Understanding High Blood Pressure & Proteinuria in Pregnancy: What You Need to Know

Question
I am 29 weeks pregnant and my blood pressure recently shot up to about 146/100. My OB/gyn said that I just have hypertension, because I am pregnant and overweight and put me on 1000 MG of Methyldopa a day to bring things down. I pushed my doctor to do a 24 hour urine test and sure enough they found abnormal amounts of protein, but she asserts that means that I have always had hypertension and the protein is the result of damage(she says my kidneys are at 8% damage) I have sustained from that, and not toxemia. She told me that she doesn't believe in toxemia. My blood pressure has always been 120/80 until two weeks ago. She says that is high for my age and that she will put me on blood pressure medication when I deliver and I will have to stay on it for the rest of my life. My hands are swelling and my eyes always look like I spent the night crying when I wake up. My mother and sister also had toxemia with their first pregnancies. I am 32 and this is my first baby. Should I be concerned that she is overlooking something? Could I have toxemia?


Answer
Preeclampsia usually does not appear at your  stage of pregnancy. It is probably PIH (pregnancy induced hypertension) and I, too, would start you on Aldomet (alpha methyldaopa). However, if your blood pressure continues to that high, you should be on bed rest and should also see if your Liver Function Tests, platelets, and Uric acid are abnormal. You may or may not need hypertension medication after the baby is born, but an obstetrician is not the one to decide that. If there is any doubt, consult with a nephrologist. If you have any epigastric pain, or see spots before your eyes, or become swollen in your legs, arms, and face, call your doctor.