I have a friend who has been monitoring her blood pressure since 20ish weeks due to a high number at an appointment with her general doc for illness. It's been mostly okay since then, fast forward to this week. She's 37 weeks with PUPPS and on Wednesday had a blood pressure of around 163/108. They monitored her, did bloodwork labs, and an in office dipstick test (twice maybe?), then sent her on her way (no 24 hour urine ordered, no follow up monitoring scheduled.) I told her to do kick counts, keep an eye on her blood pressure at home, and not to hesitate to go in or bug her doctor if she starts feeling off.
Today her blood pressure was "up" again. It was high enough today that they sent her in for monitoring again. I encouraged her to ask for a 24 hour urine if/before they sent her home, and explained why they are better tests than the dipsticks. Well, they sent her home, on bedrest now, and told her that her "labs were so good" (I think her labs from Wed.) that a 24 hour urine is unnecessary. (As a sidenote, I'd probably be dead now if I'd had that kind of care- my blood pressure was normal and labs went from normal to bad to horrible in 18 hrs )
Anyway, my question is, is there really a reason not to bother with a 24 hr urine in this case? Why wouldn't a dr order one? I don't get that.
Also, is the recommendation to only deliver at 37 wks for pre-e or is it for hypertension too? What was that study?
Any extra thoughts on this are appreciated.
Talked to my friend again today---
My friend was sent home yesterday on bedrest due to high bp, but her Dr told her to stop taking her bp at home, because the dr thinks that anxiety/stress or possibly the pupps is making her blood pressure so high. I know that "white coat syndrome" can sometimes make someone have high blood pressure, but I've never heard of it happening at home too, or it being *that* high. My friend thinks her doctor thinks she's been a worrywart her whole pregnancy, but I feel like her blood pressure is high enough for legitimate concern here and it's unlikely stress/anxiety related. I have told her to keep monitoring her blood pressure at home anyway and to just bypass her doctor and go in to the Women's Evaluation Unit at our main high risk/highest NICU hospital if her blood pressure is "up" again. Does that sound about right, "in our nonmedical" opinions