Chronic hypertensive at 27 weeks spiking BP.

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alviarin
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Re: Chronic hypertensive at 27 weeks spiking BP.

Postby alviarin » Tue Apr 07, 2015 02:36 am

Sorry to hear you had a rough time, but glad to hear you are both doing well! Thanks for the update, and congratulations on the birth of your little one!
Hypothyroid mom to
Connor (severe pre-e at 38 weeks)
Claire (dx'd with pre-e and induction at 37 weeks)
Annabelle (chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)

Charmed
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Re: Chronic hypertensive at 27 weeks spiking BP.

Postby Charmed » Sat Apr 04, 2015 11:13 pm

Thank you! Pressures were hovering around 140/90 for a few days, but have been regularly falling to more normal levels. I'm still on 800 mg of labetalol per day, and will probably stick with that while breastfeeding. Then I hope to go back to atenelol.

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caryn
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Re: Chronic hypertensive at 27 weeks spiking BP.

Postby caryn » Fri Apr 03, 2015 02:54 am

Welcome Earthside, Ben!

It sounds like you're finding a new normal, even with a rougher landing than anyone would choose. Your tone is delighted and contented, even with that dehiscence. How have your pressures behaved postpartum?
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

Charmed
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Re: Chronic hypertensive at 27 weeks spiking BP.

Postby Charmed » Fri Apr 03, 2015 02:28 am

@alviarin: I was definitely always concerned because of my prior history, we knew superimposed PE could be an issue... and I ended up definitely on the wrong side of the coin two weeks ago now!

So on March 18th, we went for a scheduled ultrasound and checkup, and my blood pressure was high as usual, but OB didn't like what she saw with growth on the sono, so she was going to schedule me for a visit with a specialist the following week. We didn't make it that far. My blood pressure spiked and I just didn't feel right that evening, so we called said OB and she said to go on to the hospital and expect to stay the night. We headed to our delivery hospital and got settled in, and immediately they found protein in my urine. We were hoping to keep things under a little control with a bed-rest and observation stay for 10 day, but after a visit with the high risk specialist on Thursday morning, he decided I'd need to be delivered within 48 hours, and we planned a c-section for Saturday, March 21st at 7am, bright and early!

Alas, we didn't even make it that far! I started magnesium sulfate & steroids to help baby's lungs get going, but we couldn't keep my blood pressure down enough, and baby was getting lethargic. So Friday night after another high risk consultation, we pushed everything up and did the c-section that night, about 7 hours earlier than planned. Ben Louis was born at 11:50pm, March 20th, at 33 weeks and six days gestation. He was 3lbs 1oz, 15 inches long, and furious! Even through the haze of anesthesia, his cry was the most beautiful thing I'd ever heard.

He did beautifully! He was off CPAP after about 30 hours, removed from bili lights for jaundice on about the 3rd day, and has been feeding via gavage like a champ! Mama didn't fare so well, however... We continued with the mag sulfate for another 12 hours and I was in terrible pain. Turns out I had an extraordinarily bad hematoma that caused my incision to bleed after we checked out on Tuesday, and I ended up readmitted the same night we tried to go home. The incision had dehisced, and it took ANOTHER trip to the ER to get it dealt with after a second bout of bleeding. It's finally on the way to getting healed properly.

So Ben arrived not at all how we expected, but he is here and doing spectacularly. I'm finally getting back to some level of... well, I don't know if I'd say normal, but at least stable and sane. Our community and family have pulled out all the stops being there for us, and we feel so incredibly blessed and humbled. Not to mention the amazing nurses and doctors that cared for both Ben and me, they were absolutely incredible.

Oh, and Saturday the 21st? We were supposed to have his shower. My little party crasher. <3

alviarin
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Re: Chronic hypertensive at 27 weeks spiking BP.

Postby alviarin » Tue Feb 17, 2015 02:37 am

I don't know if this makes you feel any better, but my docs all told me that it was pretty common for chronic hypertensives to have to up their BP med dose during pregnancy. That being said, being a chronic hypertensive does put you at higher risk of developing superimposed preeclampsia:
http://www.preeclampsia.org/forum/viewt ... perimposed

You could always ask your OB about the possibility of a baseline 24 hour urine collection test. My OB this last pregnancy would have me run another 24 hour urine test every time my BP started trending up, to see if my proteinura levels were also increasing (or not).

