High BP - does that automatically mean PE and early delivery

[mardarse]

Hi,

I'm 36+4 and blood pressure has been creeping up over last couple of weeks. Yesterday it was 164/84, consultant is keeping an eye on me and I'm back at the hospital on Friday for another bp & urine check (urine currently clear). She said yesterday that I wouldn't make it to 40 weeks so I guess they'll just keep an eye on it until they think it's either stabilised or gone too high and admit me. She was reluctant to give me bp medication in case that brought it too low and made me ill.

Does anyone have any experience of this? Were you admitted until baby was born / induced / given medication? I just want to have an idea what to expect. I know baby is almost term now but it looks like I would need an ELCS as I have a scar from my previous EMCS and induction with a scar would not be ideal. I've also read that ELCS before 39 weeks is not good for babies and a number of them end up in SBCU / have respiritory problems if delivered before.

I think I'm just having a panic and asking for a bit of reassurance from people who have been through similar. Thanks for reading!

HI mardarse
my BP started to creep up in the last few weeks with ds1. I don't think I had any significant proteinuria or any swelling or other symptoms so the hospital said they weren't sure if it was just my BP going up 'naturally' at the end or the start of pre-eclampsia.
I was told that they wouldn't let me go past 40 weeks and was given the option of induction at 39 weeks in the end so that was what happened. I normally have high bp though when not pregnant and also have kidney problems so those things contributed to the final decision to induce as well. I was admitted the night before the induction to have the gel. I have heard some people be admitted early for monitoring and bed rest if it looks like pre-eclampsia might be starting.
Sorry I don't know about ELCS at 39 weeks but it seems that inductions for medical reasons are done at that point if they can wait til then to actually avoid any potential respiratory problems. I guess it is because your due date can be a rough estimate so may be 2 weeks out either way?

My blood pressure started to go up around 35 weeks. I also had a small amount of protein in urine. The first time my blood pressure was unacceptably high they admitted me to hospital and gave me some medication to bring it down. They said if they could control the blood pressure overnight then they would let me go home and I would be monitored twice weekly in the Day Assessment Unit. Otherwise they mentioned induction.
So that's what I have been doing for the last 3 weeks. I keep having to go in to check the blood pressure but as the medication seems to keeping my blood pressure at a normal rate, they seem satisfied to let me carry on as normal for as long as possible. I am now 39 + 4 and am hoping to go into labour naturally asap!

I have been induced twice with high BP, the first time was proper PE with all symptoms, at 36+ weeks. With my second pregnancy I was induced at 38+ when my BP started creeping up as they didn't want to wait until I was so ill. Second induction was really quick!

Should add, I was hospitalised for 5 days before induction first time. Sometimes they like to do that 24 hour urine collection thing?

Thanks for all your info. I'm trying not to panic as the consultant seemed v calm and not overly worried yesterday, just cautious and I do feel in good hands.

Yummymango, good luck for the next few days - I hope you're not kept waiting too much longer.

BerryLellow, sounds like they kept a good eye on you too and caught the high bp early. I should have added that I was admitted and induced with mild PE last time and had to do that 24 hour urine collection thing so I think they are being super cautious this time which is good.

wheels, good to hear they kept an eye on you too. I think I wouldn't be so concerned if I could delivery naturally, but like you say a due date is just an estimate anyway so a few days earlier might not be the end of the world.

I'll be 34 weeks on Saturday. I was told yesterday that my blood pressure was a bit higher, that there is a bit of protein in my wee, and that I'm measuring slightly smaller than I should be. It's really worrying and I can't help feeling as if being really stressed about my house-move (supposedly tomorrow and Friday) has contributed to these symptoms. I'm trying hard to be calm and not worry today, but I have to say it's not working very well.

I'd really like to know if people who have had small babies having suffered with PE have found their babies have health problems afterwards?? Anyone??

Good luck to the rest of you.

