Pre Eclampsia support

For Women & their families who have suffered with Pre Eclampsia, Eclampsia, HELLP syndrome, Pregnancy induced hypertension (PIH) and related conditions.
 
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 New and wondering if I should be worried...

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2ndTimeMummy
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PostSubject: New and wondering if I should be worried...   Mon 28 Nov 2011, 7:33 pm

Hi there!

I've been googling like mad trying to find out whether I have anything to worry about or not, unfortunately the info from Google is so mixed it's hard to know! Sorry it's so long!

Ok so I'm just gonna give you guys all the bp readings I have to hand.. I'm hoping you can tell me if it's a perfectly normal trend or if you think there is cause for concern...

12wks: 120/72
16wks: 107/64
18wks: 105/65
22wks: 90/50
27wks: 100/52
29wks: 117/65
30wks: 94/60

Most recent:

25/11/11 - 15:30 - 117/75
25/11/11 - 17:45 - 140/79
25/11/11 - 23:00 - 148/75

26/11/11 - 01:00 - 118/65
26/11/11 - 07:45 - 124/68
26/11/11 - 12:45 - 140/75
26/11/11 - 18:30 - 132/74
26/11/11 - 22:00 - 141/78

27/11/11 - 10:15 - 145/75
27/11/11 - 19:00 - 116/64 (post-nap)

28/11/11 - 01:00 - 128/70
28/11/11 - 03:00 - 148/83
28/11/11 - 11:00 - 132/73
28/11/11 - 18:00 - 126/73

All these readings were taken after at least 30mins of resting.

Anyway, a week ago last Thurs I got a reaaally bad headache that paracetamol wouldn't budge (with visual disturbances) so on the Sat I called the out of hrs GP and got an appt. When I went my BP was as doc put it "high for you" it was around 125/70 (I didn't think this was high but nvm) - and I had +protein in my urine so I was sent upto Maternity Assessment (on the form I had to give to hosp under Diagnosis the GP had written "?PET" pre-eclamptic toxemia). When I got there my bp had gone back down to 115/65, no worries there and my urine was now clear, weird! Anyway, I was given a prescription of co- codamol and sent home. Then my OH reminded me we still had my Grans bp moniter in the cupboard so I decided to keep a diary of my BP (which is all of the Most Recent readings). Anyway, when I went to bed on the 27th I noticed my ankle was swollen, just the one, the right one and thought "oh crap" as swelling was the only symptom of Pre-E that I hadn't been experiencing, that same night when I lay down and snuggled in, I got a shooting pain in my chest.. Sorta in the middle but more right sided it only lasted about 30secs overall - it was a sharp pain that gradually got less and less stabby till it was gone.. I decided if my ankle was still swollen when I woke I would give my mw a call.. It was so I called, nothing to worry about, all normal ??

Also, last night, I took my bp at 01:00am because that's when I had been reading for an hour and was going to bed. I read for a further 2hrs and the reason I re-took my bp at 03:00am was because I got tingling in my feet and my calves were achey.. I was lying in bed though ?

I haven't had a mw appt since (I have one on Weds) - so I'm not sure if protein has re-appeared or not but I'm hoping someone can advise whether I should be giving my mw a report on the BP readings I have been getting. What do you think ??
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Liz Pidgley
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PostSubject: Re: New and wondering if I should be worried...   Mon 28 Nov 2011, 9:32 pm

Hi there,

Welcome to the site.

Im sorry to hear you have been feeling unsettled. Your readings (I assume are at your appointments) are well within the normal range and if anything on the lower side. But as long s you are not feeling faint or dizzy this is not a problem.

The other readings you give, I again am assuming, are taken from your Grans BP machine? If this is so then the first thing would be to say that unless her machine is a Microlife A3BTO, then it is highly probable that the machine are not telling you the truth.

When you are pregnant your BP works in a totally different way and because of this other BP machines will be likely to simply guess at a reading. The £BTO is the only machine in the UK to be validated to use in pregnancy and can cope with a high blood pressure or PE pregnancy.

The +1 of protien in your urine may be significant. Protien is often good evidence that all may not be well. Having said that it can be there for many reasons most typically a urine infection or contamination of the urine dip stick.

If you have had PE before it is unlikely to recur before the gestation of your last pregnancy so this might offer you some comfort.
What you might find most useful is to get a pot of dipsticks from your chemist, they cost about £8 if your BP machine is not the one I have mentioned, then I suggest this will be the most accurate and cheapest way for monitoring your pregnancy. Any protien of +1 or more needs to be reported to your midwife or GP.

If on the other hand the machine is the 3BTO then is does seem that you BP is a little labile and 2 daily monitoring from your health care professionals is necessary.

I hope this helps but please do let me know if I can help at all.

Best Wishes for a long and continued pregnancy and baby arrives just when s/he should.

Liz


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2ndTimeMummy
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PostSubject: Re: New and wondering if I should be worried...   Mon 28 Nov 2011, 9:55 pm

The BP monitor I have been using is called Omron M2 Basic. As it was on a list of health assured monitors I thought it would be ok ?

I am unaware if I had Pre-E in my last pregnancy.. I was in and out of the hospital due to bleeds and always had protein in my urine, at the time, I didn't realise that was anything to worry about the the midwives never mentioned it to me.. My son was IUGR and was born at exactly 37 weeks.. At my last midwife appt before I went into labour she noted that my BP had been high for several weeks + the protein so she sent off a sample to the lab. I went into labour before the result came back so I have no idea what it showed.

