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High-Risk Pregnancy
Another Pre-E Question - Does your Doc communicate with you?
I'm 20 weeks and was just diagnosed with Pre-E. I don't like my doctor for a number of reasons (and kind of doubt the diagnosis) and am interviewing other doctors this week to try and switch.
To make sure my expectations aren't crazy - what happened when you were diagnosed? Did you doctor actually talk to you? (The nurse called and told me and said they'd see me in 4 weeks for my regular appointment, and to call if I had bad headaches or unusual swelling) Did they refer you to a high risk ob right away?
I know enough about pre-e from google, etc., but I'd like to the doctor to call me and say this is what this means, this is what we're going to do, do you have questions, % of premature birth is x, warning signs, etc.
They did say I had a mild case, so I'm not expecting that they would have immediately put me on bed rest, but it's also really early to be diagnosed, and at least some websites say early diagnosis = increased morbidity, so I'd like a modicum of hand holding.
I don't think I'm asking too much, but can you guys confirm whether or not my expectations are reasonable? thanks!
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Re: Another Pre-E Question - Does your Doc communicate with you?
Why were you diagnosed? How high was your protein? How high is your BP? Did you get put on meds? Did they suggest bed rest?
If you are diagnosed that early, I would be concerned that they are just letting you continue on with daily life. At 20 weeks, the baby can't survive. I would say bed rest is the best course because you have a long way to go. Not to scare you, but pre-e progresses really quickly and it needs to be watched definitely more frequently than every 4 weeks!
My doctor does not hold my hand and give me facts and figures, but he does take conditions seriously and we are always planning what the next step is. I also go into each appointment prepared with a list of questions and concerns for him to answer.
Ditto with JennlovesAustin.
My mom was dx'd at 20w with me and was put on bedrest immediately. No, her OB didn't give her all the facts and figures, but was concerned with her daily activities, etc.
And I would be asking the same questions about the diagnosis. Why aren't they having you come in earlier to discuss your condition? And yes, it can progress FAST and you need to be monitored more closely! Did they even send you to L&D for monitoring and bloodwork? I would be hounding the OB for answers.
My BP has been high at appointments (130/90 in first tri, 125/80 in second tri), but I've been monitoring my BP at home (with a doc approved cuff) and its generally been decently low (120/75ish, which is consistent with pre-pregnancy bp). I've had a couple high spikes the last week bc of stress (135/100) but they don't last more than 5 minutes. And the doctor said my bp was generally good.
My protein at a 9 week baseline was 283, and last week it was 350 (which prompted the diagnosis).
No meds, no bed rest, literally not a word about either, only "call if you get bad headaches or if your BP stays high"
I really want to ask the ob questions, but the nurse said there was no need for the appointment and I should just wait. Which wouldn't deter me if I really wanted answers, but I want to switch doctors, and don't want to invest a lot of time in this one anymore if I can switch.
Thanks for all the advice!
OK, so you most likely had hypertension/high BP before you got pregnant if you are starting off that high in first tri. With pre-e, your BP usually has a pretty sudden jump. Yours looks steadily high.
For mine, I baselined at 120/80 then up to 150/90, then at one appointment I was at 190/100 and I got put on bedrest. My protein was 241 so I am not pre-eclamptic yet, but they are constantly watching me. I monitor BPs at home and have bi-weekly growth scans to check on the baby. I am also on medication for the high BP.
If your doctor truly believes you have pre-e, then he should be doing preventative measures such as putting you on bedrest and a better monitoring program - at least bi-weekly. 20 weeks is WAYYYYYYY too early to have to have an emergency delivery so I would be doing everything in my power to keep your BP down and stay healthy.
I would think they would be seeing you more frequently! I agree that pre-e can develop really fast and you should definetely have spoken with your doctor about the long term plan! You should check out www.preeclampsia.org. they have experts and really great info on what to expect! I have elevated bp's and was put on bedrest at 27 weeks (I am now 32 weeks) and I am sure that it has helped keep things at bay! THis is my third bout of pre-e! I would definetley get yourself a bp machine for home and be very aware of visual changes, swelling and bad headaches! I would also request to see a high risk doctor since you are so early in you pregnancy! I am sorry that you don't like your doc! I would defintely not worry about demanding better care!!!! Good luck!
The only reason I'm not being seen so frequently is b/c I just got diagnosed at last week's appt. and got put on bedrest - and I'm already being seen again tomorrow, with a u/s. And I'm so far along that my OB can induce me at any point.
If I was 20w, however, that would NOT be acceptible!!
Good luck!
any preexisting health condition? high bp, thyroid, lupus, diabetes, obesity, hormone issues like pcos??? I would agree with pp who raised concern about chronic hypertension. sometimes people don't know until they get pg and start going on those appts and realize their pressure is higher than they thought. and then too, with a baseline 24hr urine protein level that high.. what week was that taken??? get a second opinion, request a referral to a perinatologist.
I was told my 1st was a "textbook preeclampsia case." I thought wth? lol. but I had a baseline of 90/60... started with mild labile pressures at 20wks.. (up to upper 120s/70s, then back down, yo yo) , N/V returned at 28wks, swelling started at 31wks, b/p started staying high at 32wks, headaches, seeing stars, visual disturbances, more wt gain and swelling spurts... all followed, spilling protein, then hyper reflexes and the pree anxiety that you just feel crazy... ended up delivering at exactly 37wks after a weekend long induction with 4+ protein and pressures in the upper 150s/120s and a mag sulfate infusion... had high b/p for about 6wks pp (really high with bottom number over 100 and nosebleeds and headaches for the first 2wks of that).
with ds completely normal b/p throughout, just saw stars throughout. 37wks hit, b/p was 106/60 or 70 at the appt.. 2 days later, headache, nosebleed, pressure up to 130s/90s... up and down, increased anxiety (I call it "THAT" pree anxiety), was induced within a week. never checked a 24hr urine. b/p normal immediately post delivery. 100/60s.
good luck. Hope you dodge the mod to sev pree bullet and have a healthy term baby. I agree with pp who recommended www.preeclampsia.org. Great support group.
Maybe this is me being stubborn (v possible), but I don't think I had preexisting high bp. my pre-pregnancy records showed all normal bp's, and i'm (relatively) normal on the home monitoring. It's only high at the doctors office.
I have no other pre-existing conditions, and I think (but could be wrong bc haven't been able to talk to doc) that they only diagnosed me based on the elevated protein levels, and not the bp, bc last visit they said the bp was really good.
glad to hear that bed rest seems to be so effective. honestly, i'm not sure i could mentally do 20-ish weeks of it, but good to hear that others have made it work.
i'll check out the preeclampsia.org website, i think i've looked at it before.
thanks everyone!! it really helps to hear about each experience.