I would make sure to let the doc know about the increase in swelling at your next appointment. I had cankles for most of my pregnancies, but when I gained more than a few pounds in a day that was for me personally a sign of worsening preeclampsia. Please take a look at the signs and symptoms page if you haven't already: https://www.preeclampsia.org/health-inf ... n-symptoms

Let us know how you get on.
Hypothyroid mom to
Connor (severe pre-e at 38 weeks)
Claire (dx'd with pre-e and induction at 37 weeks)
Annabelle (chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)

Charmed
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Re: Chronic hypertensive at 27 weeks spiking BP.

Postby Charmed » Sun Feb 15, 2015 04:35 am

Doctor found no protein and normal BP at last appointment, and isn't worried! I'm still not sure, my measurements are still returning high 140/90s. Occasional headaches, but I am pregnant, of course, so there's that. Finally getting puffy fingers and feet, but of course it's about that time at 28 weeks! Hoping all remains normal and trying to remain calm.

Charmed
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Re: Chronic hypertensive at 27 weeks spiking BP.

Postby Charmed » Mon Feb 09, 2015 06:32 pm

Thank you for the response! I've stayed quiet most of the weekend (of course at 7:30 Monday morning, the dog had to tear a toenail off and send our Monday into a tailspin, sheesh!), so yes, as much self-imposed bed rest as possible. BP has been down to 130s/80s, but that seems suspiciously high for taking 200 labetalol twice daily, especially when it was 'normal' in the 120/70 range at just 100mg.

I have an appointment to see my OB this afternoon and hopefully get some answers then.

KetchupSpud
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Re: Chronic hypertensive at 27 weeks spiking BP.

Postby KetchupSpud » Sun Feb 08, 2015 10:01 pm

I don't think you're being too paranoid. There may be such a thing, but I think it's very far from where you are. :)

I think being proactive is a huge advantage and it sounds like you're doing exactly that. I'd say with where you are in symptoms, calling first thing Monday should be fine. (Good for you calling the on-call over the weekend!) They should run tests to look at protein and blood work and figure out a plan from there. Have you tried self-imposed bed rest to see if that helps keep your bp down?

Let us know what you hear from the doctors. Good luck!
Mama to Logan Patrick (8/23/14-8/26/14) & Bryce Anthony (8/23/14-9/13/14), frateral twins born at 23w5d due to severe pre-e turning into HELLP.
Hoping for a rainbow in Sept '16.

Charmed
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Chronic hypertensive at 27 weeks spiking BP.

Postby Charmed » Sun Feb 08, 2015 05:40 pm

Hello all!

I'm Beverly, 34 years old and 27 weeks with our first child, a boy. I was diagnosed with chronic essential hypertension in my early 20s and have been medicated successfully for about ten years. I'm otherwise healthy, at a healthy BMI, no smoking, etc. Just got the good genes from Mom and Grandpa.

That being said, we knew it was 'on fire' when we started trying to get pregnant, and we're lucky to have a conscientious OB who's kept a close eye on me and baby both during this pregnancy (lots of extra ultrasounds are nothing to complain about!), and we're both doing well.

In the midst of my 1st trimester, after I'd weaned off of lisinopril (very effective for me alone, but a risk for baby) in hopes that we could manage my blood pressure, we decided to go back to labetalol at 100m twice daily. This has been wildly successful for many weeks, with great measurements in the 120s/70s... until now.

Of course I'm in the habit of regularly checking my BP, and upon a regular check last night, I was suddenly at 143/96. I waited an hour and a half and measured again to find 122/92 @ about 11pm. At about midnight, I measured to find 150/110, repeatedly after ten minute intervals (and switching arms). I called the on-call OB, who advised to up the dose of labetalol to 200m, which I did.

This morning I continue to measure in the 130s/high 90s range, despite two 200m doses of labetalol in the last 12 hours. Husband and I even made a trip to the pharmacy down the street in case my home monitor was off - another measurement in the 130s/90s. We also looked for any urinalysis test kits, but nothing was available.

No other major signs seem to be presenting - I had a slight headache yesterday, tired after shopping for gliders, but otherwise fine. I'm urinating plenty regularly (baby boy seems to like dancing on my bladder), and he's moving and shaking as usual. That at least is comforting.

My concern comes from my past medical history and the rate at which preeclampsia can present and become dangerous. Our L&D hospital is a half hour drive away, though we do have other emergency centers close by. Am I being paranoid? I plan on absolutely calling for an appointment on Monday as soon as the office opens, but... is that soon enough? Can I BE too paranoid?


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