Anonymous wrote:

jindc wrote:hm I've never been told to lie on my left side and relax - I take it on the dr's office bed thingy every time.
What is considered high if 140/90 isn't the standard some of you are using here? I think last time I went my BP was 131/73.

also, can't change practices at 36 weeks. Any doctor on call will deliver me, though - it's GW.

131/73 is actually relatively high. At that BP my docs were having me rest periodically on my left side during the day and eventually bedders when it got around 135/80-something. Especially if it is on an upward trend, your doc is correct to keep an eye on it.

jindc wrote:

Anonymous wrote:

jindc wrote:hm I've never been told to lie on my left side and relax - I take it on the dr's office bed thingy every time.
What is considered high if 140/90 isn't the standard some of you are using here? I think last time I went my BP was 131/73.

also, can't change practices at 36 weeks. Any doctor on call will deliver me, though - it's GW.

131/73 is actually relatively high. At that BP my docs were having me rest periodically on my left side during the day and eventually bedders when it got around 135/80-something. Especially if it is on an upward trend, your doc is correct to keep an eye on it.

but it's not any higher than it had been previously, which is why I'm wondering if there isn't an upward trend, why it is a sudden discussion of induction. It's regularly been, as I can remember, in the 120s-low 130s, and when I got a higher reading she said that the lower number was what was important and if it got to 90 that would be a concern. If it had regularly been in this range, why wasn't it brought up before so I could have extra monitoring or whatnot?

I'm just confused, I guess. It wasn't really explained to me why it automatically meant we should discuss induction at my next appointment, etc.

Anonymous wrote:

Anonymous wrote:

jindc wrote:hm I've never been told to lie on my left side and relax - I take it on the dr's office bed thingy every time.
What is considered high if 140/90 isn't the standard some of you are using here? I think last time I went my BP was 131/73.

also, can't change practices at 36 weeks. Any doctor on call will deliver me, though - it's GW.

131/73 is actually relatively high. At that BP my docs were having me rest periodically on my left side during the day and eventually bedders when it got around 135/80-something. Especially if it is on an upward trend, your doc is correct to keep an eye on it.

Gestational hypertension is diagnosed when blood pressure readings are higher than 140/90 mm Hg in a woman who had normal blood pressure prior to 20 weeks and has no proteinuria (excess protein in the urine).

Please provide cites if you're going to dish out medical advice.

http://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=90&ContentID=P02484

Anonymous wrote:

Anonymous wrote:OP, I think you should go read the HYPITAT study (available for free here: http://obgyn.med.umich.edu/sites/obgyn.med.umich.edu/files/Hypitat.pdf), because it doesn't say anything remotely close to what the PP said it did. The women in the study all had SUSTAINED readings of >95 diastolic, which you have not had, so you would not even have qualified to take part in it. There is a study currently being conducted about the merits of treating mild hypertension in pregnancy, but it won't be completed until the spring and the results won't be published until sometime after that.

I just researched this issue because my systolic BP is slightly elevated at 32 weeks, and what I found is that the primary concern about mildly elevated BP in late pregnancy is that it could turn into preeclampsia. You are obviously being monitored for that. Beyond that, there isn't much they're going to do for you because they generally don't consider giving meds until BP is sustained 160/110 (some docs probably do, but standard of care is not to intervene until BP gets very high, because meds can bring it down too much and that can be bad for the baby). According to the studies I read, the risks to baby from hypertension that is *NOT* preeclampsia only kick in at high levels -- mild hypertension does not increase negative outcomes for baby in the absence of preeclampsia. There is more concern about negative cardiovascular effects for mom but given that you are already nearing the end I don't think that's a concern for you.

It sounds to me like you are a victim of size discrimination by your doctor and I would be very concerned about delivering with this practice. They are clearly setting you up for induction for reasons that are not based on actual evidence of a medical indication for such. Two random high blood pressure readings in the presence of otherwise normal ones and the absence of any clinical indications of preeclampsia is just a tempest in a teapot. It's good to be vigilant just in case you were to develop pre-e, but telling you they think that you will get it is totally unethical and out of line IMO.

The point of inducing for high BPs is to avoid preeclampsia and the inherent danger of elevated BPs alone. You are really minimizing. And the spikes are always a concern - the common practice of having you lie on your left side, "relax", whatever, actually produce false readings.

OP may not yet meet the definition of hypertension in the HYPITAT study but that is obviously the standard of care her OB has in mind, so she should know about it, especially if her BP starts to increase.

If you really distrust your doc that much you should change practices.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, I think you should go read the HYPITAT study (available for free here: http://obgyn.med.umich.edu/sites/obgyn.med.umich.edu/files/Hypitat.pdf), because it doesn't say anything remotely close to what the PP said it did. The women in the study all had SUSTAINED readings of >95 diastolic, which you have not had, so you would not even have qualified to take part in it. There is a study currently being conducted about the merits of treating mild hypertension in pregnancy, but it won't be completed until the spring and the results won't be published until sometime after that.

I just researched this issue because my systolic BP is slightly elevated at 32 weeks, and what I found is that the primary concern about mildly elevated BP in late pregnancy is that it could turn into preeclampsia. You are obviously being monitored for that. Beyond that, there isn't much they're going to do for you because they generally don't consider giving meds until BP is sustained 160/110 (some docs probably do, but standard of care is not to intervene until BP gets very high, because meds can bring it down too much and that can be bad for the baby). According to the studies I read, the risks to baby from hypertension that is *NOT* preeclampsia only kick in at high levels -- mild hypertension does not increase negative outcomes for baby in the absence of preeclampsia. There is more concern about negative cardiovascular effects for mom but given that you are already nearing the end I don't think that's a concern for you.

