High blood pressure in pregnancy?

[tiffany k]

I'm 24 weeks with my 6th baby. At my appointment yesterday, my bp was 146/87. Normally, it's 110/70. The tech had me relax in a quiet, darkened room for 10 minutes and then took it again from my other arm. It was 136/74. The nurse I saw for my appt said nothing about it and when I inquired if that seemed high, she asked if I was on bp medication. I said I wasn't and she just made a note in my chart and told me to schedule an appt in 4 weeks like usual. I'm concerned because those 10 minutes were the most relaxed I've been in nine years, since becoming a mother, so what's my bp like in reality? Is high blood pressure only a concern at the end of a pregnancy? Anyone out there who has BTDT? Maybe I'm worrying over nothing.

[Sherri in MI]

But it can happen at any time. It MAY be a sign of preeclampsia. Note I said MAY be. HBP doesn't mean you DO have preeclampsia, but it does mean you COULD and should be monitored (more regular blood pressure checks) I'm not a doctor and I don't want to worry you. Preeclampsia is totally treatable, but should not be ignored. I do think you should call you doctor and discuss it with him. In my personal, non-medical opinion, it's my understanding you should be monitored a lot more closely. Four weeks seems long to take another reading. Did they mention if you were spilling protein in your urine? Do you have any swelling?

 

I developed preeclampsia at the very end, when I went in to be induced. They took my blood pressure (it was off the charts I found out later) and rushed in & put me in bed. This was on a Friday morning and I was as happy and relaxed as could be, since I wasn't in labor yet. The previous Monday I had been to the doctor and my blood pressure was fine. That's why I'm suggesting your bp should be check more often.

 

Here is a link I found that discusses high blood pressure in the second and third trimesters. Don't be alarmed but be concerned and get informed and call your doctor and ask questions!

 

http://www.webmd.com/baby/tc/preeclampsia-and-high-blood-pressure-during-pregnancy-topic-overview

 

Feel free to PM me if you have any questions on my experience, or just want reassurance.

 

I hope this was helpful without panicing you. I remember what it was like to be pregnant and all the concerns and questions I had in my head. Blessings to you and keep us posted!

 

Sherri

[happyhomemaker25]

My BP was a little high at my first OB appt. He sent me to a cardiologist. :glare:

It's been pretty normal since. The cardio did not find anything wrong. My OB was being overly cautious because of some other issues I was having.

I would monitor it at home if possible and record the readings to let your OB know.

I have been reading up on the Brewer diet. The amount or protein in the diet is supposed to help avoid PreE.

[StephanieF]

I had to monitor mine throughout the pregnancy, it was easy to do and the machines are not very expensive. I also "checked" my machine with the OB's to make sure that we were both taking similar readings. If you have a machine you can take it daily or sev times a day if necessary.

Stephanie

[JenAL]

I had high bp will all 4 of my pgs. But after the first one, I was offically diagnosed with hypertenion.

 

With the 1st one, my bp started to get high around 18 weeks I believe. It steadily went up & we were unable to control it with meds. I was placed on full bed rest but ended up developing pre-eclampsia & ultimately ended up delivering via emergency c/section 2 months early. The other 3 pgs, I was medicated the entire pg & while my bp wasn't wonderful, it never got as high as it did with my first one (we're talking readings of 180/100 for my 1st pg!).

 

I would definitely keep an eye on it. Make sure you stay hydrated & watch for an signs of high blood pressure...headaches that won't go away with tylenol, blurry vision. Also report ANY swelling to your doctor immeidately.

[Susan in TN]

My OB always said his main concern was with the lower number - in your case, it's within a normal range. I wouldn't say there is anything to be concerned with yet unless you are having other symptoms that concern you.

[lisamarie]

Mine started going up around week 20 with my 1st pregnancy. I ended up on full bedrest by week 24. I just had high blood pressure at that point, I wasn't spilling protein and my HELLP blood work came back fine. It wasn't until I was at 30 weeks that I started spilling protein and then at 32 weeks I was put on hospital bedrest and was delivered via emergency c/s at 34 weeks when my protein numbers went really high and my blood pressure couldn't be controlled with bedrest.

