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Would you call OB right away about this? Or just wait? PreEclampsia


Elisabet1
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I feel like I am on the edge of pre-eclampsia symptoms. Nothing is severe yet. Just light nausea, light cramps, recurring medium headache, blood pressure inching up but not high yet (but my BP is usually low so wonder a little bit if this is troubling as it is higher than usual 135/80 when I am usually more like 100-110/50-60). It is probably a complete waste to call now, as I do not seem to have preE now, but I feel like it should be watched.

 

I go in tomorrow for my regular appointment. Would you just wait until then? I am afraid if I call before the symptoms are much, then they will see nothing wrong and I won't get taken seriously when things get worse. But I also feel a little like maybe a little closer monitoring could be a good idea. But I am unsure what closer monitoring would be. Anyone have experience with this?

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I have experience with this. We did regular urine catches (styrofoam fishing box filled with ice to hold your sample gallon jug works well) and I monitored my bp from home. I also took Epsom salt baths most nights, ate low carb/120g protein/tons of veggies/lots of water. I made it 12 weeks past the first glimmer of problems, but still delivered two months early.

 

In your shoes, I would take an Epsom salt bath, and go lay down on my left side for a couple of hours and reassess the blood pressure. I would absolutely be talking game plan tomorrow with ob or peri, and I would call in at any point I hit 200/100 or I had a blinding headache.

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Call.

 

Did your OB give you any kind of instructions at what to do when you were discharged from the hospital for these symptoms last week?  Does your OB know you were seen in L&D for this?

 

You should not have to rely on people on message boards for these types of instructions, especially given that you were already seen for this exact thing.  Your doc shouldn't have let you leave L&D without a specific list of things to watch for and things to do (hydrate, for example, eat protein-rich foods, bed rest...whatever her protocol is for this type of thing).  If you're afraid your doctor won't take you seriously now because you don't have enough symptoms and then she also won't take you seriously "when things get worse" you need to switch to a doctor you can be open and honest with and one you can trust.

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A rise of over 30 systolic and 15 diastolic is what they used to determine my preeclampsia because my BP ran so low to begin with.  Diagnostically above 140/90. What where your discharge instructions?  How are you treating this?  I would call, if nothing else than to clarify what you should be do and when because it doesn't sound like you have an adequate plan and things can get dangerous quickly.  I would also make sure you OB knows you were in LD for this, sometimes this isn't communicated with it being a Monday.  They may want to see you right away with continued symptoms.

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I'd call but not get too upset if they wait to see you tomorrow.  As long as you know what to look for and they are clear about how high your bp can go before being seen, I'd be ok just waiting until tomorrow to be seen. 

 

 

If they wait to see her tomorrow, she should be given clear instructions on self-care and a complete "if -- then" briefing, covering scenarios ranging from mild escalation to a full-blown emergency plan.

 

 

Praying for you Elisabet1.

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I agree with calling in.  My bp is typically low too, and when I had pre-e it wasn't out of a normal range, but I had every other symptom raging so I persisted.  A 24hr urine catch caught it and I was scheduled the next day for an induction...which b/c of the pre-e was an ordeal...you can read my birth story in the expecting sub-forum.  If I would have waited, I'd be dead and so would my baby.  

 

 

Get in there.  If your doc is incompetent, the advice to go straight to L&D is good.  Just tell them that you'd rather risk looking like an over-protective momma than escalating to pre-e. Most are happy to put your mind at ease even if you aren't in any danger.

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CALL!! And if you feel too strange, go in. I've had PE twice-once it went from slightly elevated BP to Class A HELLP quite literally overnight, the 2nd time it probably would have if it hadn't been that they did the emergency C-section before it got even close.

 

 

 

 

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So I just got back. My protein was fine (just trace) and such. So I am supposed to get my own BP cuff and monitor. I have a fair amount of swelling and I was told to check my BP three times a day. Fill out a chart for that. Call if anything gets any worse. But everything checked out ok. And I am going to switch to weekly visits now.

 

Did I already post that last week, that the sonogram showed the baby to be 5 pounds 7 ounces at 31 weeks! I am thinking no vbac of rme.

