FTM & 24 hour urine test. Help!

rice0308

I've had mild to moderate swelling for a few months, but my OB was never concerned. On Thursday my swelling got worse and I was in a lot of pain. I checked my BP at work and it was high. It's never been high. I called my doctor and her nurse told me to check again in the morning and if it was still high that I would likely have to come down for a check in the office and a urine sample. Well yesterday morning it was high. They found some traces of protein in my urine (also a first) and decided t was best to send me to L&D for bloodwork. I'm 35 weeks, will be 36 on Monday. Also, my OB had just went out of town and won't be back until Monday. They hooked me up to a monitor to check my BP every twenty minutes and also monitor the baby's heart rate. The doctor on call checked my cervix and I'm closed. My blood test came back fine. No signs of PIH (pregnancy induced hypertension). At 3pm they started me on a 24 hour urine test. My swelling has remained, but my BP has gone down. Not back to normal. But it has gone down and stabilized. They said the baby is fine. I asked the doctor on call yesterday what her thoughts were and if she thought I'd have to deliver early. She said she was a straight shooter and thinks that I won't have to and will likely be on bedrest until baby is ready to come. I've had three nurses since then and I just asked my current nurse how long it would take for my test results to come back. She said a few hours and asked if I was told I could go home after the test. I said that the previous doctor told me she was optimistic that I would. She responded saying something along the lines of "they may keep me at the hospital on bedrest and that I could potentially deliver early". I have no idea where she got that from as my BP has gone down and my urine test hasn't finished. I just feel like I'm getting different answers to my same questions. Most of what I know about his test and the results I found online. Most of what I read seemed to indicate that many women did their urine tests at home and were put on bedrest until delivery time at full term. Basically, I just want to know if this has happened to anyone else and if so, how was it managed and what questions can I ask to get a better handle on my treatment plan and what is happening to me. Any help is welcome!

JLW0504

I would ask to speak to the attending physician. Let him/her know you're getting mixed answers.

I've been hospital bound for six weeks now. As a precaution, I think you should stick around as you don't know what's causing the swelling. The baby I'm sure is fine but, you may not be. The 24 hour urine test results depend on the lab facility. If they're not back logged, it can take as quick as 30 min. otherwise, it could be a fee hours.

It's always best to play it safe. I hope all goes well and wish you a safe rest of your pregnancy and a safe delivery.

lmyrmo

It's too bad you are getting mixed answers. Swelling can occur with preeclampsia (PIH is an outdated term that would seriously concern me if my providers were still using it because I would have to assume they are not following current guidelines), but it is not part of the criteria for evaluation anymore. High blood pressure in the absence of a normal labs is gestational hypertension. If moderate and it doesn't escalate to preeclampsia (which is the bigger concern), it is recommended baby be delivered by 39-40 weeks. If severe or requiring meds, 37 weeks. And if preeclampsia occures, possibly sooner depending on severity. I would talk to your midwife or physician and get a straight answer. Unfortunately, there are a lot of practices that keep practicing like they were taught instead of following newer guidelines set by ACOG. I am not saying that is true of yours though. A lot of docs labeled women with PIH when I first started working as a labor nurse 9 years ago with one or two elevated bps and nothing else. The labor nurses knew it as "Please Induce Her" as this would get t b em out of loopholes for early (and convenient) reasons for inductions. I am glad to work a a midwife in a practice with physicians that are more careful about induction criteria.

lwentland

Not to scare you but it does sound like you are developing pre eclampsia. Symptoms can come on suddenly. I developed it at 39 weeks with my first. I had one slightly elevated bp so the 24 hour urine collection was ordered. As soon as my results came in my doctor recommended an induction. My son was born later that weekend, perfectly fine. I also have to be induced with this baby, next Sunday at 37 weeks. This time, it's more complicated and odd. I've had some strange test results (some things fine and some are pretty bad). I just have to trust my doctor despite the fact that I desperately wanted to go into labor on my own. Good luck to you!

Pontot31

I developed high BP during my last pregnancy and was able to keep it down at home on bed rest. I was put on bed rest just before 35 weeks and kept it controlled enough that I was allowed to make it to 41 weeks. The watched me closely for pre-e but I never developed it.
I did weekly blood draws and 24 hour urine collections and all of the labs came back perfect until the very last one at 40w5 days when I had a slightly high amount of protein in my urine blood test still came back fine, though.

One of the things that kept me from being induced was taking my BP at home 4 times and day when I was resting and logging it. I brought the log in to my appointments to show how it looked on bed rest. Luckily my midwife was happy to monitor me very closely rather than jump right to early induction.

I had a ton of swelling. I gained 75lbs and lost 40 right after the baby was born. The swelling mostly stayed in my feet, legs and hands, never my face.

This time I am luckily not having the same issues. But I do log my BP every day just to be sure and I bring it in to every appointment.
One thing that has helped me, I think, is being on the GD diet. The higher protein and less sugar and carbs is keeping my swelling away completely.

vomitrosa

I'd like to tell you not too stress or worry too much (but every doctor is different) I was hospitalized for monitoring with my first for the same reasons...they had me stay twice for a 24 hour period...do the urine and blood...and baby was absolutely fine. When they say deliver early....they will definitely try and prolong you as far as possible past 37 weeks if they can. I ended up.not delivery early, DD came on her own at 38 weeks. This time around its the same....I have blood every 3 weeks, I've done 3-24 hour urines and I get NST's twice a week due to the high BP. They won't let me go to 40 weeks but hoping he will come naturally before that. Its definitely scary but it sounds like they're saying baby is fine so that's great.

jln114

Thanks for sharing, everyone. My bp has been slightly elevated for the past month (I'm 33w4d) and I've done two 24-hour urinalysis plus lots of bloodwork. The protein is just a little high and everything else looks good, and baby is measuring fine & looking healthy on a growth scan. So we're just keeping weekly appointments, going to L&D on occasion, and hoping she stays healthy inside me for a few more weeks. It's scary not knowing. One little silver lining is I have bronchitis and have been ordered to stay home from work this week, so I hope that rest helps too. Sending well wishes to everyone.

rice0308

Thank you all for your replies!! I was sent home Saturday evening after my nurse went to bat for me. The rule was that I had to come back Sunday morning for another NST and urine test. Both of those went well. No contractions, baby is healthy and active, and there wasn't protein in my urine. I was sent home after about two hours and was put on bedrest with bathroom privledges and advised to follow up with my OB on Monday. She was out of town all weekend so I really didn't know what was going on and was very scared. Her nurse called me yesterday and told me to remain on bedrest and they will assess me at my regular appointment which is tomorrow. I have a feeling that I will be on bedrest for the remainder of my pregnancy. The on call physician used the term "gestational hypertension" on Sunday. From what I've gathered, baby can still come at any time. I'm praying that I can still deliver vaginally.