It sounds to me like you are a victim of size discrimination by your doctor and I would be very concerned about delivering with this practice. They are clearly setting you up for induction for reasons that are not based on actual evidence of a medical indication for such. Two random high blood pressure readings in the presence of otherwise normal ones and the absence of any clinical indications of preeclampsia is just a tempest in a teapot. It's good to be vigilant just in case you were to develop pre-e, but telling you they think that you will get it is totally unethical and out of line IMO.

The point of inducing for high BPs is to avoid preeclampsia and the inherent danger of elevated BPs alone. You are really minimizing. And the spikes are always a concern - the common practice of having you lie on your left side, "relax", whatever, actually produce false readings.

OP may not yet meet the definition of hypertension in the HYPITAT study but that is obviously the standard of care her OB has in mind, so she should know about it, especially if her BP starts to increase.

If you really distrust your doc that much you should change practices.

What I stated above is that there is no inherent danger in mildly elevated BP. Inducing to avoid preeclampsia is ridiculous at 37 weeks. Not everyone who has elevated BP is going to develop it, so that's a lot of unnecessary inductions that have their own risks and side effects. I am not minimizing and you are just wrong about having an occasional high reading and about relaxing. Those readings are not false, they are closer to normal. Everyone's blood pressure rises in a threatening situation. I don't need to switch practices because I am with a provider who follows the conventional standard of care and isn't chomping at the bit to induce at the first reason she can trump up.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, I think you should go read the HYPITAT study (available for free here: http://obgyn.med.umich.edu/sites/obgyn.med.umich.edu/files/Hypitat.pdf), because it doesn't say anything remotely close to what the PP said it did. The women in the study all had SUSTAINED readings of >95 diastolic, which you have not had, so you would not even have qualified to take part in it. There is a study currently being conducted about the merits of treating mild hypertension in pregnancy, but it won't be completed until the spring and the results won't be published until sometime after that.

I just researched this issue because my systolic BP is slightly elevated at 32 weeks, and what I found is that the primary concern about mildly elevated BP in late pregnancy is that it could turn into preeclampsia. You are obviously being monitored for that. Beyond that, there isn't much they're going to do for you because they generally don't consider giving meds until BP is sustained 160/110 (some docs probably do, but standard of care is not to intervene until BP gets very high, because meds can bring it down too much and that can be bad for the baby). According to the studies I read, the risks to baby from hypertension that is *NOT* preeclampsia only kick in at high levels -- mild hypertension does not increase negative outcomes for baby in the absence of preeclampsia. There is more concern about negative cardiovascular effects for mom but given that you are already nearing the end I don't think that's a concern for you.

It sounds to me like you are a victim of size discrimination by your doctor and I would be very concerned about delivering with this practice. They are clearly setting you up for induction for reasons that are not based on actual evidence of a medical indication for such. Two random high blood pressure readings in the presence of otherwise normal ones and the absence of any clinical indications of preeclampsia is just a tempest in a teapot. It's good to be vigilant just in case you were to develop pre-e, but telling you they think that you will get it is totally unethical and out of line IMO.

The point of inducing for high BPs is to avoid preeclampsia and the inherent danger of elevated BPs alone. You are really minimizing. And the spikes are always a concern - the common practice of having you lie on your left side, "relax", whatever, actually produce false readings.

OP may not yet meet the definition of hypertension in the HYPITAT study but that is obviously the standard of care her OB has in mind, so she should know about it, especially if her BP starts to increase.

If you really distrust your doc that much you should change practices.

What I stated above is that there is no inherent danger in mildly elevated BP. Inducing to avoid preeclampsia is ridiculous at 37 weeks. Not everyone who has elevated BP is going to develop it, so that's a lot of unnecessary inductions that have their own risks and side effects. I am not minimizing and you are just wrong about having an occasional high reading and about relaxing. Those readings are not false, they are closer to normal. Everyone's blood pressure rises in a threatening situation. I don't need to switch practices because I am with a provider who follows the conventional standard of care and isn't chomping at the bit to induce at the first reason she can trump up.

Go ahead with your bad self and your google md, then. The gist of OP's q is whether it is normal for doc to be concerned about high bp short of pre eclampsia. My answer is yes, my notably crunchy MIDWIVES were concerned and monitored for the eventual problem that did develop.

Anonymous wrote:Out of curiosity, why couldn't the mom who had magnesium see her baby for 20 hours? Was it a problem with the baby, or with the mom, or a standard protocol when magnesium is being administered?

Anonymous wrote:

Anonymous wrote:Out of curiosity, why couldn't the mom who had magnesium see her baby for 20 hours? Was it a problem with the baby, or with the mom, or a standard protocol when magnesium is being administered?

That was me. They told me I couldn't see him while on mag, because I couldn't be disconnected from all the monitors to go to the NICU. After 12 hours, they just kept pushing the time back and back and back. I was like a caged animal. Baby was in the NICU so couldn't be brought to me, and L&D wouldn't let me go. I was to the point of wanting to check myself out AMA just to get to see him. Inova Fairfax. Still haven't quite gotten over it, obvs!