Any advice on preventing high blood pressure, pre eclampsia and small for date baby?

[lowrib]

I'm 22+2 weeks pregnant.

A recent doppler scan showed I have one artery with a 'notch' on the blood flow - the other is working fine.

I've been told I have a raised risk of a small for date baby, high blood pressure and pre-eclampsia.

At the moment everything is fine (my baby is large for date, blood pressure is normal).

They have prescribed baby-strength aspirin to thin the blood, and will scan me every 4 weeks from now on.

I'd like to know what I can do to minimise the risks? Does anyone know if there's anything I can do to support my baby so there's less risk of her/him being small for date later in the pregnancy?

What can I do to stop blood pressure getting high? Or to prevent pre-eclampsia?

Can anyone recommend a good home blood pressure monitor? (Reliable, but not too expensive!)

I am going to ask my doctor, but if anyone has any advice I'd really appreciate it, thanks

well...

i think one of the possibilities for small for dates woudl be because of a lack of blood flow, and that hasn't presented as a problem yet.

the other factor is that if your bp does rise then you'll be treated with beta-blockers, and women with beta-blockers tend to have smaller babies. not teeny weeny ones, within normal ranges but just smaller. so not much to worry about there.

pre-eclampsia afaia is a disease of theories... all they know is, have placenta, may get pre-eclampsia. no placenta, you won't.

so i don't know if there's much to be done, really. try not to get stressed (although wtf does that mean and it might be a bit of a red herring anyway wrt pre-eclampsia). if you think that taking your own bp will calm you, then do so. it might not, however, and a lot of docs don't like patients using them.

i always threaten with PE, it is a pisser, but surely you should take comfort from the fact that you don't actually have a single PE symptom? the chances of you developing any in the next ten weeks or so are extremely slim, tbh, and even after that you can start meds to control the bp.

if i'm being honest, i think that you've probably been unnecessarily scared by teh docs here wrt the PE. they're keeping an eye on placental blood flow, that's the main thing. i was scanned once a month, now get scanned once a week as am later on than you, everything's fine, but the sonographer told me that even if it isn't fine as such, babies come out fine and dandy with far-from-perfect placental blood flows, so as long as tehy're monitoring then it's fine.

plus, my bp is majorly wonky and i have had some swelling and visual disturbance and headaches and the baby is measuring not huge etc but one swallow does not a summer make. so it sounds like you're getting great care, i'd focus more on that and your complete lack of symptoms than i would the possibility of developing PE in the future.

my obs, who has a big brain, reminded me that i was being monitored and that most women with PE come into the hospital feeling really, really, really, REALLY lousy and it's the first the hospital knows of it. PE will NEVER get to that extent with us because we're already in the system.

good luck with everything. no googling.

Are you repgnant Aitch? I didn't realise. Congratulations. . When are you due?

Lowri - I replied on our ante-natal thread. Try not to stress too much about pre-eclampsia (stress will def not help your BP!). The fact that you are being monitored and know to watch for symptoms is the best protection you can get. Pre-eclampsia is dangerous because it catches people unawares and that won't happen to you.

I had pre-e last time and am being monitored closely in this pregnancy. I have some relaxation and breathing CDs that are meant to help me relax and keep my BP down. I am watching my weight (Drs seem to be very pleased that I am starting with a low BMI this time). But there is not much else to do.

Get a home BP monitor so you can montior your pressure in a stress free environment. See your midwife immediatly if you get any headaches, visual disturbances, lots of swelling etc. But mainly just try and relax, the chances are you will be fine .

Thanks Aitch, and thanks again artichokes for the advice and reassurance, I appreciate it.

I'm pleased to say I'm not overly worried, just trying to learn what I can.

BTW, well done with the low BMI, artichokes-not something I've had for quite some time now!

There is unfortunately nothing you can do to prevent pre-eclampsia apart from not get pregnant. Like Aitch and artichokes said, you are being monitored, which is great because undiagnosed PE is most dangerous for mums and babies and if you get it they will pick it up immediately.

