hospital bed rest for HBP

i never had high blood pressure before getting pregnant. then suddenly at week 16 i started getting readings of 130/90 and higher. because this showed up before week 20 they called it, "chronic high blood pressure" in spite of the fact that i've never in my life had a high reading before now. this began a pattern where i would visit the perinatal specialist one week, get huge thumbs up and smiles for how well the babies are doing, then visit my OBGYN the next week and get tsk-tsks about my blood pressure.

fortunately it's been holding pretty steady up until this point and the perinatal specialist has been all optimistic that i'll make it past 35 weeks. i've had no contractions, hardly even braxton hicks, and my cervix is holding strong and long. even the OBGYN was starting to ease up on me and suggest that i might just make it to week 36 or 37 since my BP wasn't rising. they've had me on modified bedrest at home, and even allowed me to continue to telecommute to work.

then suddenly here at 32 weeks it all started changing. over the weekend it felt like the babies were moving less than usual and by the time monday rolled around i realized that i wasn't even close to making my kick counts. so i called the doctor's office and they called me in for a non-stress test. we monitored baby A first and his signal was wonderful. then we moved to baby B and he sounded fine for a while, then suddenly his heartrate plummeted. then it skipped a beat, then it came back up to normal. then plummeted again and skipped, then came back up to normal.

the doctor said he could have simply rolled onto his own umbilical cord but sent me to the hospital immediately. this of course set off a wave of anxiety as we sat through the first few hours of monitoring. my blood pressure was extremely high because of the stress, like 165/108. that's when the doctor came in late last night and said the words we didn't want to hear, "we're deciding if we'll be delivering tonight."

i know lots of twins arrive at 32 weeks and do well but it was such a scary thing to hear anyway. i couldn't keep myself from crying and i just kept saying, "too soon, too soon." this just made the blood pressure worse.

it's been a struggle to stay calm and not be anxious in an effort to bring my blood pressure down. if i can relax i can drop as low as 127/85. the problem is staying relaxed. we monitored the babies for 12 hour straight and got nothing but beautiful rhythms. my perinatal specialist had a peek on U/S early this morning and was confident that they're doing great. we ran a full panel of blood tests and the results came back wonderful.

still, the doctors are talking about delivery. we're doing a 24 hour urinalysis to determine if the spike in blood pressure was damaging enough to be too risky to continue. the collection phase is done at midnight and hopefully within a couple of hours after that the hospital lab will return our results. i've got every finger and toe crossed that my protein levels are within tolerance. they're threatening magnesium sulfate, which scares me because i've read so many horror stories about how it makes you feel. i've already received one round of steroids for the babies' lungs and i'll be receiving another tonight.

i'm just such a jumble of emotions at this point. i'm scared first and foremost for the babies, because i so badly wanted to make it past 35 weeks. i feel like it's my fault if they arrive early because i can't keep my blood pressure under control. i was naively optimistic that i'd make it that long so it feels like this is suddenly happening too fast. i'm also feeling like i should have been more patient about the fetal movement and not gone into the doctor and set all of this in motion. sort of like, if i'd just stayed home i'd still be home and as all the testing has shown the babies would be fine either way. i feel like i made a poor judgment by being too hypersensitive about their movements and jumped the gun, and that's landed me in the hospital at risk for delivery before 33 weeks.

it's just a scary time right now, waiting through these last 3 hours of urine collection and then waiting for the doctors to tell us what's going to happen. everything feels completely out of my control.

thanks for letting me rant.

 

I wish I had some valuable advice but I don't...all I know is that I had a ton of problems keeping my babies in and I understand your feelings of blaming yourself. It's out of your control and you're doing a great job by being so aware of the fetal movement and taking care or it, even if you don't like the results. I'm sure you and the babies are in good hands, and we'll be thinking of you tonight. Good luck with the testing, and I hope you get good news and are able to keep those little ones in a few more weeks! :hug:

 

Have they taken your bp while you're on your left side? At 18 weeks I went on mod bed rest because my sitting bp was 152/106 but after lying on my left side for 3 min, it went down to 106/59. Make sure they rule out that your bp is not "positional." I'd hate for your babies to be delivered without excluding all the possible reasons for the high bp.

Good luck momma!

