PIH and Chronic Hypertension

This section is for discussions with other women who have probably been through the same signs/symptoms that you may be experiencing. Please note, we cannot offer medical advice and encourage members to discuss their concerns with their doctors. New members, come on in and introduce yourself!
z1ggy23
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Re: PIH and Chronic Hypertension

Postby z1ggy23 » Sun Aug 21, 2011 03:17 pm

I just don't think we understand superimposed preeclampsia terribly well, even more than PE in general.

I'm 34 weeks tomorrow, and my BP is edging up. I had a scare 2 weeks ago that sent me to L&D, but otherwise, doing better than anyone expected. I was severely preeclamptic at 37 weeks last time with a BP rise from 32 or so. My BP is well controlled, but I'm considered to be at high risk because my underlying HTN is serious (I was 160/100 when I started meds, and later had them doubled because I was the same again). My baseline is worse this time than it was in my first pregnancy, but I'm doing better. I think the meds are good for me overall, but I'm not sure they affect my PE at all--and I think if I avoid it, it may be because my OB doesn't want to push it any farther. I"m not sure I'd make it to 40. I'm still worried because unlike some chronics, I never spiked super high BP. I went over 160/100, but none of those crazy 200/120 BPs you hear about and which are supposed to be more common if you're chronic.

Plus, I think part of the reason my BPs look so good is that I'm using better meds--I'm on Toprol XL, same as pre-pregnancy. I had tight control before I got pregnant and my internist/OB/MFM have kept my pressures around 120/80.
I am with you on this (I also don't spike super high, but run a high baseline non-pregnant (well pregnant as well)). I often wonder if the meds actually mask some of the PE symptoms because my baseline is about 135/85 (it was running about 122/75 until a couple of weeks ago) with a few spikes into the 140/90 range, but I am spilling protein and am seeing stars (fleeting but definitely there)... but my BPs are Beautiful (well acceptable for me because I am chronic... the same BPs and protein last time had my OB putting me on bedrest in the hospital :\ ). I don't know what to think any more (FWIW, I am 33+3 and was dx at 32+4ish last time and 37 the time before. I was not chronic with either of those)
Brandilyn, loving wife and mom to three PIH/CHT/PE babies
M (8/07) 38w1d
L (9/09) 37w3d
E (9/11) 37w

alexis
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Re: PIH and Chronic Hypertension

Postby alexis » Sun Aug 21, 2011 03:07 pm

I just don't think we understand superimposed preeclampsia terribly well, even more than PE in general.

I'm 34 weeks tomorrow, and my BP is edging up. I had a scare 2 weeks ago that sent me to L&D, but otherwise, doing better than anyone expected. I was severely preeclamptic at 37 weeks last time with a BP rise from 32 or so. My BP is well controlled, but I'm considered to be at high risk because my underlying HTN is serious (I was 160/100 when I started meds, and later had them doubled because I was the same again). My baseline is worse this time than it was in my first pregnancy, but I'm doing better. I think the meds are good for me overall, but I'm not sure they affect my PE at all--and I think if I avoid it, it may be because my OB doesn't want to push it any farther. I"m not sure I'd make it to 40. I'm still worried because unlike some chronics, I never spiked super high BP. I went over 160/100, but none of those crazy 200/120 BPs you hear about and which are supposed to be more common if you're chronic.

Plus, I think part of the reason my BPs look so good is that I'm using better meds--I'm on Toprol XL, same as pre-pregnancy. I had tight control before I got pregnant and my internist/OB/MFM have kept my pressures around 120/80.
Chronic hypertension
Aliza - 01/05/2007 - Severe preeclampsia, emergency CS 37 weeks
Isaac - 09/26/2011 - controlled on 150mg Toprol, NO PE, 39 weeks!

laura
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Re: PIH and Chronic Hypertension

Postby laura » Sun Aug 21, 2011 01:16 pm

Gosh, I can't remember where I saw it, but remember Anne saying that half of all with PIH would develop PE.

