POTS- BP bottoming out? — The Bump
High-Risk Pregnancy

POTS- BP bottoming out?

I am a first time mom, currently at 17.5 weeks and considered high risk due to suffering from Chiari Malformation and Syringomyelia. I also suffer from POTs which basically means my BP drops or bottoms out and my hr dramatically increases. I haven't had any issues during my pregnancy (surprisingly) up until this week. I have started getting dizzy and have come close to passing out a few times. Luckily, I know my body and have been able to prevent any major events. I spoke with my doc and they want me to monitor for a week.. the only solution they have is a steroid treatment, not ideal for a pregnant lady. I go back to the high risk doc on Monday but was curious if any one else suffered from this and if any one had any advice or things that might have helped their situation. I am very lucky to have had an easy pregnancy thus far and if this ( and the dreaded, omg i'm dying heartburn) is the only major issue I have, I'll take it. But any advice would be greatly appreciated!

Example of my BP:
this morning,  laying down was 104/52 with hr at 80, sitting went to 97/44 hr at 79 and then standing went to 103/55 with hr to 119. BP remained pretty stable but my hr is my main concern right now. BP has been all over the place though since I have been trying to control it. Ha. 

Re: POTS- BP bottoming out?

  • babylimasbabylimas
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    edited January 2014
    One of sisters deals with POTs (among other heart issues.) I'm glad you aren't having many issues during the pregnancy! That could be rough.

    Just in general, I had those same symptoms early on without any overriding issue. Just to reassure you some, at your point in pregnancy it can be normal to have those spells. I had a number of fainting spells and have random blood pressure drops. I'm sure your situation is much more serious, I just wanted to mention that there could be a degree of normalcy to it so you don't feel too nervous! Though I'm no doctor. ;)
  • jg1011jg1011
    250 Answers 500 Love Its 1000 Comments Third Anniversary
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    edited January 2014
    I don't have POTS, but rather NCS where both BP and HR bottom out. I had a relatively uneventful 1st pregnancy, but was monitored super closely. My 1st tri was the worst---on top if low bp and dizzy spells being a normal side effect of pregnancy, all the hormones sent my autonomic system and therefore my NCS into a tailspin! I ended up getting IV infusions to keep my blood volume up. It didnt matter how much water I drank, it wasnt enough. So we did two liters of IV fluids every three days.

    As soon as I was about a week into 2nd tri, I felt MUCH  better. We did IV as needed. I still had moments where I had issues, but not too awful. 

    Third tri I had issues again. That's when pre-eclampsia started too. My electrophysiologist and both my OB's (high risk and regular) felt this was due to all my autonomic stuff. I ended up delivering at 35 weeks.

    I had significant issues POST delivery. It took a good 6 months for my symptoms to stop flaring. My BP would go from too high to too low and then back to too high....it was nuts. Again, all hormones (and likely sleep deprivation added to it!). Once I got past that 6-8 month time, it did get better.

    Also wanted to add that I have a pacemaker so that helped tremendously with my issues as well. 

    Good luck! 


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  • I went to the High Risk DR yesterday. They want me to continue to monitor, I have to get up and down a certain way and they want me to wear compression socks when I am on my feet for long periods. 

  • I have vasovagal syncope (fairly mild) and I suspect I also have POTS as well.  Around 16 or 17 weeks I started experiencing the same thing you are.  I would have to sit down multiple times in the shower to keep from passing out and I had to bring a barstool into the bathroom so that I could get ready in the morning.  It was the worst I've ever felt since I was officially diagnosed in 2007.  Around 25 weeks it disappeared and I felt normal the rest of my pregnancy (and ever since). 

    I told my OB about my issues and he said it must be an inner ear issue and that if it continued he would send me to an ENT.  :-/  Yeah, he didn't get it even though I explained to him what VS was, so I stopped mentioning it to him since I knew how to control it.  Throughout my pregnancy my BP was always around 90/65, but it did creep up a little bit towards the end. 

    One thing to be aware of is the effect epidurals can have on BP.  That was the main reason I wanted an epidural free birth.  Do some research on POTS and epidurals and bring it up with your OB (if you want an epi, of course).  There are ways they can try to prevent the BP drop.  

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  • My way of delivering has yet to be determined. I had brain surgery in 2009 due to the two disorders I mentioned and due to my bovine patch, I am technically not suppose to push or cause any increase in inter-cranial pressure. I am 99% sure that I will be having an epidural no matter what... and so far it looks like most doctors are recommending c-section. No decision will be made until after we speak to the anesthesiologist team and see their opinion. So I'm sure my POTS will be all over the place. As long as baby is healthy, I'll take the pain. 

  • I had to go c-section. No choice. My EP, anesthesiologist, high risk OB, and reg on all agreed. They felt the pushing could make the BP unstable and if it suddenly dropped and i passed out or spiked and i seizured we would be in trouble, especially if baby was in the birth canal already.

    The anesthesiologist was very concerned about epidural dropping my BP so he started 3 IV lines in case. In the end my BP did drop, but he was able to medicate me. Like I said earlier, dealt with wide BP swings post partum. Took months to level out. 
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