 

My recommendation would be to have your doctor run the hellp bloodwork panel to give you a baseline so they will know if things go south. I would also request a 24-hour urine sample test to check for protein in your urine. And then I would buy a home blood pressure monitor and start recording your BPs.

 

Chances are that it's just a one time fluke reading and that you'll be fine, but preeclampsia is one of those things that can strike really fast. Some people it comes on gradually, others it happens overnight. That's why I would want to monitor my BP at home so I know if it's going up. I would lay down for 30-45 minutes and then take a reading at the same time every day.

 

I did have elevated BP with my second pregnancy but only during my 2nd trimester. It went back down around 28 weeks and I was fine until after I delivered when it spiked back up and I had to go on BP meds for a few months. My 3rd pregnancy I was fine the entire time and then it spiked again after delivery and had to go on meds for a while.

[dansamy]

This is from a BTDT mother. I started to develop high BP at 28 weeks. My OB had me come back at 29 weeks. Still elevated. At 30 weeks, I had an appointment for that afternoon. I felt awful. I called the office and they had me come in that AM instead of waiting until the afternoon. When I got there, they checked my BP, weight and urine and wheeled me straight over to L&D and put me on monitors. My BP was 2xx/1xx. I had an emergency c-section. It was one of the most life-changing things I've ever experienced.

 

I ended up being diagnosed with HELLP syndrome with all three children. I have never carried to term. I have never gone into labor. HELLP definitely changed my life. It is dangerous and can develop very rapidly from a "little high BP" to a downright deadly emergency.

 

I would watch your BP at home with a home BP cuff. Stay well hydrated. Rest. Notify your OB if you see elevated BPs on your home cuff.

[abbeyej]

If I were you, I would increase my water intake and begin taking Epsom Salt baths whenever possible (daily, if you can), and I would try to check my BP myself a couple of times over the next week or so. If it continues to stay high, call back in and ask to speak to an OB or MW directly about your concerns. Also, be aware of any changes like dizziness, blurred vision, headaches...

 

But work on your hydration and do Epsom salt baths. And monitor for yourself... I don't think you need to be panicking or anything like that -- but it's also not something I would simply ignore at this point.

[cillakat]

I'm 24 weeks with my 6th baby. At my appointment yesterday, my bp was 146/87. Normally, it's 110/70. The tech had me relax in a quiet, darkened room for 10 minutes and then took it again from my other arm. It was 136/74. .

 

Without writing a tome, I'll just mention three things:

vitamin d3

magnesium

potassium

 

It shouldn't be too difficult to get it under control but it IS a top priority.

 

Nutrition is critical (including sufficient D) and nutritional issues are virtually always the cause of high blood pressure, pregnancy induced high blood pressure and pre-eclampsia.

 

http://www.vitamindcouncil.org/newsletter/pregnancy-and-gestational-vitamin-d-deficiency.shtml

"Preeclampsia

 

 

J Clin Endocrinol Metab. 2007 Sep;92(9):3517-22. Epub 2007 May 29.

Maternal vitamin D deficiency increases the risk of preeclampsia.

 

Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM.

 

 

Preeclampsia is a common obstetrical condition in which hypertension is combined with excess protein in the urine. It greatly increases the risk of the mother developing eclampsia and then dying from a stroke. Dr. Lisa Bodnar and her colleagues found women with 25(OH)D levels less than 15 ng/mL had a five-fold (5 fold) increase in the risk of preeclampsia.

 

 

and from the same link, this:

 

"the American Academy of Pediatrics (AAP) recently recommended that all pregnant women have a 25(OH)D blood test because Vitamin D is important for normal fetal development (p. 1145): "Given the growing evidence that adequate maternal vitamin D status is essential during pregnancy, not only for maternal well-being but also for fetal development, health care professionals who provide obstetric care should consider assessing maternal vitamin D status by measuring the 25-OH-D concentrations of pregnant women. On an individual basis, a mother should be supplemented with adequate amounts of vitamin D3 to ensure that her 25-OH-D levels are in a sufficient range (>32 ng/mL). The knowledge that prenatal vitamins containing 400 IU of vitamin D3 have little effect on circulating maternal 25-OH-D concentrations, especially during the winter months, should be imparted to all health care professionals.""