You shoudl be aware that automatic blood pressure machines can give falsly low readings in pre-eclamptic women, so by all means get one for peace of mind, but make sure that you are also going to have your bp taken regularly by your mw or doc. If you are going to get PE your bp will go up whether you are stressed or not, although being stressed might give you high bp iykwim.

Symptoms of PE, which I'm sure you have been told, are headaches, visual disturbances, sudden swelling esp in hands, face or feet and pain under the ribs. I disagree with Aitch's consultant that most women with PE feel lousy - I felt absolutely fine and had no idea there was anything wrong when I was admitted with a bp of 180/110, and met lots of women in hospital who didn't know why they were being kept in as they felt fine. That's why it's so important to go to the check-ups.

But chances are you will be fine, especially if you have no other risk factors for PE, so am very glad you're not overly worried! Good luck

yes, but liege, what did they do about your PE in the end?

I was the same as Leige. I had no symptoms I was aware of other than major swelling which I had for weeks before pre-eclampsia was diagnosed. I went for my routine MW appt and had +++ protein in my urine and high BP, those to symptoms combined with the swelling meant she sent me straight to the hospital.

At the hospital they kept me in, made me save every drop of urine I created in 24 hours (that was fun, I had to carry a big jug of pee everywhere I went). That 24 hour urine collection suggested my kidneys were not functioning right. The induced me straight away and 36 hours late DD arrived. The strange thing was she was 2 weeks early and my placenta was supposeduly not functioning well but she still weighed 9lbs 4oz!

i assume he meant women not in the system... we're all in the system if we're getting bp checked etc. and it looks like the OP is very 'in the system' if they're flagging her as a PE risk from now. i presume your swelling will have flagged you too, arti.
33 weeks, btw. i'll be lucky to make it to 38 weeks, i'm told.

Lowrib - I've had PET twice - both times resulting in delivery of the babies (both well btw). I got a fairly cheap BP monitor from Amazon - think it was about £8 which allowed me to home monitor which saved me having to go in every day to be monitored.

The 24 hour urine collection is not fun not least because the big container they give you to collect it in is slightly too small for 24 hours so you end up with two, one full to bursting and one with a teeny tiny widdle in it .

Seriously though, having had it once I can tell you that if the docs know you are at high risk they don't take chances and do monitor you very carefully - expect to spend a fair amount of time in hospital for observation.

Also don't muck about, it's a dangerous and nasty illness. It took me eight months to get over the first episode and I'm still attempting to recover from the second (not least because I had a messed up caesarian and have to have further surgery).

Finally prepare yourself mentally for the fact that the decision may be taken to deliver your baby early and fast - which may mean a caesarian or a very limited trial of labour through induction.

also... if they do make you do the 24 hour thing (i know from previous experience despite never actually developing PE) they put acid in the bottom of the container to keep it right. do not piss directly into the container, oh no... [splashback]

Aitch - I'm mightily impressed you tried - the top of mine was under an inch across

lol, no, this was big bugger. i mentioned my agonies to the nurse and she said 'oh shit i forgot to give you the metal containers, didn't i?'

er, yes.

Metal? . We get plastic flasks - like you get 5litres of veg oil in, and a bespoke jug (yes indeed the NHS does indeed have a 'urine collection jug for women' in their catalogues apparently! )

i had PE with last pregnancy, this preg am now 36+5 and no signs of it. had notching and raised PI-means blood flow being forced through placenta this time at 23 weeks. being scanned regularly and still abnormal blood flow but consultant not concerned. they put me on 150 of asprin daily which i've just stopped at 36 weeks. babe measuring good size on scans

no, it was an orange plastic container with a yellow lid, not unlike people used to keep pasta in during the 80s. hyyyuuuuuge thing, quite embarrassing. but you were supposed to get little foil bowls to take away with you, so you could piss into them and pour.

I was always told that working late into your pregnancy,depending on the type of work you do,can bring on high Blood pressure and pre-eclampsia.

