My doctors were going to induce at 40 weeks if I made it that far. The one d-bag was adamant that I wouldn't be allowed to go that far (that it would get bad or I'd get pre-e or whatever). I ended up going into labor on my own at 38.5 weeks.
Post by LauraMoser on Sept 4, 2012 19:57:56 GMT -5
I developed PIH about 3-4 weeks before DD1 was due. They monitored me closely from that point on, and wound up inducing me a day before my due date. I was not put on any medication for it though, just taken out of work.
With this baby, I had HBP before becoming pregnant, which I was on meds for. They switched my med to a safer one and have monitored me more closely the whole way. I've had three ultrasounds so far (only ever had 1 for DD1, and 2 for DD2) and have another for about two weeks from now. I don't know for sure, but I imagine if my numbers spike, they will either put me on bed rest or induce me, depending on how far along I am. I am hopeful that I'll go into labor on my own though, as my BP has been well maintained by the med.
Post by barefootcontessa on Sept 4, 2012 20:09:07 GMT -5
My BP rises in late second tri and starts there until delivery usually and then drops after delivery. It never is terribly high. I think 140/100 is about the highest it goes. I never took meds, although OB has me checking at home with instructions to call if it spikes. I have to have c-s, so I only go to 39 weeks anyway. My OB does not seem to worry, but that may be because he is familiar with how things go for me in pregnancy. It sounds like OB is expecting a rise down the road.
I was induced at 37 weeks . My BP was no longer being controlled by medication and the decision was made. I had been on modified bed rest since 33 weeks. The last 3 weeks i was having no stress tests every other day. At the point I was induced my BP was 180/110. Not okay.
I was put on magnesium to prevent me from having a stroke. We tried some drug to soften my cervix and waited 4 hours. At the end of that time my cervix was the same, and my BP was even higher. I had an emergency c-section 24 minutes later.
I was induced at 38 weeks. I have chronic controlled hypertension though, but the numbers were creeping up. Between 34 and 37 weeks I was getting twice weekly NSTs and weekly BPPs. On a Friday (37+ weeks) DS took too long to pass the NST, so I went in for another BPP. He didn't pass that, so I went to L&D for a another NST which he eventually passed. They asked me to come back Sunday, where he also took too long to pass the NST. The OB said it was best at that point to induce. I was there all day on Cytotec so they could monitor DS and my BP (not alarmingly high, but high), went home that night, then came back the next morning to be admitted for the full induction.
When I was put in a delivery room, the OB asked if I wanted him or a midwife. I went with the midwife. I was on pitocin during the day but not at night. I wasn't making much progress dilating and had a manual dilation based on the midwife's recommendation (Foley catheter inserted in cervix). DS was born Wednesday night. My BP did not react well to the pain and I got an epidural at 4 cm. The pain of the BP cuff going off was worse than the contractions. Once I got the epidural my BP stabilized.
My BP got worse after delivery and I swelled badly. I ended up getting a diuretic added to my regular BP medication.
They were talking about inducing me at 37 weeks. DS was also measuring at 41 weeks at 35. I went into labor at 36 weeks and had an over 8 lb baby. It was all sorts of craziness.
I developed pih between my last appointment and when my water broke (37.5). However, my doctor knew that things weren't looking great at the last few appointments. He wanted to induce me no later than 40.5 weeks. He also told me the baby would probably be earlier than that. He also made a comment that I took as he would want to induce me even earlier if things didn't look at a future appointment, but he didn't say induce. My doctor leaned towards not telling you all the what ifs, but sometimes thinking out loud. My husband said he seemed like he wanted to do all the worrying for you.
Post by kimibrighteyes on Sept 4, 2012 22:37:14 GMT -5
It sounds as if you have gestational hypertension which is a more current name for pih. There is actually a large study that addresses this question. It suggests that outcomes for mothers are better if they are induced Once they are beyond 37 weeks compared to waiting. No study is perfect but he may have a good reason or not letting you go to 40 weeks.
Also most of the guidelines world wide are suggesting a single pee called a "spot urine protein to creatinine ratio" can be used instead of a 24 hr urine. My center rarely uses a 24 hr urine these days.
I've included the link to the study below if you are interested
My doctor was fairly vague at my appointment last week at what was going to happen to me. My blood pressure has responded pretty well to the medication I'm on and has never risen above 140/100. Here was the conversation we had.
