POTS diagnosis at 20 weeks

tygraa1

Hi all, I am currently 20 weeks pregnant and was just diagnosed with POTS. My symptoms started 5 weeks ago. My doctor believes the flu shot aggravated my immune system which in turn has caused something to go awry with my autonomic nervous system. I am now considered high risk in my pregnancy because of the low blood pressure and tachycardia. There is really no info on the Web regarding this condition while pregnant and my OB hasn't ever had any patients with this condition so I'm pretty scared at this point. Have any of you ever went through pregnancy and delivery with this? I really am curious to know about delivery, is a vaginal birth going to put me in jeopardy or should I push for a c section? Because this condition is rare and not much is known about it, I feel like I have to inform the doctors about everything I can find on it and what's the best course of action for me and the baby. Any info or advice would be greatly appreciated.

scubakate

I've had POTS since I was a kid and also have Ehlers-Danlos Syndrome.The biggest thing is stay hydrated and change positions slowly.  They'll also have to be extra cautious with an epidural, our plan is for me to get 2-3L fluid bolus first and for them to start with a very small dose and gradually increase the dose as my HR can tolerate it. POTS doesn't usually have the drop in BP, that would be more orthostatic hypotension.  POTS is diagnosed when there is a sustained HR >30bpm above resting baseline with a change in position without the accompanying drop in BP seen in orthostatic hypotension.  I wouldn't necessarily push for a c/s since there's more risk for blood loss etc, but I suggest talking with a MFM doc about that.  

Here's a good link for information though it can be a bit technical.

https://crm.cardiosource.org/Learn-from-the-Experts/2013/02/POTS-Diagnosis-and-Treatment.aspx

Did you have a tilt-table test?

tygraa1

@scubakate‌ No, I haven't had one yet. I see the cardiologist next week but I'm not sure what they are going to do, of anything, noone here seems to know what this is or how to go about treating it. My PCP thinks I can have a normal labor and delivery without any special precautions put in place. I am really scared and don't know what to do at this point. My BP drops sometimes but only when I'm sitting still. It has also went up at times when I'm taking my BP standing. My resting hr is about 77 laying, 90 sitting and 115 to 120 standing. If I walk, say 20 feet, my heartrate jumps even higher, to about 135 or so and immediately drops back down once I sit and I get terrible heart palpitations when my heart rate goes up. It's all so confusing and frustrating.

scubakate

@tygraa1

I would try and relax the best you can.  It's not the end of the world, although it may seem like it.  I would do some research, check out that link I posted and do more on POTS and pregnancy.  It isn't all that uncommon in pregnancy and in women, it's just not always given the formal name.  You'll be ok

soontobemomof6

I struggle off and on with POTS; hydration is the biggest key for me!!