PIH -What's the protocol for detection/action?

Do you have a burning question you just have to ask our Medical Board Experts about hypertensive pregnancies? Please email your question to expert@preeclampsia.org Keep in mind, however, that we won't be able to answer every question and our docs can't offer medical advice and won't be able to comment on specific medical cases.
expert on call
Registered User
Posts: 297
Joined: Sat Feb 15, 2003 09:30 am

Re : PIH -What's the protocol for detection/action?

Postby expert on call » Tue Aug 03, 2004 10:32 am

The fact that you have had multiple high blood pressures on different occasions is quite concerning, even without the appearance of protein in the urine. Typically even very conservative physicians would begin treating blood pressure that gets up to the 160/100 range or higher. While there are no definite protocols about treatment of high blood pressure in pregnancy it is probably time to begin taking action in terms of treatment with medications or consideration of delivery

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.

Registered User
Posts: 10
Joined: Thu May 13, 2004 12:53 am

PIH -What's the protocol for detection/action?

Postby dmatisse » Sun May 16, 2004 04:55 pm

I am currently under the care of a high-risk Dr. and have been on Bedrest since Week 23 (after a Preterm labor/incompetent cervix debate - my closed cervixed had shortened from 4.1 cm to 1.5 cm between u/s week 20/23)

2 weeks ago I had a spike in my BP 180/110 (I've spiked 3 additional times 160/100 range) while at the consulting Dr.'s office (we all laughed about my "white coat" syndrome.) The BP did go down after lying down for 5 minutes. {130/80) 1 week ago it read 150/90 at my usual Dr.'s appointment, again going down after lying down. Then on this last Thursday's appointment I spiked again, at the consulting Dr.'s office to the 180/109 range.

I've got a home monitor that shows readings of 130-150/80-90s anytime I get out of bed (taken sitting after 3 minutes rest - but when lying down after 5 mintues I would get lower readings.) During the last 3 days the readings are higher 140-150's/80-99's and take longer to go down and now hang at about 135/85.

I didn't know what tests are used but I've had Lab work done twice with "no significant lowering of my platelets."

My question is - what protocols are in place for my situation? My baby girl is now 32 weeks +3 showing normal growth (30 percentile) at my last u/s. Amniotic fluid 14.5/diastolic reading 1.9.

I'm nervous about waiting to "get critical" before action is taken - and yet I obviously want Sarah to get all benefits of being in my womb.

What lab tests should be done? Are there criteria to induce based on those tests? Are results quick enough to act? I also purchased Albustix (Reagent Strips for protein in urine.) My urine has consistently shown "none" for the last 3 days... however today it indicated Trace (the scale is: none, trace, 30+, 100++, 300+++, over 2000++++. I'm not sure how that corresponds to the 1+, 2+, 3+ I've been reading about.)

The part that is hard to manage besides the issue of exchanging one "problem" for another, (I had such huge relief about getting to week 32 with my crazy cervix to then hear my consulting Dr. say, "I don't think we'll be delivering because of your cervix - I think we'll be delivering because of your high blood pressure.") I really had NO IDEA about PIH, Pre-Eclamsia, HELLP and Eclamsia prior to one weeks ago and the consulting Dr. didn't do urine or order blood work - he just released me back to my Dr. who was on vacation saying he was diagnosing pro-active hypertension (I react to stress and activity with hypertension).

I the nurse at my Dr.'s office and assertively asked for "the appropriate" tests to be run. At this point I know I need more education and to feel more confident about there being a plan of action/observation and feeling confident to "catch" this all in time.

I certainly appreciate and value any and all information.

Return to “Ask the Experts”

Who is online

Users browsing this forum: No registered users and 2 guests