Me: So how will this PIH diagnosis impact my labor and delivery? Dr: Well as you know at this practice I like to support women going into their labor any time on their own from 38-42 weeks of pregnancy. But I'm not sure if that will be the case for you. Me: Well, so 42 weeks probably can't happen. But what about 40? Dr: Not so sure about that either.
I am going to push a bit harder at my appointment Thursday but if you had PIH how did your doctor handle your delivery? Were you induced and at what point?
I was induced at 39w3d because that was when she felt that the risk for her staying in was worth the risk of section with induction. It was (mostly) favorable and she was born the same day I was induced.
ETA: I was only diagnosed PIH never to pre-e and didnt spill proteins, but was ridiculously swollen. I was on some type of bedrest from 26 weeks til delivery.
Thanks kimi. That study was what started freaking me out via Dr Google. Although I guess I could take it the opposite way, that the baby would be fine if she needs to be born in a few days vs a few weeks. Hopefully I'll know more of the plan tomorrow.
I would be reassured by the study. I hope everything works out the way you want it to, but most of all I wish you a healthy baby (and healthy mom)
Will you have to repeat your 24 hour ua at any point?
I will ask on Thursday. I know they didn't find any protein in my sample last week but it was just one pee, not the 24 hour one I took the week before. I think they can sense my type A nature and are trying to keep me from freaking out but clearly I am just doing that on my own anyway
I really do understand this, but what will happen between now and 40 or 42 weeks just isn't predictable. I will tell you that I was completely fine at a Monday appointment and had an emergency induction -- mag sulfate, the works -- 3 days later.
Post by iheartbanjos on Sept 5, 2012 9:15:41 GMT -5
I didn't have PIH until 41 weeks and I didn't even get to go home from my appointment, I had to walk across the street and get admitted to L&D. By the grace of God, stripping my membranes was enough to send me into labor (I hadn't even been checked yet at that point as my pregnancy was largely intervention free.) I had to do fetal monitoring and lay on my side for several hours, stalled out at 5cm, and had to allow them to break my water to keep things moving. I was under a bit of a time restraint, but never felt rushed. The midwives kept things calm and kept the OB out of the room (I had to have an OB after I was diagnosed with PIH.)
I had to do my whole labor start to finish at the hospital, but otherwise had the med free birth that I wanted.
Did they already do labs to confirm that it isn't pre-e?
I delivered at 32.6 due to pre-e and HELLP and was on mag sulfate for 24 hrs after delivery which is the devil-hate that stuff! I was on bp medication most of my pg though. It was PIH..I do not have high bp when not pg. I had to do that stupid 24 hr urine test like twice a week for 3 weeks. I hated it!
It sounds like your Dr is monitoring you well and hopefully the bed rest will keep your bp down. Good luck and hang in there!
Appointment today was really good! Blood pressure was 135/85 and they think since it has been the same the past two appointments the medicine seems to be doing its job. No protein in the spot urine check or other signs of pre-e. Baby is in great position for birthing and very active. Until/unless they see a spike in my blood pressure or other pre-e symptoms they will not schedule an induction and think I could still carry to term! So I'm cautiously optimistic. Thanks for all the support.
Given your blood pressure today, are the letting you off modified bed rest/letting you return to work?
Glad your appointment went well. I had PIH at 36 weeks and went on bedrest for 10 days. I was induced at 38w4d. I was on magnesium (which sucked ass). They broke my water and I labored with an epidural for 12 hours before having a csection because DD was stuck and would decend.
I never had protein in my urine and all my labs came back fine. I just had 3 weeks of ridiculously high blood pressure.
Given your blood pressure today, are the letting you off modified bed rest/letting you return to work?
They want me to stay on the modified bed rest. Who knows, maybe I should've pushed further on this one but I was pretty happy with the outcome so I am kind of ok with it. At my next appointment though I'll ask again. Honestly I don't really want to go back to work full time in the office, but it would be nice for the weekends
I completely understand not wanting to return to work fulltime. I had a BP spike today and have been put on "bed rest" through the weekend. I have an appt tomorrow to discuss the results of my blood and urine tests from today and to check my BP again. I dread going on bed rest since I still am so far out from my EDD in Jan. I get cabin fever very easily. Its only been a day (not even really) and I am already bored out of my mind. Hence why I came out of lukerdom.
I'm glad you had a good update! I will admit -- I'm surprised that they don't plan to repeat the 24 hour urine, and if it were me, I'd be pushing for that. Just my 2 cents. Either way, I of course hope that your BP stays down and that you're able to go to term w/o an induction.