Induction for Gestational Hypertension

[Anonymous]

Anonymous wrote:39 weeks is full term now.

http://www.acog.org/About-ACOG/News-Room/News-Releases/2013/Ob-Gyns-Redefine-Meaning-of-Term-Pregnancy?IsMobileSet=false

Whatever. My doctor at one of the top maternal hospitals in the country said it was the right thing for my health and my baby to induce at 37 weeks. My baby is perfect. And pre-e can be dangerous, even deadly. If I were OP (I was) I would trust my doctor not strangers on the Interwebs.

[Anonymous]

I was in the same boat and agonized over it. In the end, I had the baby at 37 weeks. Baby had a little bit of jaundice, but did great. The pediatrician said he absolutely recommends induction at 37 weeks for PIH. Sometimes it's riskier for baby on the inside than out.

[Anonymous]

I feel like a broken record here, but google HYPTITAT. A very large randomized study found that inducing at 37 weeks was superior to expectant management for hypertension.

[Anonymous]

Latest ACOG recommendations are for induction at 37 weeks for gestational hypertension or preeclampsia. Uncomplicated chronic hypertension can go longer. The reference is ACOG's "Hypertension in Pregnancy" document which is about 100 pages but the first 10 or so are the executive summary. This is a change from prior recommendations. As an OB, to me it sounds like your OB is doing the right thing especially when you describe your BPs being as high as 180s systolic - that is not normal. Best of luck to you and your baby!

[Anonymous]

OP again- BP readings today were in the normal range and baby was doing well- growing, moving- nurse practitioner didn't really have an answer as to pushing back induction to 38 weeks- said I will have to talk to the DR on Friday.

[Anonymous]

Anonymous wrote:Out of curiousity: How high are OP and PPs talking? I'm sort of in the opposite position in that I have borderline HBP (especially the bottom number... typically, 125-130/85-90; occasionally, 90-95, but always sub-90 with a few minutes of rest or while laying down on left side) that developed suddenly around 34 weeks and my OB doesn't seem particularly worried about it b/c I don't have protein, swelling or bad/constant/intractable headaches. I'm now well far enough along that I could be induced safely and am surprised she doesn't seem to be considering it at all.

In case anyone is ever looking at this thread later... I am the above poster and the day after typing this, I got a call from the OB re: the labs I hassled her into running. Turns out my liver enzymes indicated the start of HELLP syndrome. Ended up with an emergency c-section -- got there just in time for a spinal to still be safe (platelets dipped to 40K the next night) -- and spent a day afterwards on a mag drip. Baby is perfect and showed no ill effects -- I was very lucky HELLP developed at full term. My BP started to rise post-delivery (was actually OK during the c-section), but now seems to be coming down on light meds. Labs were still abnormal at discharge, but everything was heading the right way. Will follow up in a week. Bottom line: trust your gut if you think something is wrong.

[Anonymous]

Mom of two 34 week preemies induced due to preeclampia here. Do what your doc says. There's a lot of hype about "full term". Not trying to minimize how "longer in the oven is best", yada yada yada, but sometimes that's not the case. My kids had intrauterine growth restriction due to my hypertension and I'm so grateful we didn't wait any longer than 34 weeks. BTW- they're both totally healthy with no deficits- Thank God! Won't be having no. 3 though. Couldn't imagine rolling the dice again.

[Anonymous]

There is tons of research about the value of full term pregnancies (check out the March of Dimes campaign) - but that is UNLESS there is a health risk to the mom and baby!! As someone who had gestational hypertension (and now chronic hypertension) and preclampsia and a bad birth outcome - agree it's not a matter to gamble with if your doctor is advising otherwise.

[Anonymous]

Mother of twins here - born via scheduled c-section at 37 weeks one day after having fairly elevated BP for the last 6 weeks of pregnancy, and then one urine test (at 37 weeks) showing protein in urine.

I wanted to wait. Dr. pressed for delivery and had me talk w/ a second physician to reinforce the advice.

What convinced me?

"You are FAR better off delivering these babies in controlled circumstances, with the doctor you know and trust, and controlled anaesthesia etc... You do not want to end up in an emergency delivery in the middle of the night, compromising your health at the same time."

You are very well along OP and your baby will almost certainly be completely fine. Plumping up will be more critical in the first couple of weeks than if you had carried to 38-40 weeks, but developmentally the hard work is done. And a healthy mother is pretty critically important after delivery also.

Good luck!

[Anonymous]

Hi op,

Had pre e at 37 weeks. Dd ended up being super small 4 lb 13 oz. Maybe they can do a biophysical profile to make sure baby measures healthy. What the pp sad about the health of the placenta is important to cnsider, make sure baby is getting what baby needs.