Hi whizzyrocket, I had mild PE picked up at 40 weeks with DD. My BP had been rising and there had been protein in my urine for 2 / 3 weeks but nobody had seemed overly concerned about it. My DD was 6lb 3 so not tiny, but probably smaller than she should have been and spent 2 nights in SBCU. She is 2.9 now and has no health probs whatsoever and is a bouncy, happy, energetic little thing.

If you are worried though, phone your MW and explain why you are worried or do you have a Day Unit you can go along to and ask to have your urine and bp checked? Everytime I have had an issue and ended up in the Daycare Unit they have been really lovely and said they would rather see me than have me sat there worrying.

NO, high bp doesn't automatically mean PE and/or early delivery. I'm suprised they don't want to give meds though, I was given them in both pgs. !st pg I was only hospitalised for 24 hours for urine collection (at about 38 wks when my bp went to 160/106). I was discharged after the 24 hrs, my bp was fine(ish) again. I was induced at 39+5 and had an EMCS after 11hrs labour (due to foetal distress).

Second pg I had an ELCS at 39+1, it was great. My mw vaguely tried to talk me into VBAC but I couldn't go past 40wks and they couldn't induce me so I went for the ELCS - no regrets.

Try not to worry. I have had bp issues in both previous pregnancies and am currently on my third (but only 18 weeks so fine for the moment). The first time I was treated with bp medication and they decided to induce at 40 weeks, although baby decided to come of it's own accord at 39 weeks. Second time, I was induced at 38 weeks but I did plead with them for this as the meds were making me extremely sleepy and I felt I wasn't fully capable of looking after my toddler. If this hadn't been the case, I and they would have been happy to keep going. If they can keep your bp controlled with meds and you have no protein in wee/other signs of PE then they will very likely not induce you until 39/40 weeks, and by then your baby may well have put in an appearance! The important thing is that the high bp has been noticed and they are going to keep an eye on you and ensure you're cared for safely. Best of luck!

fingers crossed mardy that your BP behaves itself and you don't develop any other signs of pre-eclampsia and can have your ELCS at 40 weeks! :)

Sorry just read that you've had an EMCS - so instead of inducing you'll get an ELCS. Also, given that they have not prescribed any medication yet, looks like they are not overly concerned about the bp and will simply keep a close eye on you.

Not in my case. I had fluctuating bp from about 38 weeks and was in and out of the day assessment unit for blood and urine checks up until I went into labour at 40+10. Unfortunately I developed severe pe the day I went into labour so in hindsight my high bp together with massively swollen feet and ankles were prob a sign that things weren't quite right. I think every case is different, the midwives and consultants were umming and aahing with me for days about whether to induce but unfortunately must have decided with me that there wasn't enough of a medical need!

Thanks mardarse I didn't really know what PE entailed until I had a look on the web this morning. Very worrying when you find out though.

There isn't anything much the midwife can say that she didn't yesterday- she was very calm and unconcerned but took blood and urine samples to be tested at the hospital. I only met the woman yesterday (booking-in in a new area) so I don't really feel I can hassle her again already. Besides which I'm at the old house today, some distance away from the new midwife, as I have to do some more packing up and getting ready for the removals men tomorrow morning.

I'm glad to hear you had no problems with your dd though. It must have been worrying to have her kept on SBCU. As they don't seem to be making a fuss I'll have to assume that my baby is fine and get on with things. After all I can't be like this for the next 6 weeks!

Don't worry too much, you are do close to term that your baby isn't likely to suffer from being premature. Make sure you know the other symptoms of pe and be vigilant for them and see a hcp ASAP as soon as they arise. My son born during pe is a determined willful little bugger is a lot healthier day to day than his non pe sister but has remained small on the 9th percentile.

I have chronic high blood pressure in the region of 140/90 and even higher when pregnant. My medication has made it fluctuate and sometimes go low but the worse that happened was a bit of fainting and lethargy. dc1 was induced at 38 because waters broke so not bp related, dc2 was natural at 41 +2 and dc3 was emcs at 39 for non bp reasons. My care has always been highly monitored and on a 'lets see what happens' basis. I am suprised they wont medicate. As you can see my births have all been different so i dont thik there is a prescribed way it will go...i was also told i wouldnt go beyond 40 weeks but as you can see with dc2 they did let me.

