Cross Posted, Help, don't know if I'm getting good care!

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Re: Cross Posted, Help, don't know if I'm getting good care!

Postby adickerman13 » Thu Nov 17, 2016 01:21 pm

Thank you for posting this. You basically asked all of the questions I have and have all of the concerns I have. My husband and I are discussing the possibilities of conceiving and I have the same plan as you! I am currently working on my own health first. How did everything go? Did you have your second child?

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Re: Cross Posted, Help, don't know if I'm getting good care!

Postby theyabutfamily7 » Tue Feb 23, 2016 10:00 pm

Oh awesome, thank you for the links!

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Re: Cross Posted, Help, don't know if I'm getting good care!

Postby alviarin » Tue Feb 23, 2016 06:17 pm

I would also be nervous waiting a month for my next appointment.

Does the MFM know your pressures have been running higher? Can you try to get in to see them sooner, to ask how frequent your appointments should be? Or even just call and ask to speak to the nurse at their practice? During my second pregnancy my OB kinda blew me off as a "worry wart" even when my pressures were trending up; however I requested a referral to a MFM based on some high pressure readings and the MFM laid out a more frequent monitoring schedule that the OB was then obliged to follow.

Something else you could ask your midwife is about a 24 hour urine test. Even if they don't think you are preeclamptic, it might be good to have a baseline to compare to later.

The ACOG Working Group report on Hypertension in Pregnancy recommends "The close monitoring of women with gestational hypertension or preeclampsia without severe features, with serial assessment of maternal symptoms and fetal movement (daily by the woman), serial measurements of BP (twice weekly), and assessment of platelet counts and liver enzymes (weekly) is suggested.
Quality of evidence: Moderate Strength of recommendation: Qualified" ... -Pregnancy

For some references on how to monitor blood pressure:
viewtopic.php?f=19&t=321 ... syhKulX45Q
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)

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Cross Posted, Help, don't know if I'm getting good care!

Postby theyabutfamily7 » Mon Feb 22, 2016 10:57 am

Hi There, I need advice!

So I had Pre-e with my son who just turned four, and am currently 28 weeks pregnant.

I had severe pre-e with my son, he was IUGR severe, 33 weeks, and my pre-e probably onset at around 28-30 weeks. We caught it around 31 weeks when I was hospitalized for IUGR and borderline high BP.

So question is, how should this pregnancy be managed? I am concerned so far because my blood pressure has been hanging out rather high since around 22 weeks, (130's over/90s) and is now progressing even higher, (140's-150's still over 80-90). They also seem to be sporadic. In the morning it will generally be lower, and increase in the evening, but usually by laying down and resting it will go down.

I've had labs, and just had a growth scan, so far, both of them look good, and no one is concerned about my blood pressure. I'm not supposed to go in for another growth ultrasound for another 7 weeks, which concerns me, because I'll be 34 weeks then, and things could easily develop in between then and now. My care providers (midwives supplemented by MFM) seem to think that I just shouldn't check my blood pressure all that often, (2x daily and only after resting for 30 mins) because I could be artificially elevating it by worrying about it too much. (Which I really doubt is the case). It was low before, and my midwife still hasn't increased frequency between visits. I'm not supposed to be seen again after this 28 week appt untill 32 weeks, and the midwife probably won't even take my labs.

I called to ask about my blood pressure tonight, and what should I do, was told to come into L&D to be checked, they did a strip on my baby and then no labs, measured BP after laying down and sent me home again.(I had to bring in my 4 YO and stay from 10-pm-almost 2 am) I'm just really frustrated and feeling like I'm not getting good care.

So my question for you all, what is good care for catching sudden onset Pre-e? How often should I be seen, what should be looked for, and how seriously should I take my BP readings as an indication that I'm developing Pre-e. Is it a good idea to only take my BP after resting for 30 min? How often should I be taking it daily, and in what position/arm. What is cause for going in to the hospital after hours to be assessed? Cause for hospitalization? I'm confused, and I don't like how things are being handled, because no one can seem to give me a straight answer to any of my questions, and seem to instead be focusing on the fact that I have anxiety as a means to dismiss symptoms. (I do have an anxiety disorder, but I feel able to distinguish my own panic attacks from legitimate concern as to my care. Panic attacks are very distinct!)

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