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Old 09-13-2013, 04:21 PM   #1
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Gestational Hypertension Experiences?

I'm interested in hearing from you mamas who have dealt with gestational hypertension (or chronic hypertension) during pregnancy. Specifically how you and your doctor decided to plan/approach delivery. I have GD and suspected (but not confirmed) chronic hypertension. My BP has been slowly climbing since 35 weeks (37 weeks today) and in the last few days has been over the 140/90 mark - triggering the pre-e screening labwork, etc. so far, so good on that. But I keep reading about PIH and chronic hypertension being a medical indication for induction at term and want to read more. My doctors office is slow at returning messages and I can't talk to the OB for a whole WEEK waiting for our next appt. :-/ I'll be 38 weeks by then and am wondering what recommendations they might have in store.

Curious to hear others' experiences.

*******
Also, to clarify - I'm really NOT interested in any discussion about avoiding intervention or trying to do things naturally, etc. I'm as crunchy as the next person (I'm a birth doula and have had an hbac) and I'm genuinely interested in hearing about medical experiences and NOT arguing the merits of intervention. Plus I'm hormonal and cranky. So have mercy and don't use this thread as an opportunity to make a point. Thanks in advance. :-)

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Old 09-13-2013, 04:59 PM   #2
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Re: Gestational Hypertension Experiences?

I don't know that I have much to say that will help. I TTC this baby for nearly 5 years. Once I got pregnant I started stressing a bunch, freaking out about the pregnancy and I felt my heart racing so I went to the pharmacy and got a BP cuff for home. I also called the doc and told them. They had me monitor my BP 3 times/day until my first appointment two weeks later. The first 3 or 4 readings were high, 140ish/90ish. Then I settled down, stopped stressing myself out and my readings normalized, down to 110-120/70 something.

I took those readings into the first appointment and my OB said I must have chronic hypertension. I did the 24 urine catch around 18 weeks to set a baseline, it was basically no protein in the whole collection. I also have had NO abnormally high readings in the office since then. The highest I've seen is this last week, 124/88, but I'm 38 weeks preggo so that is in the realm of normal.

Due to all of this she will not let me go past 40 weeks. I am also a VBAC if possible so we are going to induce a week from today if I've made enough progress (good Bishop score) or we'll do a repeat c-section if I haven't made enough progress.

I find it really frustrating that she thinks I have "chronic hypertension" when I haven't had a high reading in the office AT ALL. Most of my readings have been in the 110/70 range. That has really affected my ability to have a successful VBAC, because of course I don't want to be induced, but at this point it's not an option not to, unless he comes between now and the 20th.
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Old 09-13-2013, 05:22 PM   #3
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Originally Posted by debdebdebby13
I don't know that I have much to say that will help. I TTC this baby for nearly 5 years. Once I got pregnant I started stressing a bunch, freaking out about the pregnancy and I felt my heart racing so I went to the pharmacy and got a BP cuff for home. I also called the doc and told them. They had me monitor my BP 3 times/day until my first appointment two weeks later. The first 3 or 4 readings were high, 140ish/90ish. Then I settled down, stopped stressing myself out and my readings normalized, down to 110-120/70 something.

I took those readings into the first appointment and my OB said I must have chronic hypertension. I did the 24 urine catch around 18 weeks to set a baseline, it was basically no protein in the whole collection. I also have had NO abnormally high readings in the office since then. The highest I've seen is this last week, 124/88, but I'm 38 weeks preggo so that is in the realm of normal.

Due to all of this she will not let me go past 40 weeks. I am also a VBAC if possible so we are going to induce a week from today if I've made enough progress (good Bishop score) or we'll do a repeat c-section if I haven't made enough progress.

