Reply to Pre-E questions....anyone have experience?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]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 &gt;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. [/quote]

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.[/quote]

Can you please provide some cites (or reread what you're referring to, since it does NOT match your description of it) to go along with your fear-mongering? OP does not meet the threshold even for pregnancy hypertension, let alone Pre-E. So while it's good to be prepared and monitor for anything that is happening, there's absolutely no reason for her doctor to be talking induction over an isolated couple of readings in the 130/80 zone!

Here are some cites that directly contradict you:

[b]Mild high blood pressure in pregnancy usually only requires close monitoring.[/b] If you have high blood pressure that is rapidly increasing or has reached moderately high levels, you may be treated with blood pressure medicine.

Severe high blood pressure (higher than 160 mm Hg systolic or 110 mm Hg diastolic) can result in poor fetal growth (intrauterine growth restriction) and is likely to be treated with an antihypertensive medicine.

source: http://www.webmd.com/baby/tc/preeclampsia-and-high-blood-pressure-during-pregnancy-treatment-overview

"Your midwife will diagnose high blood pressure if:
Your blood pressure shows a reading of 140/90 or higher for two readings, four hours apart.
Your blood pressure shows a one-off reading of the bottom number (diastolic) of 110 or more. The diastolic reading is more important in giving information about your health. So if this figure alone is high, it's enough to mean you have high blood pressure.....[b]gestational hypertension isn't usually a problem[/b], although you will be referred to hospital for specialist care.

http://www.babycentre.co.uk/a554818/blood-pressure-in-pregnancy#ixzz2gP7hXlU1"

source: http://www.babycentre.co.uk/a554818/blood-pressure-in-pregnancy#ixzz2gP7ZaJqw

[b]If PIH is mild, it can be treated at home[/b]. If you have been diagnosed with PIH and your doctor recommends home treatment, you will need to maintain a quiet, restful environment with limited activity or bed rest on your left side.

It is important that you follow the diet and fluid intake guidelines from your health care provider and maintain your scheduled appointments. Your perception of fetal movement every three hours is also important. Any changes need to be reported to your health care provider immediately.

If PIH becomes worse, you will need to be admitted to the hospital where you can be closely monitored. Your health care provider will work with you to maintain the health of you and your baby. In severe cases, the baby may have to be delivered. High blood pressure is treated with medication, and magnesium is given through an IV to prevent seizures.

source: cleveland clinic

http://my.clevelandclinic.org/healthy_living/pregnancy/hic_pregnancy-induced_hypertension.aspx[/quote]

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