Among chronic hypertensives with controlled BPs the pe rate was between 10-25%. So there is hope! The key to look for is whether your pressures can be controlled. Hope this helps.
Mom to Allie (1998, severe PE)| Camille (2003, oligohydramnios )|the Dude (2007, chronic hypertension)
The Captain is my hero!

flori
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Re: PIH and Chronic Hypertension

Postby flori » Fri Aug 12, 2011 00:11 am

I have actually been wondering this as well. I was chronic before my first pregnancy and my bp was not controlled during. I am well controlled now with Labetalol and Lisinopril (which I know will have to be changed once pregnant). It does concern me that there is still the increased risk of PE, but hopefully I'll make it long enough to take a baby home.
Flori, 30
Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.

z1ggy23
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Re: PIH and Chronic Hypertension

Postby z1ggy23 » Thu Aug 11, 2011 09:42 pm

I had PIH/PE with both of my previous pregnancies... no BP meds for either of those. I went into this one chronic and was well controlled on meds (HCTZ and Metaprolol prior to pregnancy and Methyldopa since pregnant)... until I hit 31 weeks (I am still on meds, BP just isn't staying down anymore). My BP is not yet in the danger zone on a consistent basis, but I hit in about once a day and stay in the vicinity of 135/85 the rest of the time :(

My Dr. has told me that I have no hope of making it past 38 weeks, and, if my BP trend continues, we will be throwing in the towel no later than 37 weeks. She also told me earlier on that with my history and my BP levels it was more a matter of when than if (and she has been taking every precaution as a result). (FWIW, she was my OB with both my previous pregnancies, so she knows all the history).

That being said, a good friend of mine when in to her pregnancy chronic, but on a much lower dose of meds (250mg Methylopa/day as opposed to my 500mg 2x/day) and never had a single BP issue and made it all the way to 39 weeks (she . Her OB (same office as mine, but different Dr) had her doing semi-weekly NSTs at the end, but other than that, she had no problems or extra precautions. She was chronic but never had PIH or PE with her first.
Brandilyn, loving wife and mom to three PIH/CHT/PE babies
M (8/07) 38w1d
L (9/09) 37w3d
E (9/11) 37w

mommy2maddie
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Re: PIH and Chronic Hypertension

Postby mommy2maddie » Thu Aug 11, 2011 08:39 pm

That doesnt give me alot of hope. :( With my first two pregnacies I had high b/p but not medicine. However I did not develop PE with my second, I was on my way there (b/p creeping up, protein in urine), I started showing signs at 28 weeks that I may develop it but made it to 35 weeks without actually getting it. My water broke, so I will never know if I would have gotten it, but my guess is I probably would have. I want a third baby but with two kids at home, I dont really want to travel down the high risk pregnancy road. I can do a bunch of doctors appts but I could not stand a long stay in the hospital. :cry:
Alissa 23
DH Richard 25
DD Madison Rene 6/2008 29 weeks 4 days 2lbs. 7oz. 45 days NICU Severe PE
DS RJ 10/2009 35 weeks 5lbs. 13oz. 5 days NICU PPROM
Baby #3 Due July 2, 2012

trish
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Re: PIH and Chronic Hypertension

Postby trish » Thu Aug 11, 2011 06:22 pm

You'd think we could catch a break being labeled chronics but we don't. :( We still have a higher chance of developing super imposed PE. I was well controlled on one small dose of one BP med prior to pregnancy & while pregnant needed to keep upping that dosage & delivered sooner than my other 2 pregnancies (where I wasn't chronic nor on any BP meds) And PP I had a heck of a time getting my BP back under control & still take 2 BP meds at a high dose 3.5 years later. :(
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

mommy2maddie
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PIH and Chronic Hypertension

Postby mommy2maddie » Thu Aug 11, 2011 05:03 pm

So I am a little confused, I know that if you have chronic hypertension, you at are higher risk of developing pre-eclampsia. I also know if you are not chronic but develop pregnancy induced hypertension, you are at a greater risk of developing pre-eclampsiaand PIH almost always (I know it doesnt all the time) leads to PE. So I guess my question is if you go into a pregnancy as a chronic and well controlled on medicine, do you have a lower or greater chance at developing PE then the person who develops PIH? I know this is a weird question but with both of my last to pregnancies I had PIH, I am now a chronic, well controlled on meds, I was just wondering if this gives me any advantage.
Alissa 23
DH Richard 25
DD Madison Rene 6/2008 29 weeks 4 days 2lbs. 7oz. 45 days NICU Severe PE
DS RJ 10/2009 35 weeks 5lbs. 13oz. 5 days NICU PPROM
Baby #3 Due July 2, 2012


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