Induction For Hypertension: Is This Necessary?

I am 32 weeks into my first pregnancy and have been diagnosed with preeclampsia. My blood pressure has been high and I am taking medication, however, I have no other symptoms -- no swelling, no vision problems, no headaches, no protein in the urine, nothing other than the elevated blood pressure. I have been home on bed rest for the last two weeks. My doctor has said she wants me to get to week 34 if possible before looking into inducing, and has said she doesn't see me going past week 37 or 38 at the most. She has indicated that unless there is an emergency, she usually induces as opposed to a C-section. She has further recommended I become prepared for an epidural, since early inductions can be more painful than "normal" births.

All this has me extremely nervous. Please comment on the impact pre-eclampsia has on my options. Is early induction typical? Is such a birth usually more painful? What triggers are looked for when considering an early delivery?

Thank you for your attention.

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

While I don't pretend to know more about your situation than your own provider, I do find it a bit odd to be talking about induction already. In the absence of any associated symptoms, it sounds like you are more likely to have preexisting hypertension or some form of pregnancy induced hypertension rather than preeclampsia.

Induction in either case would be based on fetal and maternal well-being. This would be determined by blood tests such as liver function studies, 24 hr urine collection for protein, platelets and by serial blood pressure readings and by fetal tests such as biophysical profile, non-stress tests, ultrasound measurement of fetal growth, contraction stress tests and the like.

They may choose to prescribe meds or sometimes aspirin will help in this situation. But I do think that unless they are not revealing everything to you, that a decision about induction should be based on more parameters.

I agree with your concern and would think about seeking out a second opinion if possible.

Thanks for writing and I wish you a satisfying birth experience.

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