Questionhi brenda i would really appreciate any help you could give me as i am very worried about my daughter..she is 26yrs old and 19wks pregnant with her second child.A few weeks ago she started to feel very uncomfortable with a racing heart she has also had consistantly high b.p and blood in her urine,she had an abnormal e.c.g but a heart scan was normal.She is going for a kidney scan on tuesday but my biggest concern is the fact that because she is only 19wks no-one is checking the baby?
AnswerDear Barbara,
I would suspect that the OB doctor is actually keeping closer tabs on the baby than you are aware of. What you have shared might indicate that your daughter MAY be suffering from preeclampsia. Preeclampsia is a medical condition where hypertension arises in pregnancy (pregnancy-induced hypertension or PIH) in association with significant amounts of protein in the urine. While BP elevation is the most visible sign of the disease, it involves generalized damage to the maternal endothelium and kidneys and liver. Preeclampsia may develop from 20 weeks gestation (it is considered early onset before 32 weeks, which is associated with increased morbidity) and its progress differs among patients. Some women develop high blood pressure without the proteinuria (protein in urine); this is called Pregnancy-induced hypertension (PIH) or gestational hypertension. Both preeclampsia and PIH are regarded as very serious conditions and require careful monitoring of mother and baby. Symptoms may include:
- increased blood pressure
- protein in the urine
- edema (swelling)
- sudden weight gain
- visual changes such as blurred or double vision
- nausea, vomiting
- right-sided upper abdominal pain or pain around the stomach
- urinating small amounts
- changes in liver or kidney function tests
The following factors may increase the risk of developing PIH:
- A first-time mom
- Women whose sisters and mothers had PIH
- Women carrying multiple babies; teenage mothers; and women older than age 40
- Women who had high blood pressure or kidney disease prior to pregnancy
Once diagnosed, the goal of treatment is to prevent the condition from becoming worse and to prevent it from causing other complications. Treatment for pregnancy-induced hypertension (PIH) may include:
- bedrest (either at home or in the hospital may be recommended)
- hospitalization (as specialized personnel and equipment may be necessary)
- magnesium sulfate (or other antihypertensive medications for PIH)
- frequent fetal monitoring
- continued laboratory testing of urine and blood (for changes that may signal worsening of PIH)
- medications that may help mature the lungs of the fetus (lung immaturity is a major problem of premature babies)
- delivery of the baby (if treatments do not control PIH or if the fetus or mother is in danger). C-section delivery may be required, in some cases.
Whether or not your daughter's doctor(s) end up determining that she has PIH, there are things that she can do to help keep her BP under control. They include:
- Use little or no added salt in meals.
- Drink 6-8 glasses of water a day.
- Limit fried foods and junk food.
- Get enough rest.
- Exercise regularly.
- Elevate feet several times during the day.
- Avoid alcohol.
- Avoid beverages containing caffeine.
- Her doctor may suggest a prescribed medicine and additional supplements.
Again, I'm sure that the baby has been monitored to a degree. However, at 19 weeks - there is not alot that can be done right now except to determine the cause and severity of this. Once that is done, they can more efficiently recommend treatment and be more informative of the risk to the pregnancy and your daughter.
I hope this has helped you and answered your question. I wish you and your daughter well.
Brenda
