general thoughts from the doc this morning

Somehow this morning's discussion was both reassuring and not at the same time. *sigh*

In general, high blood pressure in pregnancy is considered a risk factor for pre-eclampsia. When questioned on this, he said that there were a couple schools of thought on this.

Pre-eclampsia used to be called toxemia, because the diagnosis came with normal, healthy young women who suddenly became very sick - blood pressures sky high (like 200/160), retaining enough water to gain 10-15 pounds in a week, etc. As far as doctors were concerned, it appeared to be a reaction to a toxin of some sort. It requires protein in your urine (a symptom of kidney damage) to diagnose. The biggest factor here is that your blood pressure is so high from blood vessel spasm that the baby stops getting nutrients and oxygen, as do most of your own internal organs. If left untreated, it can develop into eclampsia, which includes seizures and possibly death for mother and baby.

One school of thought is that high blood pressure diagnosed after 20 weeks, without protein in your urine, is just "pregnancy induced" hypertension, and should be treated much like chronic hypertension.

The other school of thought (and what their office follows as a more conservative route) is to assume that since about 1/4-1/2 of those with pregnancy induced hypertension eventually develop pre-eclampsia, that it's probably a mild form of the illness, and that agressive treatment of the blood pressure issue limits the ability of other issues to develop, since they appear to be caused by the blood pressure rise.

So, weekly check-ins with the doc, and continued monitoring of my BP at home, and as long as things stay fairly stable, all is well. In a few weeks, we'll start regular non-stress tests where they monitor heart beats while the baby is still and while it's moving, along with ultrasounds to check that she's growing and still getting plenty of blood flow - they assume for the most part that since the placental blood carries nutrients and oxygen, a baby that is growing normally is getting sufficient oxygen. Further, assuming all remains well, they're still not willing to let things go beyond my due date (and would really prefer that I deliver before then) because the longer we go, the more likely there are to be complications.