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And fat babies squish down very nicely - head size and positioning make a much bigger difference. A poorly positioned tiny baby, like my last one (6 lbs 10 oz) can be a much harder birth than a much larger well positioned baby (like my fourth, at 8 lbs 4 oz).

 

And even at 42 weeks I have never had a kid over 8 lbs 15 oz, but ultrasounds and even midwives guessing by fetal positioning and palpitation regularly guess my children will be in the 10+ pound range. Nobody knows, and if you're telling yourself your baby is huge, he won't be born easily, the VBAC will fail - it probably will. Maternal attitude and self talk going into birth makes quite a difference in how a birth progresses and the choices that are made. You cannot control the outcome, necessarily, but do NOT underestimate how the mindset you cultivate in yourself matters to how you approach labor.

 

I agree  with position is more important than size.  my smallest was c-sec.  her head was just "slightly" "off" (there was a blotch of MY dried blood on her scalp of where she was pressing against me - so I know exactly where she was presenting.). she never descended past -2.  she still has a misshaped head.  I was told my pelvis was too small.  she was my smallest - and ONLY c-sec.

 

 

my "easiest" delivery?   weighed 9lbs 8ozs . . . as soon as I was dialated, his attitude was 'get out of my way, I am coming through'.  and he easily came right out.  (I don't want to think about how much my biggest was . . let's just say - he wasn't it.)

 

I also agree the 'guestimate' of sizes on an US/external manipulation - is a crapshoot.  they can be off by over a lb - either way. (and I personally have had that happen on mutlple pregnancies.  My L&D friend has had many patients where that happened.)  when you consider how much a baby weighs - that is ALOT.

 

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I have had successful vbacs. But with my last baby, who is 9 pounds 3 ounces, I went in to labor naturally. And stayed in that condition for 44 hrs. The contractions were 2 minutes long and very big by the end. It was awful. I could not cope at all. I was screaming and crying. And I did not even dilate a finger tip. I do not even know why I never dilated. I did have excess amniotic fluid last time. So far, I do not this time. But since I have no clue what went wrong last time, I pretty much do not have much confidence this time. I wonder if my aging uterus is the problem? I am not sure. The perinatal doctor did comment that my uterus is quite thick. Do not know if that could cause anything.

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A thick uterus is wonderful. It is more likely the baby was poorly positioned if you were having aggressive and long contractions but little dilation. This last baby in December was my worst labor, even though it was done at home and a successful HBAC. He was well positioned but we didn't know he had a double nuchal cord around his neck that was very tight. So the midwives could feel he was engaged and his head was properly positioned, but I was stuck in transition and he refused to drop. It took three hours of transition to get him to tuck his chin and drop, then he was born quickly. But I dilated very slowly because he couldn't apply pressure to my cervix to dilate it. The midwives could barely get the cord untangled for his torso to be born, it was that tight.

 

We had zero decels or fetal distress, and they were monitoring me closely because of the VBAC. Fortunately for him my labor was gentle and not augmented, so he didn't lose any oxygen. Unfortunately for me, that gradual process meant I was stuck and couldn't progress until he was good and ready to let me :D

She never came down at all. But this pregnancy, I feel like he is already dropping. He feels low and I feel sore down there. I seem to recall on my vaginal births, I was sore between the legs for the weeks leading up to the delivery.

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I consider it interesting (in a "is there anything to this, or pure concidence?" kind of way)  that the two times I had pitocin (#1 & #5) - both were because of SRoM before labor began.  contractions never got into a good pattern by themselves, so I was given a pit drip to make them do their thing.

 

I was induced once - with ARoM *before* i was in labor. as a VBAC I was hooked up to an IV for hydration only. (that was policy.) I quickly got into a good labor pattern, and everything proceeded smoothly.  slowed a little after I had an epidural.  (it just hurts more with ruptured membranes.) still reasonable.  my biggest complaint with that kids delivery is if he'd just waited THREE more MINUTES!!!!, i'd have had another full day in the hospital.  I wasn't physically ready to go home, but my insurance wouldn't pay for it.  I needed another 12 hours.

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