Difference between PIH and Pre-E?

StarryNight39 · January 2010

I was just released from the hospital after 2 days with a dx of PIH and strict bedrest.

I had an awful experience in the hospital and am so clueless about what is wrong with me, the dangers, etc. And I won't see my OB till tomorrow.

So what is the difference? Is PIH dangerous? My 24 urine came back @ 284. (Not sure if that is good or bad) Will they induce early because of PIH?

bump54321 · January 2010

Generally PIH and Pre-E are two terms for the same thing from what I understand. Did you have high bp AND proteins in your 24 hour urine sample?

pumpkinwife07 · January 2010

I had PIH and was induced at 36w2d. DD arrived two days later. Every doctor is different. My pressures were creeping up even higher... I was around 150/90 - sometimes even higher. Before getting pregnant I had LOW BP.

I wasn't diagnosed with Pre-E until after DD was born. We were home for 4 days when I felt sick. BP was 205/114. Spent the next 3 days in the hospital on magneseum (sp).

Good luck. It's scary, but everything will be fine. I was thrilled to be induced. I knew the baby was going to be ok and that she was safer on the outside and I was better of not being pregnant anymore. Thank god I was induced. Things post delivery turned bad for me quickly.

Keep us posted!

StarryNight39 · January 2010

I had high BP @ the office 164/109 which got me a trip to L&D and a 2 day stay. On hospital bedrest the numbers went down to 130's-140's to 70-high 80's. They were only seeing a trace protein when they dipped it.

StarryNight39 · January 2010

pumpkinwife07:
I had PIH and was induced at 36w2d. DD arrived two days later. Every doctor is different. My pressures were creeping up even higher... I was around 150/90 - sometimes even higher. Before getting pregnant I had LOW BP.
I wasn't diagnosed with Pre-E until after DD was born. We were home for 4 days when I felt sick. BP was 205/114. Spent the next 3 days in the hospital on magneseum (sp).
Good luck. It's scary, but everything will be fine. I was thrilled to be induced. I knew the baby was going to be ok and that she was safer on the outside and I was better of not being pregnant anymore. Thank god I was induced. Things post delivery turned bad for me quickly.
Keep us posted!

I feel really guilty, but I am going to ask tomorrow about being induced @ 37 weeks. My first daughter was born @ 35w (and was fine, no NICU needed or anything) and my second was born @ 37 weeks and also was fine. I just am worried sick about the high BP and my baby and me, which in turn I am sure rises my blood pressure.

aocain02@yahoo.com · January 2010

I've wondered the same thing. I've had high BP since the 1st tri and my OB never gave me a diagnosis of anything except I have high BP and not to go online reading about pre-e. I was put on meds that kept it under control until I hit 34 weeks then at 35 weeks my BP was 140/94 and the nurse asked if I was trying to have this baby early. Monday at my appointment it was up to 148/98 I think and my OB didn't say anything about it. I am scheduled to be induced Monday night if I haven't had my baby by then since I'll be 41 weeks so I'm thinking maybe that's why. I just hope it goes back to normal after I give birth.

Julia-Henry · January 2010

jsmott76:
Generally PIH and Pre-E are two terms for the same thing from what I understand. Did you have high bp AND proteins in your 24 hour urine sample?

Not quite. PIH is just high blood pressure due to pregnancy. Pre-E is high blood pressure, swelling, protein in urine, and potential organ failure. Often, PIH comes before Pre-E, but some women develop PIH and never move into Pre-E.

If you have the blood pressure issues AND protein in urine, then you're usually considered to have Pre-E, or to be borderline.

If you just have PIH, then they'll monitor you for problems. With Pre-E, it depends on how 'bad' your symptoms are. PIH is still dangerous, but usually not as risky as Pre-E.

bump54321 · January 2010

StarryNight39:
I had high BP @ the office 164/109 which got me a trip to L&D and a 2 day stay. On hospital bedrest the numbers went down to 130's-140's to 70-high 80's. They were only seeing a trace protein when they dipped it.

I've had the same thing. High blood pressure and elevated proteins, but not high enough for a Pre-e diagnosis. So, I've been diagnosed with chronic hypertension as opposed to PIH (even though my bp wasn't high before pregnancy) because my proteins from the 24 hour urine sample weren't over 300. But, I think every doctor handles it differently. I'm on strict bed rest and blood pressure meds. Seems to be working and LO has been looking great.

bump54321 · January 2010

Julia-Henry:
jsmott76:
Generally PIH and Pre-E are two terms for the same thing from what I understand. Did you have high bp AND proteins in your 24 hour urine sample?