This baby (a girl) is also measuring behind and I have a low AFI.. I am getting another scan on 9th Dec to check things again. Tbh, I came here because I never know if it's worth mentioning to my midwife as they all seem so uninterested unless your about to go into labour or something.
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Liz Pidgley
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PostSubject: Re: New and wondering if I should be worried...   Tue 29 Nov 2011, 10:09 pm

Hi there,

The M2 basic is a great machine and is accurate in most situations but not in pregnancy Im afraid. (Or if you have an irregular heartbeat.)

It is more than possible you had a form of PE in your last pregnancy as placental bleeds and IUGR are both signs. The 'out ward' clinical indications are (most typically) an increasing level of protein in the urine and then a BP that rises. But not all presentations of PE are 'typical' and as such can be harder to detect.
For some Mums the PE affects them most, for others the baby is affected and for a few both of you are affected.
Because of your history it is essenhtial (as in the PRECOG guidelines) that your care is managed as high risk. This is simply because it is the safest option.
It makes more sense to care you you as if the worst is going to happen than be caught off guard but this does not mean that your care is horribly clinical - just thorough.

Because your last baby was born at 37 weeks, IF PE does recur it is likely to be at the same time or up to 2 weeks later and follow a similar path. The guide lines say that from now till delivery you should be seen at least weekly and every other day if there are clinical signs.

If you would like to talk things through I am more than happy to talk to you on the phone - you can stay anonymous if you want to. The number is 0845 241 0989 and Im around 9-12 noon. Of course if you want to post thats fine too!

best wishes
Liz



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2ndTimeMummy
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PostSubject: Re: New and wondering if I should be worried...   Tue 13 Dec 2011, 11:38 am

Hi there Liz,

Thanks again for your reply. After reading this I invested in a Microlife BP3BTO-A(2) moniter and its pretty much the same story, higher readings. However I've had no more reports of protein in my urine. Now, as you menrioned before, its unlikely it would occur earlier than before so now my question is, could the raise in bp be taken as a sign of things to come or am I over worrying about this?

Also, after reading one of your replies on another thread I dont know if its relevant to mention that I have low platelets, non gestational with a diagnosis of ITP. Does that make any difference at all?

Thanks, you've been a huge help!
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Liz Pidgley
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PostSubject: Re: New and wondering if I should be worried...   Tue 13 Dec 2011, 12:53 pm

Hello again!

It is possible that the higher blood pressure is a marker of pre eclampsia again....but it may not!
Conditions like pregnancy induced hypertension (which sometimes develops into PE) is equally possible.
I would strongly suggest asking your consultant for a doppler ultrasound to look at the resisitance of blood in the uterine arteries. This will give you a clear indication of how likely the arteries and the placenta are working and ultimatley the risk of the placenta deteriorating due to PE.

The ITP does mean that you are at an increased risk of developing HELLP syndrome, which is a complication of PE, but to define the risk would need an accurate monitoring of your platelets throughout your pregnancy and potentially a theraputic transfusion of platelets.

I think for you, the diagnosis of PE would present symptomatically and on the basis of protienuria so you will need to be closely monitored.
At every appointment I would expect to see the consultant as opposed to one of the team as consultancy brings with it more years of expertise and 'hands on' experience. This is in clear guidance of the PRECOG guidelines for antenatal care.

From all that you have said, I think its right (and totally understandable) you are concerned about the care you should receive. Until baby is safely in your arms I suspect you will continue to worry. But this worry is also what is going to keep you and baby safe. Looking up as much information as you can to pre empt how PE might present itself is your safety net. Knowledge is the only true power against it - and you are doing all the right things in finding out all the answers you can.

I hope your pregnancy continues to be long and uneventful!

Best Wishes
Liz

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2ndTimeMummy
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PostSubject: Re: New and wondering if I should be worried...   Wed 14 Dec 2011, 7:34 pm

I'm so frustrated and don't know what to do!

My last two midwife appts my bp has been fine, no protein in urine etc. i've just been lying on my sons bed with him for approx an hour, got a sudden headache, thought uhoj better check bp.. Low and behold 154/86. However, if i was to be seen you can bet it would have stabilised by the time I got there! I feel neurotic!
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2ndTimeMummy
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PostSubject: Re: New and wondering if I should be worried...   Sat 17 Dec 2011, 1:12 pm

Hi again Liz,

I thought I'd come give a bit of an update. My bp readings since that 154/86 have been..

15/12/2011 - 14:00 - 131/81
15/12/2011 - 18:00 - 116/72
15/12/2011 - 22:00 - 135/80
15/12/2011 - 23:59 - 151/81

16/12/2011 - 10:00 - 135/81
16/12/2011 - 14:00 - 154/90
16/12/2011 - 18:00 - 149/82
16/12/2011 - 22:00 - 141/83

17/12/2011 - 10:00 - 128/85
17/12/2011 - 14:00 - 123/91

So after I received the 154/90 reading I decided to call my doc and take all my results with me for review.. When I got there my bp had gone down to 151/75, I also had trace protein in my urine. I got sent to maternity assessment for a serial bp monitoring. She took 3 bp readings, 10mins apart, they were.. 149/76, 140/70 and 135/78. So I was sent home, she said because my booking in was 72, my readings were fine.. She wouldn't even look at my bp record either, she never asked, nor gave me the chance to explain any symptoms either. I'm still worried because although my bp has fluctuated quite a bit over the last couple of weeks, it's starting to get higher and stay higher. So if my booking in was 72, when should I be worried about my diastolic ?

I have woke this morning with a pounding headache, co-codamol isn't budging it but I haven't had any visual disturbances thus far.

I have no idea if I am pre-eclamptic or not, but even if I'm not, my bp raising like that, surely signifies some sort of hypertension, even if it's isolated systolic hypertension ? I don't know.

Thanks again Liz!

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