I'm 34+ weeks pregnant with our second child I developed

Patient

Q: I'm 34+ weeks pregnant with our second child. I developed preeclampsia with out first at 36+ weeks and was enduced the day I turned 37 weeks. Everything went great with the birth except some slight excess bleeding. My concern is that I may have developed it again. My reasoning for this is that I have the same pain in my right ribcage that I did with my son and my blood pressure is high. It's up and down though, it hasn't stayed high. The hospital we go to doesn't think my BP is high and they also don't take a urine sample at my appointments. Should I be concerned or am I just over analyzing it?

Doctor

A:   Hello,
Thanks for the query.

It is good to learn that you are conscious about your hypertensive status. If you were a preeclamptic patient in the earlier pregnancy then it is likely that you would be again with an increased chance by 15 -120% in this pregnancy as well. The most important thing is to monitor blood pressure twice a day, early morning and evening blood pressure and maintain a record for a week. If anytime a constant blood pressure recording of more than 140/90 mm Hg is noted it indicates gestational hypertension and then a urine test for proteinuria with 24 hrs urine same to be done to differentiate between pre-eclampsia and gestational hypertension and thereafter accordingly protocol based management should be decided. I feel you should monitor your blood pressure yourself and record with the help of electrical home bp instruments which care easy to use. Then you may review with your Physician with the record and allow him to analyse the same.
I hope I have been able to address your concerns in detail.

Wishing you good health.
Regards

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