I find it really frustrating that she thinks I have "chronic hypertension" when I haven't had a high reading in the office AT ALL. Most of my readings have been in the 110/70 range. That has really affected my ability to have a successful VBAC, because of course I don't want to be induced, but at this point it's not an option not to, unless he comes between now and the 20th.
Well hopefully baby will come between now and then. :-) Have are you feeling about being induced as a vbac? I had a home vbac with the last one, and was induced with my first (ended in a cesarean). I'm feeling ok about possibly being induced with this one - mostly bc I just have a gut feeling that I want him OUT NOW. Not bc I'm uncomfortable or anything, I'm just concerned about him.
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Old 09-13-2013, 07:10 PM   #4
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Re: Gestational Hypertension Experiences?

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Well hopefully baby will come between now and then. :-) Have are you feeling about being induced as a vbac? I had a home vbac with the last one, and was induced with my first (ended in a cesarean). I'm feeling ok about possibly being induced with this one - mostly bc I just have a gut feeling that I want him OUT NOW. Not bc I'm uncomfortable or anything, I'm just concerned about him.
I'm generally a very scientific person when it comes to medicine and I don't put a lot of stock into mommy instinct (ie everything will be fine because I think it will approach to birth). BUT I would definitely pay attention to your feelings on this one. If you think he needs to be out now I'd bring it up right away with your practitioner. When was the last time you had your BP taken?
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Old 09-13-2013, 10:37 PM   #5
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Re: Gestational Hypertension Experiences?

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Well hopefully baby will come between now and then. :-) Have are you feeling about being induced as a vbac? I had a home vbac with the last one, and was induced with my first (ended in a cesarean). I'm feeling ok about possibly being induced with this one - mostly bc I just have a gut feeling that I want him OUT NOW. Not bc I'm uncomfortable or anything, I'm just concerned about him.
If I've made more progress I will be okay with it. My OB would like my Bishop score to be around an 8, which would indicate a 90% success rate of a vaginal birth at induction. Tuesday my score was a 4, which is a greater than 50% chance of c-section if I was induced. I was 50% effaced, a fingertip dilated and super soft. A 6-7 would probably be okay, but an 8 or higher would be better.

I agree, if your instinct says baby needs to come now, then it would be best to listen. I hope he/she comes out safe and sound!
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Old 09-13-2013, 11:11 PM   #6
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Quote:
Originally Posted by miriamleigh

I'm generally a very scientific person when it comes to medicine and I don't put a lot of stock into mommy instinct (ie everything will be fine because I think it will approach to birth). BUT I would definitely pay attention to your feelings on this one. If you think he needs to be out now I'd bring it up right away with your practitioner. When was the last time you had your BP taken?
Today it was 140/96. They drew labs and those came back normal. No protein. I have another fetal monitoring appointment set for Monday, but no appt with the OB until Thursday. On Friday I'll be 38 weeks, and they were talking about wanting to induce at 39 weeks bc of my gestational diabetes. So hopefully they'll be able to talk me through whether the new BP issues would warrant inducing earlier than 39 weeks. The reading I was doing about it today seemed to be mixed. Some providers like to induce at term for mild hypertension, some like to do expectant management until 38/39 weeks. But all agree that baby should be out by 40 weeks.

I've taken my BP at home a couple times tonight and had several nice low ones while laying down. Baby is moving like normal. I had one high one while sitting up (147/92). So I'm laying down a lot this weekend.

I wonder if it'd be fair for me to call the on-call doctor (its a 24 hour line) and explain that I haven't actually talked with an OB or perinatologist since getting diagnosed (my midwife diagnosed me with PIH and referred my prenatal care to the OB and my first appt is Thursday - but I had been seeing the OB regularly for short visits to review my blood sugar records and adjust my medication as needed).

Or if I could just email the doctors office and say I'd like to talk to the OB sooner than Thursday?
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Old 09-14-2013, 10:24 PM   #7
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I had hbp with first 2 pregnancies none this time so far- more in the 150/160 range from 4-5 months till delivery. Never was induced just monitored closely, some 24 hour urine tests etc... Lots of rest is important as I'm sure u know and left side laying. I took baby aspirin this pregnancy and swear it keep my Bp in check but who knows? Gl mama and take it easy
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