 

That statement was published in Pediatrics. 2008 Nov;122(5):1142-52. Wagner CL, Greer FR; American Academy of Pediatrics Section on Breastfeeding; American Academy of Pediatrics Committee on Nutrition.

http://www.ncbi.nlm.nih.gov/pubmed/18977996

 

 

 

This highlights the truly extraordinary role of vitamin D in healthy pregnancy:

http://www.vitamindcouncil.org/newsletter/more-vitamin-d-studies-of-interest.shtml

" Professor Bruce Hollis presented findings from his and Carol Wagner's five million dollar Thrasher Research Fund and NIH sponsored randomized controlled trials of about 500 pregnant women. Bruce and Carol's discoveries are vital for every pregnant woman. Their studies had three arms: 400, 2,000, and 4,000 IU/day.

 

1. 4,000 IU/day during pregnancy was safe (not a single adverse event) but only resulted in a mean Vitamin D blood level of 27 ng/mL in the newborn infants, indicating to me that 4,000 IU per day during pregnancy is not enough.

2. During pregnancy, 25(OH)D (Vitamin D) levels had a direct influence on activated Vitamin D levels in the mother's blood, with a minimum Vitamin D level of 40 ng/mL needed for mothers to obtain maximum activated vitamin D levels. (As most pregnant women have Vitamin D levels less than 40 ng/mL, this implies most pregnant women suffer from chronic substrate starvation and cannot make as much activated Vitamin D as their placenta want to make.)

3. Complications of pregnancy, such as preterm labor, preterm birth, and infection were lowest in women taking 4,000 IU/day, Women taking 2,000 IU per day had more infections than women taking 4,000 IU/day. Women taking 400 IU/day, as exists in prenatal vitamins, had double the pregnancy complications of the women taking 4,000 IU/day.

 

 

What does this huge randomized controlled trial mean?

 

We have long known that blood levels of activated Vitamin D usually rise during very early pregnancy, and some of it crosses the placenta to bathe the fetus, especially the developing fetal brain, in activated vitamin D, before the fetus can make its own. However, we have never known why some pregnant women have much higher activated Vitamin D levels than other women. Now we know; many, in fact most, pregnant women just don't have enough substrate, the 25(OH)D building block, to make all the activated Vitamin D that their placenta wants to make.

Of course fetal tissues, at some time in their development, acquire the ability to make and regulate their own activated Vitamin D. However, mom's activated Vitamin D goes up very quickly after conception and supplies it to baby, during that critical window when fetal development is occurring but the baby has yet to acquire the metabolic machinery needed to make its own activated Vitamin D.

The other possibility, that this is too much activated Vitamin D for pregnancy, cannot stand careful scrutiny. First, the amount of activated vitamin D made during pregnancy does not rise after the mother's 25(OH)D reaches a mean of 40 ng/mL, so the metabolism is controlled. Second, levels above 40 ng/mL are natural, routinely obtained by mothers only a few short decades ago, such as President Barack Obama's mom probably did, before the sun scare. (President Obama was born in Hawaii in late August before the sun-scare to a mother with little melanin in her skin) Third, higher blood levels of Vitamin D during pregnancy reduce risk of infection and other pregnancy complications, the opposite may be expected if 25(OH)D levels above 40 ng/mL constituted harm.

It is heartening to see the Thrasher Research Fund and NIH support such a large randomized controlled trial. In fact the Thrasher Research Fund has already funded a three year follow up and the NIH request for a follow up grant is pending. Nevertheless, a large number of medical scientists keep saying, "We need even more science before recommending Vitamin D." What are they really saying?

