Last 2 days in L&D...PIH (looong vent)

Mrs. Braxton

I've posted a bit over the past couple weeks (only on 3rd tri, i think) about some issues I've been having with blood pressure. It's seemingly come out of no where. I've never had high blood pressure prior to this pregnancy and up until 3 weeks ago it was great! I went in for a regular OB appt and it was 116/64...two weeks later, at my next appt, it was 144/90 and hasn't come down much since. I was started on 250 mg of Methyldopa 2x daily (which I am told is a very low dose.) I've also been monitoring my pressure at home. A few days after starting the medication I noticed an improvement...then my pressure started to creep up again and within a week (and just in time for my next OB appt) it was at 140/100. Over the past 3 weeks I have also completed 2 24 hour urine collections and 2 sets of bloodwork to check for Pre-E. I was told both 24 hour urine collections and bloodwork came back normal.

On Friday I went in for for a follow-up to check the progress with the blood pressure. I met with someone other than the doctor I usually meet with and when she saw my blood pressure had not come down she sent me right to L&D. The lab I'm usually sent to for 24 hour urine & bloodwork is closed on Monday and she said she wanted the results before Tuesday. So I was admitted around 10:30am Friday. I repeated the 24 hour urine. It came back normal...they did not tell me the numbers (I intend to ask my doctor Monday) but did say it was in the "normal range." They did two sets of bloodwork (one Friday and one Saturday) and said that most of the tests came back great but there were some numbers that were slightly elivated but not enough to keep me (again they didnt say what numbers...I will ask my OB Monday). They sent me for an ultrasound. I was told baby looked good...amniotic fluid was slightly lower than usual but still in the "normal range."

I was hooked up to a fetal monitor and some machine that checked my blood pressure every 15 minutes. They left me on this machine for like 4-5 hours. Baby's heartrate was great the entire time. My pressure varied but did stay under the 140/100 mark it was at earlier except for when the dr that had sent me to L&D came to visit me (then it shot up to 148/101)...10 minutes after she left t was 135/78.  After all this they took me off the blood pressure monitor but did two other NSTs (one last night, one this morning). They gave me two shots (one yesterday one today) to help baby's lungs devolop in case she needs to be delivered early (that really freaked me out) and upped my meds (250 mg 3x daily) abd made me a follow-up appt with my OB Monday. I was told no work on Monday and I'm not on strict bedrest yet but was told to "limit activity," and that bedrest may be in my future.  

I'm usually not a whiney person but this is all just so frustrating! I feel like everyone is being so vague (with giving me the lab and urine collection #s and with the amniotic fluid issue) and it's just freaking me out more. I know I'm probably stressing a little more than I should be but I would just like one of these doctors to give me an honest opinion so I can prepare myself for whatever is to come. Everytime I'm sent for these tests they make it seem like such an urgent situation and when the test results come back act like it's noting. As much as I'd love to avoid PIH devoloping in to Pre-E, if that's what they think may happen I need to know so I can prepare myself (and my job, family, ect) for what may be to come and so I can ask all my questions about what happens if it does turn in to Pre-E. I don't want to play the "what if," game unless I know it's a legitimate concern. So, far I've met all but one of the OBs and midwives at my practice and I've loved them all! They've all been great but now that theres a potential concern I feel like they're keeping me in the dark about it. So, do you think I'm being the super-annoying over concerned first time mom or do you think these are valid concerns and I should bring this up at my appt on Monday?

bump54321

Well, I've had a similar experience.  Except, I've been in and out of L&D 3 times in the past 3 weeks (2 times for overnight stays)....all for high blood pressure.  I'm also on bp medicine and after about two weeks, my bp starting creeping back up so I ended up in L&D again and my medicine was increased.  My bw has come back normal except the last time the nurse said there were some things that came back slightly abnormal, but "nothing really stood out." WTF does that mean?!  All of my 24 hour urine tests have come back normal, though slightly elevated (i.e. under 300 but there are still proteins), which means I do not have pre-e.  However, I have been on strict bed rest since I first went into L&D on 12/30 and my OB seems to intend to keep me on bed rest.  What she has told me is that she expects to have to deliver the baby early (I've had the steroid shots for baby's lungs also), and that I can expect to probably be on hospital bed rest at some point during my pregnancy.  I've also been referred to a perinatalogist to monitor the baby's growth, blood flow, etc. and to make sure the placenta isn't deteriorating.  And, I've basically gathered that the high blood pressure can develop into pre-e at anytime.  So, I'm on the strict bed rest "until further notice" so that my blood pressure stays low and that helps the pre-e from developing.   In my situation, laying on my left side and keeping my feet elevated significantly keeps my blood pressure down, but as soon as my feet hit the ground my blood pressure gets high again.

