Extremely high blood pressure and thirty three weeks pregnant

Patient

Q: I was sent to hospital yesterday with blood pressure of 170 over 96 at 33 weeks pregnant. i am on meds to lower it (100mg labetolol) and they should have still been working at the time. They sent me home on bedrest. They said i could continue to babysit the 3 years old, 2years old and 8 month old that i watch every day. I checked my bp this morning and it was 197 over 110. They have me doing another 24-hour urine specimen. So far my protein has not been high enough to declare me preeclamptic. How high should my bp get before they induce me?

Doctor

A:   I understand how worried you might be about Possible Pre eclampsia. Certainly your doctors are managing your diagnosis carefully and treatment for high blood pressure has been already established. However, if you were not suffering from hypertension before pregnancy, your most probable diagnosis at the moment should be Gestational hypertension.
When Gestational hypertension is diagnosed, careful testing to rule out Pre eclampsia or even Eclampsia must be done, that is why you are being tested again for Proteinuria which is necessary to establish the diagnosis of Pre eclampsia.  About your question, Blood pressure is not the only factor that would suggest labor induction, your overall health and most importantly the baby’s status would need to be evaluated before deciding possible pre term delivery. Most women with high blood pressure deliver their babies naturally when high blood pressure is controlled.

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