First they said we need randomized controlled trials (RCT) before we do anything. Well here is a big one. Then they say, as they did in Brugge, "We don't believe this RCT, we need more money for more RCTs." If you think about it, they are saying pregnant women should remain Vitamin D deficient until scientists get all the money for all the RCTs they want, which may take another ten years. How many children will be forever damaged in that ten years?"

 

 

End quoted material

 

Best,

Katherine

[cillakat]

Here's a doc I wrote up for a pregnant friend - she keeps kosher which is why the supplement links are kosher....

 

For future reference, it can be found here:

https://docs.google.com/Doc?docid=0AV3S7fNjwg33ZHp0bWN3cV8xNDhoczVmbTJnOA&hl=en

 

 

Nutrition during Pregnancy and Breastfeeding

 

 

general info • what/where to buy

when to take what • reminders: tips/tricks

milk supply as it relates to menstrual cycle

 

 

 

 

 

General Info

for pregnancy and breastfeeding nutrition in order of importance

It's absolutely better to get nutrients from our food than it is to get nutrients from supplements. But in 10 years of analyzing diets, I haven't found anyone getting all that they need from food.

 

 

•vitamin d3

5,000 IU per day

better yet, 1,000 IU per 25 lbs body weight. if levels are

less than 55ng/mL take 3,000 IU/25 lbs body weight for a month

then drop back down to 1,000 IU per 25 lbs body weight

 

ideally, have your hcp test 25(OH)D levels using LabCorp or ZRT

if using Quest, divide the result by 1.3 (more at vitamindcouncil.org)

 

vitamin d and gestational diabates, cesarean rates, pre-eclampsia, bacterial vaginitis

 

•zinc

30-50 mg zinc suppplementation per day from all supplemental sources

 

•magnesium

500-1000 mg per day from food and supps

eat 1/2-1c beans per day (black, kidney, garbanzo, etc)

eat 1oz raw/lightly toasted nuts every day

(pistachio, almond, pecan, walnut, sunflower, pine, hazelnut)

 

•Omega 3 from fish oil

ideally 1g DHA per day (and 500mg-1g EPA) while pregnant and nursing

no flax, borage or evening primrose till the last 5 weeks

 

•calcium 1000-1200 mg per day from food and supps

• get what you can from food supplement the rest

• 1 cup any milk/milk sub (300ish mg calcium)

• 6-8 oz yogurt (400ish mg calcium)

• 1 oz hard cheese (200ish mg calcium)

 

•multi Nutri-Supreme Research Prenatal

best prenatal multi I've found yet...

optimal formulation best iron, best zinc, best forms of B vitamins.

 

•iron

iron bisglycinate - safest, best absorbed/ assimilated form

avoid ferrous forms (in most prenatals and regular vites)

 

Purchasing Information:

 

Vitamin D-3

• drops - just olive oil and D3 (Nature's Answer-olive oil, kosher pareve)

with food

• avoid dry tablets and powder based capsules

• easy to take

• my 40 lb child takes a drop each weekday (M thru F)

• my 75 lb child takes 9 drops a week - usually one a day with an extra M and F

• I take 3 drops per day with breakfast

 

 

 

Zinc

• Blue Bonnet Chelated Zinc

• one per day in the middle of a normal/large meal

• if it causes stomach upset, take half: open capsule,

empty half out, then take.

Getting it in (see, I knew you could do it!!)

include 2 eggs each day

4-6 oz animal protein

3 servings dairy (or calcium supplements + 3 oz additional high quality protein)

10 or more servings produce

1/2-1 c (or more) legumes

1-2 oz raw nuts and/or seeds (do not rely on peanuts nor any one particular nut/see

carbs ideally from legumes, non-starchy veggies, winter squash, sweet potato, quinoia,

less reliance on potato and grains

breakfast 3-5 supps

1+c nonstarchy veg, 1/2 c fruit, 3 oz protein, more nonstarchy or starchy veg or grain

multi • vitamin d (1000iu per 25lbs) • magnesium (200ish mg )

calcium citrate or calcium containing food (250-300 mg)

fish oil or fatty fish (wild salmon, sardines, tuna, anchovy...use little to no farmed salmon)