 

I delivered at 34 weeks due to my b/p elevating--It was a roller coater of emotions--I went to the hosp. I planned delivering at and was put on monitors and such--B/P went down and I thought I would go home the next day--Next morning b/p spiked again--within 20 minutes I was put on mag(TERRIBLE STUFF) and transported by ambulance to another hospitla 40 mnutes away fue to the high risk(also had a NICU) I stayed on mag for 2 days with a catheter and my b/p came down. I was sent home 2 days later on strict bed rest and b/p meds. 10 hours later I was back at labor and delivery with shortness of breath--I delivered the next morning via c-section. Babies stayed in NICU for 12 days. I also had steroid shots for lung development which made me feel better--It is had, but try to realx and take it eay--its all for your babies. Hopefully everything will be fine--you are in my prayers

April :hug:

 

Honestly, dear, it's better if you are pre-eclampsic (which is what they are testing for with the urine and blood pressure) to take the babies out early. It's horrible, but your body won't be the best environment for them to grow in when they make that decision. But I can promise you that they will push it as far as it SHOULD go. And also, the magnesium, while really icky, isn't all that bad. It's no worse than a stomach flu that you get ALL AT ONCE instead of a slow icky feeling. And it goes away as quickly. I had the vomitting and even had to be on it longer because I was showing signs of actual eclampsia and HELP and still it wasn't nearly as bad as I had actually worked myself up about it.

Just take it one breath at a time.... try to just not THINK, because if you think, you worry! Just remember that the doctors really do want to do what is best.... No SECOND guesses.... because the "what if's" will raise your BP!

Good luck,
Dominique

 

thanks to everyone for the kind words.

they have determined that i do qualify as having mild pre-eclampsia at tihs point. 300 mg is the threshold and i'm around 400 as of today. for anyone not familiar with the range, 3000-5000 is severe. so i am just barely over the threshold for now, but it does indicate that pre-eclampsia is here and there's nothing we can do to stop it at this point. all we can do is hope that the progression is slow enough to give us a few more weeks.

they decided to discharge me this afternoon with instructions to stay on strict no-work bed rest. i will be seeing the perinatologist once a week, followed by a round of testing with the OBGYN once a week. it's literally become a game of "beat the clock" at this point. every day they stay in and my pre-eclampsia stays mild, the better it is for all concerned. however, it could change in a matter of 24 hours and we could easily end up back in this hospital and delivering at any moment.

i'm relieved to be home. my blood pressure is lower at home and that will hopefully help slow the progression of the pre-eclampsia. my husband and i are working through the logistical strategy to make sure i can stay lying on my side as much as possible (it is positional, TwinsInFL, i've been averaging 140/80 on my back in the hospital) and we're just keeping our fingers crossed.

we're visualizing a goal of october 3rd to make 36 weeks. here's hoping it's an attainable goal.

 

:hug:
I am praying and hoping you make it to 36 weeks.

 

Well, I'm not happy that you're going through this, but I'm so glad you can get some bp relief by lying down. Just think, I'm at 20 weeks and already confined to my side for the majority of the day!

Hang in there and keep us posted.

 

we were dischaged on wednesday afternoon and back in the hospital on thursday night. around 11:00 p.m. on thursday i realized the sensation that i thought was baby B rolling around on me was actually a tightening of my uterus and it was happening about 10 minutes apart each time. as the evening progressed they got worse and went from merely uncomfortable to painful in short order. called the doctor and was told to go back to the hospital.

lucky me, this happened on what everyone said was the busiest night they'd ever seen in L/D. it's a pretty enormous facility but they had so many women flooding in that they had to open up the emergency overflow areas of the hospital that they hadn't opened in years. i ended up in a room with a broken blood pressure cuff and a bed that would short out and move all by itself (and then jam) and extremely overtaxed nurses who would leave me for hours at a time in excruciating pain.

monitoring showed that the babies were fine, but i was indeed having contractions. but my cervix hasn't changed so they said it wasn't real labor. but my god, if that's not real labor then i'm scared of the real thing. they gave me morphine because i was in so much pain, but the morphine made me nauseous and i ended up vomiting and pulling all of my abdominal muscles. they then gave me percocet and finally after hours and hours of the most agonizing pain i finally got some relief and 3 hours of sleep.

the record-setting rush continued into friday so i ended up going 18 hours without seeing my doctor for the first time. she said they couldn't believe how many women were in labor that day, that they were having to put together temporary cubicles for women to labor in because they simply ran out of room. i suppose it was the barometric shift from the hurricane passing through that set everyone off.

ultimately they sent me home again with a prescription for percocet, which they told me to take if the contractions continue to be painful. but until they get closer together than 10 minutes apart, there's nothing they can really do. we're still trying to squeeze 3 weeks out of this but i have been in so much pain since thursday that i'm not sure i can make it one week, much less 3. i never dreamed i would have this much pain near the end. i expected it during labor, but i didn't expect to be sitting at home for days on end in agony while my back feels like it's breaking and my ribs feel like they're cracking from the inside out. i can't sleep because i can't find a comfortable position anywhere on earth.

i'm just not sure how i'm going to make it if i'm in this much pain already.

