Antenatal appointments high risk pregnancy

[biginjapan]

Hello - I'm 23 weeks pregnant with 4th baby (first for 7 years). My pregnancy is high risk (4th c-section/ high bp/39 years old/gestational diabetes risk) and I was wondering how often I should expect to see the midwives?

I have seen my midwife once at my booking appointment and she has been off sick/on holiday for the next two, so I have seen locums. The one I saw today was totally ineffectual and said they don't want to see me until 28 weeks. And then 34. This seems pretty infrequent to me - I am booked in for two growth scans because of my bp and saw the consultant yesterday but forgot to ask. TBH today's midwife left me a bit worried about my care.

Any thoughts? Thanks!

I wouldn't worry too much unless I was getting some symptoms. The 4th cs isn't really an issue till close to the end, if no and sugars were ok today then a check again in 5 weeks sounds fine to me. 39 is a pretty normal risk factor these days, it's more a risk for foetal development than sudden pregnancy illness is think. If you feel off in the next few weeks then give them a call but checking you every 4 weeks sounds normal to me.

This might depend on NHS area - if you are high risk for GD, this will be tested around 28 weeks, but may be at antenatal clinic (hospital) rather than community midwife? I've found that midwife appointments are roughly around 16 weeks, 24 weeks, 32 weeks and then 37 weeks, and this doesn't really change if high risk or not; the additional scans are what you are getting because of your high risk pregnancy. As I said though, might be different from NHS area to area.

I'm high risk due to twins, I don't see the midwife any more often but I will be seeing the consultant every four weeks from 16 weeks

Thank you. I feel slightly better about things. I think my main worry is bp and pre eclampsia risk - hence growth scans. My first bp reading today was 147/89 which was a bit alarming. I just thought they should be keeping more of a check on it, but maybe not.

Have they given you asprin for the pre--eclampsia risk OP?

Yes they have, but it doesn't seem to have helped. Bp is rising.

Then OP I'd get checked more often.

I am also high risk in this pregnancy and don't see the midwife anymore than I would if I was low risk but I do have extra consultant appointments. All bar one are in the last trimester.

Hmm yes if bp isn't settling and continuing to rise, maybe you need to speak to MW about being more closely monitored? Depends though if you have other p-e symptoms? Swelling, protein in urine etc? It is all about your peace of mind too, if you feel like you aren't getting enough contact time with healthcare professionals then ask for more, whether that is MW, consultant or triage.

Hi I'm a 29 weeks gone in a high risk pregnancy due to a history of pre-eclampsia & associated growth problems - dd was born at 27 weeks. I had 3 extra growth scans booked for 3rd trimester but my midwife seemed pretty unconcerned about seeing me more frequently until I had a couple of high BP readings then I asked to be seen more frequently. They don't give you a check up at your 20 week scan so she expected me to go from my 15-18 week checkup to 28 weeks without measuring my BP which I didn't think was acceptable given my history. She was ok with it but I had to ask for the extra appointments. If you are worried at all just ask to be seen more often. Xxx

Thanks for sharing stories. I've also had intermittent bleeding throughout (last bleed with clots at 19 weeks - unexplained).

TBH I think it was the really off-hand way the midwife treated me this morning that bothered me. She didn't know anything about me (asked if it was my first) or look at my handheld notes. She didn't print anything off to put in my notes and I heard her having a loud conversation outside the room with the door open about a lady having a positive DS screening and that they would have to contact her. They said her name and I live in a pretty small town. Luckily I don't know her. All in all not a v professional appointment.

Are they looking at putting you on BP meds? When are you next getting BP checked, or are you not supposed to go back until 28 weeks now?

I would ring your midwife and just say you wanted to go over your appointment notes as you were a bit concerned your BP is creeping up and check what your management plan is and a f your not happy with the response maybe go to your GP and ask the same?

I was high risk for some of the same reasons as you, from 30 weeks I had weekly scans and twice weekly BP checks. Baby was small though too so that may have been a factor.

I've had 2 high risk pregnancies due to high BP. If you're suffering with hypertension, i would imagine they would expect you to get in touch with the assessment unit (day unit/MAFU/whatever your Hospital call it) if you had a high reading or were symptomatic. Are you medicated for it?

Are you seeing a consultant? I found that they dictated how often I saw the midwife. I started having fortnightly BP checks at about 24 weeks, which increased to weekly and then twice weekly at about 34 weeks. The midwife didn't offer anything additional above the normal schedule of appts unless the consultant said so.

Thanks hella - I wonder if it's different according to area, but yes, I have seen the consultant. The midwife said that she could only get one page of notes up at a time on the computer and had to be prompted to look at the consultant's report - she just didn't give me any faith in how thorough she was. She also asked me to call and follow up the growth scans myself (when I asked her how I'd find out dates) and said I wouldn't get a letter with dates .

I think I'll call the community team on Monday and try and speak To my own midwife. They never answer and rarely return calls though. The triage at the hospital are good but it's an hour away and I don't like using them for what I think the community team should be responsible for.

I asked if I could calibrate my own bp monitor yesterday and she said that sounded too technical for her and left me to it. The readings were about 10 out - so not sure I trust it. I do have my own urine dipsticks but don't feel confident being my own midwife!

Thanks for all the advice - needs further following up I think!

Oh yeah, I also feel sick and have had a headache for a few days - she said it must be the kids being back at school .

Not medicated as usually just below the threshold. I have had high bp in previous pregnancies and no PE, so maybe less of a risk?

If you have had a headache and feel sick and have a BP almost 150/90 I think you need a review. Where's your headache, any vision issues?

When you are worried about your health you should put yourself first. Don't feel bad about accessing the hospital, if you think community should be responsible, if you can't actually contact the community. If you feel unwell tomorrow call one of the help numbers in your pregnancy book and get some further advice

If you're concerned about high readings, please call your maternity unit directly. They'll take it seriously.

I'm medicated for my BP and they take any reading over 140/90 quite seriously, and admit to hospital at anything over 150/100 (doesn't have to have both numbers over that - one is enough to be a concern). I've never had PE either, just high BP.

Are you feeling better Big?