Not quite. PIH is just high blood pressure due to pregnancy. Pre-E is high blood pressure, swelling, protein in urine, and potential organ failure. Often, PIH comes before Pre-E, but some women develop PIH and never move into Pre-E.

If you have the blood pressure issues AND protein in urine, then you're usually considered to have Pre-E, or to be borderline.

If you just have PIH, then they'll monitor you for problems. With Pre-E, it depends on how 'bad' your symptoms are. PIH is still dangerous, but usually not as risky as Pre-E.

I guess it depends on the doctor and that I'm just as confused about this. My doctor diagnosed me with chronic hypertension rather than PIH even though my high blood pressure didn't happen until after 20 weeks and I didn't have high blood pressure before. She said that the other test she ran didn't indicate that my hypertension was pregnancy induced. I've done some research and it seems as if everything I read says something different.

NastyAnnie · January 2010

Starry, according to my OB's visit yesterday (the basically pointless one..) there is a difference in PIH and Pre-e, but it's slight, and generally they are handled in the same fashion once you are as far along as we are.

For my office to consider you Pre-e, your protein count must be between 300 and 500. You just missed it. Congratulations! I did too. my levels read out at 270. So, for now, we are PIH, being closely monitored for Pre-e.

In a lot of cases PIH stays PIH and never goes past that. In some cases, it is a pre-curser to Pre-e. PIH can have a lot of the same symptoms as Pre-e, apparently (see, swelling, headaches, protein in urine, etc), and according to my doctor, it is the severity of said symptoms that distinguishes between diagnoses. So, if you end up with MORE protein in your urine (ie, passing the 300 mark) and/or, higher pressures, more swelling, worse headaches, more vision problems..etc... a pre-e diagnosis is likely.

That being said, I wouldn't feel at all guilty about asking about induction. My doctor's office plans, with a simple PIH diagnosis, to schedule my induction as soon as I hit 35w 3d, progress or none, and that is if everything stays the same as it is now (as in, doesn't get any worse). If things get worse, they will consider inducing prior to that point. At 37 weeks you'd be full term anyway, so let your doctor know it's on your mind.

Also, let someone know about the absolutely horrid way you were treated in the hospital. That is still irking me, and someone should lose their job.

StarryNight39 · January 2010

Thanks, everyone!

Annie, I meet with *my* OB tomorrow, and I am hoping to get more answers then, but what you said makes perfect sense. All the Dr's and med students said we would induce @ 37w, but they're not my doctor, so I am hoping she feels the same way.

As far as the treatment I am definitely saying something! I'm deciding if I should wait till AFTER I deliver (Dave doesn't want me to do it now and get black listed/treated badly when I deliver) or if we should do it now. I'm going to talk to my OB about it tomorrow though.

NastyAnnie · January 2010

I can see where Dave is coming from, but I would definitely at the very least bring it up to your OB. That is absolutely unacceptable.

And, yeah, especially considering your history of early births, I would say your OB probably would have brought up induction anyway. I was told by the (many, numerous, and varied) NPs and OBs I have seen since last Wednesday that in a PIH situation, getting past 35.5 weeks is gravy. Like, if we make it that long (as we hope to do, especially since Bun absolutely refuses to set up the pack n play yet...) it will be a total success. So I think induction at 37 would be more than appropriate, considering that, at that point, not only is it safer for LO to be out than in... but the risks of being out at 37 weeks are soooo minute.

Of course, I'm not an OB, but by now I've asked enough of them (I think we're going on 5) that I feel like an expert. :P

StarryNight39 · January 2010

I will definitely tell her tomorrow, and probably write a letter while I am on BR and send it once I deliver And like I told Dave yesterday, if I had a baby with me I probably wouldn't have noticed the little things. But most of the things were unacceptable!

I have an appointment @ 10:30 tomorrow morning so i'll talk to her then. she is due 2/20 herself so I am not sure what her plan of action is going to be. My labor buddy and I both go tot the same office and she had literally the EXACT same dx and her OB (one who was covering in the hospital) put her on bedrest and induced her @ 37 weeks. So hopefully that's what we are doing as well.

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