Experience with HBP during and after pregnancy?

PennyLane26 · October 2013

Hey gals! You may or may not remember that I was induced with DD because of HBP but was sent home when G was born and not diagnosed with pre-e until a week postpartum, needless to say I had some very serious complications and had to be hospitalized when DD was 5 days old. I also had GD, but that went away postpartum.

I am now 6.5 months postpartum and blood pressure is still high. I had NEVER had high blood pressure in my life until I was 36 weeks pregnant. OB originally said it was pregnancy related and should go away in the months after G's birth. Well, it hasn't - boo! I knew this would be a possibility because HBP runs in the family. I am on meds twice a day to help control it. On average it is around 140/110 without meds and 120/75 with meds. My PCP says it's now chronic and I will probably have to take meds for it forever. Stinks... but G is a fabulous trade off

I'm just wondering what pregnancy is like with HBP. It's been on my mind a lot lately as we start thinking about a FET in the new year. Obviously I had it in late third tri, but what's it like to have it early in pregnancy? Will I have to see an MFM or just my OB as a high risk patient? I am on labetelol which is safe for BFing, will I continue on the same meds? TIA!

TJ1979 · October 2013

I have no answers for you. But I remember how terrible all that was. Hopefully you can just stay on bp meds and it stays ok during pregnancy. So excited to think about your FET coming so soon!

IBackBevo · October 2013

I developed severe pre-e with DS. He also had IUGR. My BP's got pretty high, but I never threw crazy high protein levels. It was over 300 cut off, but never like 3000 or anything. The severe was due to high BP and the IUGR. They never put me on BP meds with DS, but I was on bed rest. My diastolic was as high as 118 and pretty much always over 110 unless I was laying down. My top number got as high as about 160. I don't remember exactly when I was diagnosed (I think around about 33 weeks), but I know my OB's office missed it for about a month to 6 weeks ahead of time. I was having all of the classic pre-e symptoms from about 28 weeks and the growth restriction started even before that.

It took about 6-8 months after birth for it to come back down to a normal level and never went back down to pre-pregnancy levels. (I used to actually have low blood pressure.)

Well, at about 9 weeks with this pregnancy, it started climbing again. Highest was about 158/99. I went to the doctor and they put me on BP meds. I am now laberatol (sp?) or something like that. It actually got up as high (even on meds) the other day as 179/84 after exercise, but I'm told it is not uncommon for systolic to climb after exercise. It went back down so no worries. This morning, it was normal (113/76) at the doctor's office and I also did my first 24 hour urine.

I don't know if they are classifying me as chronic hypertension or not. Since mine has strictly been related to pregnancy, I don't think I would technically fit that description, but I also don't think they will classify you as PIH (pregnancy induced hypertension) until 20 weeks. I suppose it does not really matter what definition they give you.

I don't think that pregnancy is really any different other than you get more monitoring and will probably have to see an MFM, do 24 hour urines more often and maybe do NST's and additional ultrasounds later in the pregnancy...but both of us would have likely gotten that anyway as former pre-eclamptics. I also think having either chronic hypertension or PIH puts you at increased risk for pre-e again, but because mine was "severe" and I had IUGR, I am already in the high risk category anyway.

With all of the above said, I have talked to a couple of ladies who had high BP after pre-e and went on to have relatively healthy pregnancies with #2. I think they both may have ended up with pre-e, but it was really late--like 37-39 weeks--and it was not very severe. If I can make it to 37 weeks, I will be jumping up and down.

PennyLane26 · October 2013

@ibackbevo - sounds like my situation may be similar to yours for future pregnancies. Glad to hear it is staying somewhat in the normal range on meds with this pregnancy!

@lynnyloo - I am on the same prescription and dosage! I started out on a much higher dosage but now the 100mg 2x a day really stabilizes things. Hopefully you have success in bringing it down without meds soon!

ashleymarie512 · October 2013

I had some high blood pressures in second tri that ended up turning into pre-e/HELLP syndrome. I went in at 29w6d due to pressure of 200/140 and had baby via emergency c-section a couple hours later and she only weighed 2lb 3oz.

The week before I had called dr about stomach pain and vomiting (the HELLP) but they said it was indigestion and didn't check me. There days later, my bp was that high and I had protein of about 1800 and liver enzymes were super out of whack.

I don't have an answer, but I'm glad you asked bc I've been curious about subsequent pregnancies too.

IBackBevo · October 2013

ashleymarie512 said:

I had some high blood pressures in second tri that ended up turning into pre-e/HELLP syndrome. I went in at 29w6d due to pressure of 200/140 and had baby via emergency c-section a couple hours later and she only weighed 2lb 3oz. The week before I had called dr about stomach pain and vomiting (the HELLP) but they said it was indigestion and didn't check me. There days later, my bp was that high and I had protein of about 1800 and liver enzymes were super out of whack. I don't have an answer, but I'm glad you asked bc I've been curious about subsequent pregnancies too.

Oh my! 140! I have never seen anyone with a diastolic of 140. They freaked when my diastolic was 118.

I had a similar situation to yours although not nearly as bad!!! That is just awful that they dismissed you like that. I was having all of the classic pre-e symptoms (vision changes, horrible head aches, seeing spots, high bp, etc.) and I even had protein in my spot urine check. OB sent me to L&D--which was the right move. Without even seeing a doctor or giving me a 24 hour urine (which is really the only way to accurately measure protein as you can have off readings in the spot checks), the L&D nurse told me I was having migraines and sent me home. I went about another 3-4 weeks before I was diagnosed after that...and by then my fundal height was a month behind and my LO was in the 3rd percentile. It still pisses me off when I think about it.

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