 

snack no supps

1+c nonstarchy veg, nuts, small amount carb

lunch 1 or 2 supps

1+c nonstarchy veg, 1/2 c fruit, 3 oz protein, more nonstarchy or starchy veg or grain

magnesium (200ish mg) • calcium citrate or calcium containing food (250-300 mg)

snack no supps

1+c nonstarchy veg, nuts, small amount carb

dinner 2-4 supps

1+c nonstarchy veg, 1/2 c fruit, 3 oz protein, more nonstarchy or starchy veg or grain

magnesium (200ish mg) • calcium citrate or calcium containing food

zinc (stick the zinc with whatever meal is your largest)

fish oil or fatty fish (wild salmon, sardines, tuna, anchovy...use little to no farmed salmon)

 

bedtime 0-1 supps

calcium supplement if you need it to get to 1000 mg for the day

 

......

snipped the rest to shorten the post....the full doc can be found at the link above.

 

[lisamarie]

Huh. The vit D link makes me wonder. I don't drink milk, don't eat shell fish, and live in Michigan where sunshine is sketchy at best. I was tested 2 months ago and my vit D was 21.3. Makes me wonder... Too late now, but I'll be sure to pass that info on to anyone else I know who starts having BP issues.

[cillakat]

Huh. The vit D link makes me wonder. I don't drink milk, don't eat shell fish, and live in Michigan where sunshine is sketchy at best. I was tested 2 months ago and my vit D was 21.3. Makes me wonder... Too late now, but I'll be sure to pass that info on to anyone else I know who starts having BP issues.

 

Not too late....still *really* important to optimize your D...and your kids D levels.

 

A recent study indicated that optimal levels of serum D may reduce breast cancer by 80%.

Women deficient in vitamin D are 94% more likely to see their breast cancer spread and 73% more likely to die from cancer.

 

40% reduction in bladder cancer by keeping levels between 40 and 60 ng/mL93% of patients with musculoskeletal pain are vitamin D deficient

 

vitamin D deficiency is predictive of pelvic floor disorders.....

 

seasonal affective disorder is likely nothing more than vitamin D deficiency

 

optimal vitamin D levels seems to be preventative against autoimmune disorders

 

vitamin D has a treatment effect in MS, influenza and other disorders and multiple illnesses

 

seems to have both a preventative and treatment effect in asthma

 

reduces falls and morbidity from falls in the elderly...

 

 

It's not too late.

 

Start now. Start your kids now:)

 

K

[cillakat]

And don't underestimate what dietary potassium can do for your blood pressure (produce, produce, produce)

 

Here is some more good info on increasing potassium intake:

http://www.krispin.com/potassm.html

 

More Vitamin D and blood pressure information with cites to the medical literature:

http://www.vitamindcouncil.org/researchHypertension.shtml

 

Vitamin D, blood pressure, protecting the kidneys:

http://www.ncbi.nlm.nih.gov/pubmed/19687790

"The antihypertensive properties of vitamin D include renoprotective

effects....snip.....In general, the antihypertensive effects of vitamin D

seem to be particularly prominent in vitamin-D-deficient patients with

elevated blood pressure. Thus, in view of the relatively safe and

inexpensive way in which vitamin D can be supplemented, we believe that vitamin D supplementation should be prescribed to patients with hypertension and 25-hydroxyvitamin D levels below target values."

 

Nutritiondata.com is fun to play around with.

 

Dash Diet...generally speaking, this the evidence based standard in

lowering bp through diet. It recommends 8.5 svgs produce per day though for a number of reasons, there is sufficient evidence to support intakes higher than that (ie the 10-15 svgs).

 

http://www.healthcastle.com/potassium-high-blood-pressure.shtml

 

I'd be worth getting some magnesium asap. Abbey's suggestion for epsom salt baths is good. Oral supplemental magnesium would be helpful as well. 1000 mg per day of a tolerated form woulnd't be too much.

 

Best,

Katherine