Gestational Hypertension - No Induction Option?

[Anonymous]

Did they run your urine for protein?

I had a lower BP reading than that and trace protein and GW midwives induced me.

Monitor BP, call the nurse line. If BP is still high after 24 hrs, go to L&D.

[Anonymous]

I was induced for gestational hypertensionwith lower readings (130s/80s) at 37 weeks on the dot. No protein in urine or other markers for preeclampsia. This is worth being proactive about.

[Anonymous]

Yikes. As someone who had GH turn into preeclampsia with severe features in just 6 days, I’d ask to be induced asap. My son was born at 34+3 from me literally developing preeclampsia with severe features after perfectly normal labs 6 days prior. I wouldn’t mess around.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here: Anyone been in the same position where their OB acted like it wasn't an issue and continued with business as usual? Is this OB blatantly ignoring ACOG guidelines? I'm with one of the big practices in the area, Capital Women's Care.

My next appointment is not for another week at 39w. Seems like a long time to have to wait.

I did not have hypertension but I did have a diagnosis where I should have been induced by 37 weeks. I am a physician (not OBGYN) and read the current clinical practice guidelines myself. My docs also a CWC practice said it wasn’t necessary. At my 38 week appointment, my OB and Maternal-Fetal Medicine doctor were insistent it was not necessary. My labs were fine and the ultrasounds and NSTs were reassuring. I refused to leave until I had an induction scheduled. Went to the hospital that night and left with a healthy child. Pretty sure they labeled me as a hysterical first time mom but I didn’t care. With my next pregnancy, I ended up mostly seeing other OBs in the practice. Not because I was upset, my schedule had changed and therefore the docs I saw changed. Towards the end of my next pregnancy, I ended up seeing my main OB from my first pregnancy. She apologized to me and told me I was correct. Another mother with my same diagnosis did not end up leaving the hospital with her baby. No specifics were given but reading between the lines, I deduced that that mother was either not induced until way past 37 weeks or was not induced at all. My diagnosis came with a high risk of still birth past 37 weeks.

Never be afraid to advocate for your child.

I absolutely agree with the above. I had similar readings to your first readings (145/90), and my doc sent me straight from the routine appt to L&D where they monitored me for 3 hours. The pressure didn't go up or down, but as I was term and the doc wanted to avoid me having to get magnesium and/or having things progress to pre-eclampsia, I got induced, and everything was fine.

IME, the DC area is a place that attracts what I call "phoney doctors"--people who want the prestige of being a doctor, who have gone to all the right schools, etc. but in their hearts, have zero calling to help patients. This results in substandard care like sending you, a term pregnant woman with severe blood pressure readings, to her home instead of admitting/monitoring and inducing.

As others said, you can go to L&D triage straightaway and tell them you've had high readings and have them monitor you. Dollars to donuts, you're having this baby today or tomorrow!

[Anonymous]

I had pressures slightly lower than your 160/90 at 37 weeks and some change. My doctor from GW sent me directly to the hospital and said, “your husband can get your things…but you need to go to the hospital…you should be prepared to stay.” I had gestational hypertension and was delivered. Unfortunately, it developed into preeclampsia during my induction. I am so greatful that my doctor sent me in. I am pregnant again and being closely monitored again.

I would show up to the triage area at the hospital with a bag to stay.

[Anonymous]

I had an induction for high BP. I wish I'd had a C. It was a stressful experience which caused my BP to go up even more, and I ended up with horrible PPD. Not trying to scare you, just hoping you will be smarter than I was and have the C. And make them do it immediately.

[Anonymous]

Op: can you just go to your hospital saying you’re having contractions and want to be monitored? As soon as you’re in a hospital setting with those kind of numbers I bet they keep you and induce you then and there.

[Anonymous]

OP again...

I called the office multiple times yesterday and left a message, but no one ever got back to me (surprisingly). So I ended up calling the on-call doctor after hours at the hospital, a different one, and she said to come into the office for a blood pressure check and sonogram for baby. They can't fit me in until late this afternoon. Seems like there's no sense of urgency. BP is still high after resting all day (systolic over 140s). I'm going to insist on starting induction asap today or tomorrow (or whenever they can fit me in is what I'm predicting, given their attitudes), as I've heard delivering between 38-39 weeks balances outcomes for both mom and baby when there's GH and no other features present.