In my first pregnancy I was a Theatre nurse,and had to stand in one position for hours on end(also brings on Varicose veins too)

I had Pre eclampsia(supposedly ) If i did it was very mild.

If you do want to monitor your BP at home (although your Practice Nurse would check it as often as you need,in between antenatal visits.) we use Omron Monitors,and these are available to buy quite cheaply now.

Lol Aitch - I had the acid splashback too. Plus my DH kicked my full jug over at one point and the whole ward was treated to me screaming "save my wee, save my wee". There was no way I was collecting another jug's worth . Congrats on getting to 33 weeks by the way. My friend just had a 34 weeker and she is 4lbs and fine, no time on SCBU or anything.

is there a more plaintive cry in the world than 'save my wee...'?

Acid splashback !! Thankfully I had the same collection thingy as WMMC. I spent 4 weeks in a bay with 3 other pre-eclamptic women so there was always a row of large pots of urine in the bathroom. Lovely.

Ds was delivered by cs at 34 weeks - he had crappy lungs (not PE related) so was in SCBU for ages, but is very much fine now. I had a troublesome liver and was on bp meds for a few months, but am also very much fine now! Roll on dc2!

i am actually feeling a bit ropey now... i wonder if i'm just very suggestible? or i may just have a cold?

my acid reflux has gone out of control... so sore.

Oh dear Aitch. How are you feeling this morning. I hope you are recovered and it was just raging heartburn and nothing worse (severe heartburn is quite bad enough). I am the most suggestable person in the world but it is always getting things checked out anyway when you are high risk .

I don't think you can prevent pre-eclampsia unfortunately. They look for a combination of pointers so all you can do is aim to avoid the individual problems as you would if you weren't pregnant.

Eat healthily, try not to pile on unnecessary pounds as excess weight can cause high BP and take regular gentle exercise as this can help to reduce/prevent swollen ankles

I'm following this plan myself as I had pre-eclampsia and already had rising BP and swollen ankles at this stage of my last pregnancy. So far, my BP is low and I have no swelling

I am watching tihis thread with interest. I'm 16 weeks now and my consultant has said he's worried about me developing Pre-E.

I have been medicated for high BP since dd's birth 6 yrs ago and towards the end of my pregnancy with her I had to do the wee thing too as I was admitted 4 days before she was born.

Really don't want that to happen again with this pregnancy so am worried and thinking about ways it can be avoided if possible.

Hi lowrib. I had pre-e in my preg and was in hospital for three wks before having ds because of high bp and he was low birthweight.

I didn't realise that I had high bp and had been putting my frontal headaches and swollen eyes down to my sinuses (was told by the mw doing my doppler these were signs). Otherwise I felt fine although looking back now I didn't spot and it was never brought up about how much weight I had put on suddenly, which can be another sign. Before I was admitted to hospital I put on 1.5 stone in a week and considering my ds was only 1lb something at that stage, it certainly wasn't the baby.

I agree that if you're going to get pre-e, you're going to get it. I was put on medication which never really helped and bedrest, which may have bought me a few days, who knows? Was also told not to add salt to my diet and try and lie on my left side as much as possible to increase blood flow to the baby.

On the plus side at least the doctors are keeping an eye on you and you are getting good care with the extra scans. My own ds was born 6 wks early at 2lb 12 and even though he spent 4 wks in SCBU is now a healthy 10 month old.

Good luck

I had PE with my first ds but I never felt ill. Again I put on over a stone in week at 34 ish weeks just before diagnosis. I have heard home bp monitors are no good during pregnancy. Can you ask your midwife for a pot of wee sticks? You can test accurately at home then just for peace of mind. Ask you doc to confirm but I think you might be too early to develop PE yet. Look for the signs and avoid salt as much as you can but really I don't think anyone can prevent PE as no one knows exactly what it is. I had reflexology with ds2 and tried to stay active. I don't know if it really helped but it made me feel more relaxed so just be kind to yourself