym » Wed Oct 20, 639249 9:38 pm

Good luck at the hospital. Don't be surprised if the CTG (NST) is a flop...22 weeks is very early. If they're not happy with the tracing they should do a scan while you're there. Let us know how you go.
Tracy

Jack - 37 weeks Feb '01 (mild PE dx 33 weeks)
Kate - 33 weeks Feb '05 (severe PE dx 31 weeks)

nov_mum
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Re: 22 Weeks, BP up - any positive experiences

Postby nov_mum » Wed Oct 20, 639249 7:59 am

Thank you, I will check out those links. I have been on LDA since 6 weeks so hopefully that will help matters. I have an appointment today with the hospital for bloods, bps and a CTG. They couldn't fit me in for a scan today but Monday. I had one at 19 weeks so I am hoping that a few days won't make a huge difference. I haven't read those links just yet, but if I was a chronic HT would it have shown in previous BPs?? BPs in my non pregnant state and MW appointments up to where it went off, were always 120/76ish.

I guess the fact it has happened so early this time around makes me think that there is something predisposing me. I will post back with any developments.

Bianca

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caryn
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Re: 22 Weeks, BP up - any positive experiences

Postby caryn » Wed Oct 20, 639249 3:25 am

Has anyone taken a look at you for possible underlying conditions? Usually women with a history like you're reporting are chronic hypertensives, and the trick is to tell the difference between the aggravation of your genetic tendency that's being caused by pregnancy, and actual preeclampsia. If you search on Laura's posts, you'll probably find a bunch of relevant stuff; she's a chronic who had three pregnancies with high pressures.

There's very little confirmed data supporting the use of any meds here other than a 10% benefit from baby aspirin that is still heavily disputed by our Experts: http://www.preeclampsia.org/forum/viewt ... 19&t=40560

Methyldopa is a very old, very safe med for lowering your risk of stroke, but you might need to tweak your dose or add some additional medication like labetalol to lower your pressures. Have they booked you for a scan?

Here's a link to PRECOG, which might be useful: http://www.apec.org.uk/precog.htm
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

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riehlism
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Re: 22 Weeks, BP up - any positive experiences

Postby riehlism » Sat Oct 09, 639249 8:42 am

I don't have any experience with using methyldopa. Like you, I was a labetalol and nifedapine girl.

I did have early onset PE in my first pregnancy. I had symptoms starting around 22 weeks with one headache, and maybe some flashing lights. At the end of 22 weeks I started to get high BP readings that were labile (cycles of normal then high, until it eventually trended and stayed high).

At 23 weeks I checked myself into Labor & Delivery for high BP (154/100) and they admitted me. I stayed there until I delivered. My protein during admission was 324g (where diagnostic is 300). For the longest time the only real thing wrong with me was my BP. My proteins did not rise much until the very end where everything fell apart for me.

I know you were looking for a positive experience, but mine did not have a happy ending. I am sorry I'm not much help. The average diagnosis to delivery time is 2 weeks. I fell right in there. However, there are many ladies here who have been able to hold on for much longer. I am hoping they will post to brighten your day.

Aside from the BP medication, did your OB or midwife have you on other meds , like baby aspirin? If I remember correctly you are not from the US, so your health care system works different from ours. It seems to be a trend here that doctors like to recommend baby aspirin, injectable blood thinners (Lovenox), and other sorts of medication to help with preeclampsia. While many of us start with that stuff in early pregnancy, I do believe there was one active poster who reported her doctor started her on meds (I don't not recall if they were oral medication, injectables, or both), right when her symptoms started mid pregnancy, and had a good outcome.

In any case, would your midwife be able to relay to the OB about the effectiveness of prophylatic medication at this point in your pregnancy?
Jasmin: Severe PE/HELLP and delivered at 24+6 & PCOS (29) Hubby Bubby, Frank (29)
Baby Blue stopped in to say hello and goodbye on 6/3/10
Baby Lucas was born on 10/13/11, PE and HELLP-free! Thank you baby aspirin and Lovenox
http://www.ehd.org/pregnancy-calendar.php?id=18192

nov_mum
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Re: 22 Weeks, BP up - any positive experiences

Postby nov_mum » Sat Oct 09, 639249 8:10 am

I should add that in previous pregnancies I haven't been symptomatic until around 31 weeks.


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