Nope, not with me. My blood pressure is on the high side when I'm not pregnant. As I had no other signs of PE I was put on labetalol when my diastolic reached 100. My consultant was happy with figures around 90/95, so your BP sounds positively low to me! Induction wasn't discussed even with my BP at 95, I did have an ELCS at 39 weeks but for other reasons. DS was born with no health problems. Good luck!

Have you asked your midwife about respiratory problems etc in babies born early by cs? That would seem to be the solution to me. If they're talking about a specific course of action for you ask for their reasoning.

Good luck again!

I had a few problems with my bp towards the end. In my case I was doing far too much and was very anxious about the delivery. It was nothing more serious than this and it did go down again before delivery at 37wks by emcs.

What was your booking bp? This is the important thing and it's the bottom number you're looking at. It can increase naturally towards the end but more than 20 up from your booking bp and they start looking at why it's going up. And obviously if there are any other signs of PE they will look into it. They also say above 90 is of concern.

My midwife did liver function tests, fbc and pet tests as routine to put my mind at rest.

Whizzy - DS1 was born at 36+0 and I'd had pre eclampsia for several weeks beforehand. He was small - 5 pounds 4 and did lose quite a lot of weight after birth. He was in special care for a week before we were able to bring him home. Once his weight picked back up there were no other issues. He has always been a bit smaller and a bit skinnier than many of his friends but DS2 seems to be the same so I don't think it is to do with PE.

I was diagnosed with pre-eclampsia in the last 6 weeks of pregnancy - water retention, protein and high blood pressure. I was in and out of hospital for 'rest' but I went to term (three days over) and gave birth naturally and my dd was 8lbs 4oz.

Hi there OP, I am pregnant with DC2, with my DD I was sent to my 38 week check up (monthly moitoring and growth scans due to a long standing kidney problem (me not baby) and they told me they would start me off the next day as baby was fully engaged and my BP was starting to creep. 38 weeks turned out to be a full term baby who was perfectly fine. Dont worry x

Thanks to everyone for your advice and input, it's much appreciated. I am going by the "they can't be too worried as I'm not on meds and haven't admitted me" school of thought, whilst remaining vigilant (read obsessive) for any other symptoms. I have got puffy fingers and feet but have had them all the way through and mentioned them again yesterday but they seemed unconcerned.

Blood pressure was 120/60 at booking and has been most of way through. And I'll ask about effects of ELCS on a baby before 39 weeks, yesterday I was a bit dumb struck and didn't ask half the things I should have done.

Thanks again!

hi, god its a long time since I thought about my pregnancies, I had high bp and pre eclampsia with both my preganancies. they were both induced at 38 weeks, but onnly because they had stopped growing, they dont worry about bp until tthe bottom figure is over 90. both my dd's were tiny babies 5lb 4ozs, they didnt have any prblems and actually looking at dd1 who is 8 next week I think she was always meant to be tiny anyway. I was never on medication, I think for medication your bp has to be statically high and if it fluctuates it can mean that at times your bp is too low.

Anyway really just wanted to let you know that I totally understand the anxiety, my dd's are 5 and nearly 8 now but I can still remember the appointment when I was told I had high bp.

Also if your feet and fingers have been puffy all the way through I wouldnt worry as long as they arent. the main things for you to watch out for are headaches and visual disturbances.

Oh and to answer some of the other questions, I was admitted only once overnight with my 1st pregnancy, but signed off work and told to rest, with my second pregancy I was admitted reglularly (most weekends as it happens) from 31 weeks to rest (difficult to do completly at home with a toddler) but I was never kept in for more than 3 nights, I think nowadays the see the advantage of being in your home, my mum had pe with me and was on complete bedrest, said it was awful.
Dont know anything about early elcs, although dont they always do elcs slightly early to prevent the risk of going into labou?/