Preeclampsia - Right Dr?

[nov_mum]

I saw an OB today and he at first seems pretty sensible to me. Watch and wait and monitor and it all seemed ok. He then told me that he suspects I might have had GD in previous pregnancies (despite never testing positive for high sugar levels and on my second pregnancy which was my biggest baby I had three tests including one only days before I was induced!). He then told me he thinks that despite me having Preeclampsia in all three previous pregnancies that he thinks I have about a 10% chance of developing it this time around. If this was in previous pregnancies I might have gotten excited and experienced a sense of relief while setting off to plan my home birth but I feel one of us needs to be a realist. On the plus side he won't over monitor me and induce at the drop of a hat. On the negative side he could leave things too long. I long ago gave up my dream of a home birth or even starting off labour independently let alone getting to 40 weeks only to be told that it is all possible. What do you guys think? Is my Dr on drugs or am I just too pessimistic?

I am 19 weeks today and started labetalol for high BP (180/106) two weeks ago plus dipsticking positive for protein. BP prior to pregnancy 120's/80's.

 

[Torres]

Why does he think you have GD?
Your BP and protein in your urine points to pre-e. Do you know what your protein measurement was? Do you have any other signs of pre-e? How far along were you with your other pregnancies when you got pre-e?
I would tread carefully as some Drs will allow you to go too far. With my daughter I developed severe pre-e around 35 weeks, and because my OB let me go, it developed into HELLP syndrome.
Can you see the OB that saw you for your other pregnancies?

 

[daisy72]

I'm also about 19 weeks, never had PE in my previous pregnancies, my BP is only high when in the doctor's office (130/90 vs. 115/60 at home),never tested positive for protein in dipsticking urine... and I'm already doing the notorious 24-hr urine test together with all the PE blood work . I also have GD but well-controlled. My OB insists that once you are in a highway, better start taking precautions in advance then just before banging into a truck...
Ah, and I'm also on a low dose of aspirine...

 

[nov_mum]

Why does he think you have GD?
Your BP and protein in your urine points to pre-e. Do you know what your protein measurement was? Do you have any other signs of pre-e? How far along were you with your other pregnancies when you got pre-e?
I would tread carefully as some Drs will allow you to go too far. With my daughter I developed severe pre-e around 35 weeks, and because my OB let me go, it developed into HELLP syndrome.
Can you see the OB that saw you for your other pregnancies?

I had three previous pregnancies end in induction owing to PE. First at 35 weeks, second at 38 weeks and last one at nearly 37 weeks. The nurse sent my urine away when I dipsitcked positive but sent it for a msu instead of a cpr so there was no count done. My LFTs were fine though but they always have been. We measure protein differently in NZ. Over 30 is PE. Mine got up to 900 in my first pregnancy. He thinks I might have GD because my second was a 'big baby'. He was 8lb13oz at 38 weeks which wasn't small but hardly huge either. I was tested 3 times in that pregnancy for GD and nothing showed. There is a study being done worldwide at the moment (I think it's the CHIPS study) and it's looking at the effects of not medicating people with BPs 140-150's over 90-100's and the size of their babies. The Dr I had last time told me that the band of those pressures often cause good sized babies and anything over results in IUGR. My last baby at nearly 37 weeks was 6lb 15oz. Nothing huge. I think he might be confused but will see

 

[nov_mum]

I'm also about 19 weeks, never had PE in my previous pregnancies, my BP is only high when in the doctor's office (130/90 vs. 115/60 at home),never tested positive for protein in dipsticking urine... and I'm already doing the notorious 24-hr urine test together with all the PE blood work . I also have GD but well-controlled. My OB insists that once you are in a highway, better start taking precautions in advance then just before banging into a truck...
Ah, and I'm also on a low dose of aspirine...

I agree it is better to be cautious. I started on aspirin and calcium when I started the labetalol two weeks ago for my pressures.

 

[Agiboma]

@ op i think you should change DR. I think this man is crazy, and titally off his rocker! I also had pre e in my pregnancy with my son who i delivered @ 25 weeks. How can he be so calm about pre e and you already have high bp plus protein in your urine. I take pre e so seriously, i own a diagnostic clinic and we had a lady come in a few weeks ago with pre e. You can read the story in my journal, click the link in my signature. Also once you have pre e in your country are you not considered high risk. In Canada i know they consider you to be high risk and usually most ladies spend the time in the hospital until they deliver. Please take care of yourself.

 

[nov_mum]

I had my GTT the other day and my blood sugars were perfect. I am skeptical but my hubby reckons I should wait and see what he says next time. I see him in 8 weeks time. Although I love not being classed as high risk, I have no doubt PE will eventuate again. History is the best determinate of that. I makes me nervous though : S

 

[Agiboma]

@ op so what constitutes high risk in your country. A bp of 180/106 + protein in your urine would be hospitalization until you deliver in Canada. Please dont take this lightly its not something to brush under the carpet. You have other lovely children to live for. Please take good care of yourself. Can you also change doctors?

 

[nov_mum]

Not so easily unfortunately to change Drs. I have had PE three times now so I monitor myself pretty well. I think I was spilling protein as my bp was quite high. Right now I'm enjoying my second trimester dip and my BPs never go over 140/90 on 100mg labetalol BD. I usually don't respond all that well to meds so I think my improvement in bp is due to the 2nd tri dip more than anything else . Last pregnancy I got out of my dip by 22 weeks and was having headaches with visual disturbances. This time I hope to avoid that by being on meds already. I also dipstick for protein and while I often have 1+ I will definitely be seeing someone if it goes higher or my bp is no longer stable.

 

[saffy1984]

Hi All,

I had pre e with my last baby and ws induced at 37 wks. Im 21 weeks now and attending a hypertention clinic. My bp is always realy high at the clinic - was 164/106 last week but when i tested at home that same morning it was 120/76. Not currently on any bp meds because its usually normal -- I had a 24hr monitor and that averaged at 114/74. Its so frustrating that I have such bad white coat sydrome - i get so stressed before doctors appointments which i know is brought on by the anxiety from last time. Now need to see midwife every 2 weeks. Im in the UK - so nice hearing everyone elses experiences. x