 

So all of this is to say, I completely understand where you're coming from.  I think you've got reason to be concerned.  And I think you should start thinking about the fact that you may be placed on bed rest even if your condition doesn't actually develop into pre-e, because the high blood pressure in and of itself is dangerous.

grapeape73

It is frustrating and I understand where you both are coming from.  I spent 8 weeks doing that same thing.  Mine started about 28 weeks  and nothing would control my BP except strict bedrest.  I was in and out of the hospital more than 12 times.  I'm glad your OB is being proactive. BP is something you don't want to mess around with. 

My father is a doctor and when he heard what my BP was when I was taken by ambulance to a hospital with a higher risk NICU he wanted me delivered that night. 

Apparently BP issues can manifest in a lot of different ways. Some women have super high BPs.  Some have normal BP with tons of proteine.  Some have great urine and BP , but their creatinine levels are awful.  Sometimes it is only the baby that is affected.  BP problems seriously comprimise the placenta, that is why they are doing so many NSTs and u/s. 

I would think that judging by your numbers that you will be on bedrest sooner rather than later.  the meds never could control my BP with DD.  This pregnancy so far they are working.  With my last pregnancy my BW and 24 hour urines were great, but my BP was beyond horrible if I was up at all. 

Good luck.  I hope you get all the answers on Monday.  

 

Julia-Henry

I agree with the previous posters. I'm just beginning to deal with PIH for this pregnancy, but had a very bad experience with it when I was pg with #1.

I never developed pre-e, had great bloodwork and felt fine. I just had very high BP numbers and was told to 'take it easy' - not bedrest, but limited activity. I did this from weeks 33/34 to 36/37, when baby movement started to slow down. At 36w6d, Ds stopped moving. We went into L&D, where they pumped me full of juice and, after 2 hours on the monitors, sent me home. He started kicking again about 30 minutes into the juice, and I was told to monitor movements and come back if it happened again. I was back 48 hours later, hooked up to the monitors for 10 minutes, and then on my way for an emergency c/section.

As soon as ds was born, he was fine. My PIH vanished after the birth, and all ended well. But it was very scary. During trip #1 to L&D, I was told to do 3 kick counts a day, and that I could drink juice or eat, but that poking my stomach to get baby to move did not count. For me, PIH wrecked the placenta and put ds into serious distress.

I'm being very careful this time. I'm already doing multiple kick counts, and I am much more worried about what might happen. I suspect that I won't make it to my scheduled c/section, although I hope that I get to full term.

I don't know if this is at all helpful. The one thing I can add to the other posts is to make sure you do kick counts or otherwise monitor movement. If I hadn't, my son would have been stillborn due to PIH.

Good luck. I hope your experience goes very well.

RoxBride

You don't need to know the numbers.  Your job is to do the tests and rest and wait for your doctors to tell you something else.  You can't interpret the numbers on your own, they are complex, and all need to be factored in consideration with all kinds of additional information.  Low amniotic fluid, for example, all depends on if the levels are changing, how it was measured, the position of the baby, etc.  Let them worry about the details.

With a situation like yours, they are likely just monitoring you very very closely.  They'll take all the information they have, and no one can guarantee the outcome.  It just has to go day by day.  See what your body does, try and keep the situation managed. 

Hang in there, I know it is rough, but just take it easy and see what happens at your appointment.

romans_baby

I had Pre -E with 3 of my 4 babies. I am already showing signs of having it again. The weird thing is, I only get it when I have a boy. It was perfect when I had my girl.

 Anyways with my 3rd I went into labor with Pre-E  and my BP was 165/125 way too high. Don't worry too much unless you stop feeling movement or have bleeding.

Hope things go better for you!

The longer baby stays in the healthier it'll be 

 

 

 

orthomom

I am a doctor and had PIH with my first pregnancy and they never told me the numbers unless I specifically asked.  I actually know what they mean, too.  Most doctors assume you don't know the numbers' meaning so don' t bother to tell you.

It sounds like you are doing fine, but things can change in a heartbeat with PIH and Pre-E so they are monitoring you closely.  Try to relax...stressing about it will not help you.  There is no way to predict how things are going from any one piece of information. My situation was very similar to yours (2 hospitalizations) but I was put on strict bedrest from the moment my BP went up.  It was fine one week and 180/100 the next week.  The nature of the disease is its sudden onset and its unpredictability.  My prepared for possible strict bedrest at any time since you are still pretty early.  A lot of meds don't work for PIH so it isn't a big surprise the methyldopa isn't helping much.  They didn't even bother with meds for me just bedrest which kept my pressures in the 120-130's/70-80's.  my DD was born (induced) at 36 weeks 0 days and was perfect at 5lbs 1oz.  She is a four yo dynamo and brilliant child now.  Try to relax and just do what you are told.  Good Luck.