 

I am so sorry that you are going through this! I was at the hospital on the LEAST busy day last year and so I can't begin to understand, but I really do feel for you.

I'm in Atlanta, too.... which hospital are you laboring at, if you don't mind?

Hugs,
Dominique

 

QUOTE(Dominique @ Sep 16 2008, 11:57 AM) [snapback]982439[/snapback]
I am so sorry that you are going through this! I was at the hospital on the LEAST busy day last year and so I can't begin to understand, but I really do feel for you.

I'm in Atlanta, too.... which hospital are you laboring at, if you don't mind?

Hugs,
Dominique


Northside Hospital.

Update: things evolved rapidly after my last update and we ended up delivering on Monday morning by c-section. Both babies are doing fantastically and are breathing beautifully on their own. The hardest part was not being able to see them for the first 24 hours because I couldn't get out of bed and they're still in NICU. but now I'm able to be in there and with them as much as I want and I'm just so grateful that they're doing so well.

Oh, and yes the magnesium sulfate was as bad as everyone said. But it's already a distant memory and such a small detail compared to these two little boys I have in my life now.

Jacob William - born 9/15/08 @ 9:04
Owen Michael - born 9/15/08 @ 9:05

 

QUOTE(piccologirl @ Sep 17 2008, 01:21 PM) [snapback]984676[/snapback]
Northside Hospital.

Update: things evolved rapidly after my last update and we ended up delivering on Monday morning by c-section. Both babies are doing fantastically and are breathing beautifully on their own. The hardest part was not being able to see them for the first 24 hours because I couldn't get out of bed and they're still in NICU. but now I'm able to be in there and with them as much as I want and I'm just so grateful that they're doing so well.

Oh, and yes the magnesium sulfate was as bad as everyone said. But it's already a distant memory and such a small detail compared to these two little boys I have in my life now.

Jacob William - born 9/15/08 @ 9:04
Owen Michael - born 9/15/08 @ 9:05


CONGRATULATIONS!!!!!!! I was just reading your post and getting the updates...I'm so glad everything worked out in the end. Congratulations on your precious babies!!

 

Congrats! Northside is the best place to be in that situation! My peri also operates out of Northside, so he keeps telling me I'll end up there if I don't watch the BP!

Glad to hear they are breathing on their own. Get your rest, momma.... the NICU time will fly by and you need to be healed when they get home!

Dominique

 

QUOTE(piccologirl @ Sep 17 2008, 04:21 PM) [snapback]984676[/snapback]
Northside Hospital.

Update: things evolved rapidly after my last update and we ended up delivering on Monday morning by c-section. Both babies are doing fantastically and are breathing beautifully on their own. The hardest part was not being able to see them for the first 24 hours because I couldn't get out of bed and they're still in NICU. but now I'm able to be in there and with them as much as I want and I'm just so grateful that they're doing so well.

Oh, and yes the magnesium sulfate was as bad as everyone said. But it's already a distant memory and such a small detail compared to these two little boys I have in my life now.

Jacob William - born 9/15/08 @ 9:04
Owen Michael - born 9/15/08 @ 9:05


Congrats! It sounds like things turned out just fine. I too had a really hard time with not being able to see my babies for 24 hours after they were born. It is the one thing I have had a lot of trouble getting over. It sounds like you have a great attitude! I'm so glad they are donig well.

Take care of you and those babies.

 

QUOTE(Dominique @ Sep 18 2008, 09:39 AM) [snapback]985715[/snapback]
Congrats! Northside is the best place to be in that situation!

i will absolutely agree with this sentiment. i know some women who call it "the baby factory" and feel like it's too big of a facility to have the experience they want, but my thought all along has been that i want to be somewhere where i can't throw any surprises at them. if my blood pressure goes up and i'm having contractions and it's 33 weeks, i want to be at a facility that's seen a thousand cases like mine before.

so far things have been going great. the boys are already off their IVs and they've been moved out of the special care nursery into the main NICU where their job is basically just to put on weight. the doctors and nurses keep telling us how well they're doing and how robust their health is already. they've even said it's possible they'll be going home with us in as little as a week at this rate.

jacob is taking a bottle like a champ and yesterday he breastfed like a pro for the first time. owen needs a little more practice but what he lacks in coordination he makes up for in enthusiasm.

thanks to everyone for the supportive words.

- p

 

That is so awesome! Hopefully, they will do well in the "fat farm" (what the NICU at Kennestone calls the feed and grow room) and be home soon! Make sure you are healing and resting, because as soon as they are home, forget it!

I totally agree... I'd much rather be in a "baby factory" where they've seen it before than in a poduck that has no clue what to do. I am definately less worried about the "touchy-feely" experience than the health of all of us.

Good luck!
Dominique