Anyone with GH wait as long as possible (39 weeks or later)? What were your reasons and how did it turn out?

[Anonymous]

Anonymous wrote:OP again...

I called the office multiple times yesterday and left a message, but no one ever got back to me (surprisingly). So I ended up calling the on-call doctor after hours at the hospital, a different one, and she said to come into the office for a blood pressure check and sonogram for baby. They can't fit me in until late this afternoon. Seems like there's no sense of urgency. BP is still high after resting all day (systolic over 140s). I'm going to insist on starting induction asap today or tomorrow (or whenever they can fit me in is what I'm predicting, given their attitudes), as I've heard delivering between 38-39 weeks balances outcomes for both mom and baby when there's GH and no other features present.

Anyone with GH wait as long as possible (39 weeks or later)? What were your reasons and how did it turn out?

Have them check for protein in your urine when you go in this afternoon. GH can turn into preeclampsia in a second.

[Anonymous]

Anonymous wrote:OP again...

I called the office multiple times yesterday and left a message, but no one ever got back to me (surprisingly). So I ended up calling the on-call doctor after hours at the hospital, a different one, and she said to come into the office for a blood pressure check and sonogram for baby. They can't fit me in until late this afternoon. Seems like there's no sense of urgency. BP is still high after resting all day (systolic over 140s). I'm going to insist on starting induction asap today or tomorrow (or whenever they can fit me in is what I'm predicting, given their attitudes), as I've heard delivering between 38-39 weeks balances outcomes for both mom and baby when there's GH and no other features present.

Anyone with GH wait as long as possible (39 weeks or later)? What were your reasons and how did it turn out?

If they give you a hard time, use the magic words, "I want you to write in my chart that I am asking for immediate delivery due to my dangerous BP and you are refusing".

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP again...

I called the office multiple times yesterday and left a message, but no one ever got back to me (surprisingly). So I ended up calling the on-call doctor after hours at the hospital, a different one, and she said to come into the office for a blood pressure check and sonogram for baby. They can't fit me in until late this afternoon. Seems like there's no sense of urgency. BP is still high after resting all day (systolic over 140s). I'm going to insist on starting induction asap today or tomorrow (or whenever they can fit me in is what I'm predicting, given their attitudes), as I've heard delivering between 38-39 weeks balances outcomes for both mom and baby when there's GH and no other features present.

Anyone with GH wait as long as possible (39 weeks or later)? What were your reasons and how did it turn out?

If they give you a hard time, use the magic words, "I want you to write in my chart that I am asking for immediate delivery due to my dangerous BP and you are refusing".

+1 OP. Jeez. I had pre-e the first time and GH the second. My doctor told me to just go to the OB emergency dep’t if my pressures were high after a dismissive call with a different on call doctor. She told me not to wait or call — just do it. I went into labor in triage while getting my BP monitored at 38 weeks after a high reading. I would head to the hospital if I were in your shoes. Best of luck!

[Anonymous]

That’s crazy, I had GH, I was 38 weeks and went to the hospital with signs of early labor. It might have just been BH contractions, but my BP was 160/90 at the hospital and I was induced then and there. I was also with CWC but maybe it depends which office? Are you on any blood pressure meds?

[Anonymous]

Let us know how it goes!!

[Anonymous]

Have you asked your OB what the theshold/cutoff is, like at what BP reading or gestational age they would induce/deliver?

I had a different issue in the last month of PG and my OBs took the monitoring very seriously, I came in every few days for appts. I also knew the #s that would result in being sent to L&D. At a minimum you should be able to know what their thinking is and then decide if you are comfortable with it.

[Anonymous]

At 38 weeks I would think inducing would definitely be considered the safer path. The upside of baby getting a little bit bigger doesn't outweigh the downside of you suddenly developing pre-e before your next checkup.

I had multiples so slightly different situation because they were trying to keep them in as long as possible but the day my blood pressure went to 160/90, I went into the hospital on bedrest and was monitored every 2 hours around the clock.