I am hypertensive. And I am pregnant. I am hypertensive and pregnant -again!
For those of you who do not know what that means, well, it basically means my blood pressure is raised.
A “normal” person has a blood pressure of around 120/80, at it’s worst under monitoring mine hit 195/120. This was at the beginning of my hypertensive journey when I was just 20. True, my lifestyle was not particularly healthy. I smoked (and only managed to give up when I was 28, a good 8 years later!), I drank (and still do when not pregnant), I did little exercise and was carrying a few extra pounds. Even so I was an unusual case for being hypertensive so young and so had all the tests under the sun to see the underlying cause, the main worry being kidney failure. But everything came back clear. And thus my “unexplained” hypertension was marked down as a chronic condition and medication beckoned for my future. And so I took it. And still do.
My first pregnancy, with the toddler terror, I was marked as high risk and consultant led throughout. At the time I was taking 200mg of a drug called Labetelol twice a day. This is approved for use in pregnancy but is still a cat C drug as extensive testing cannot be done on pregnant people. In my case, the need outweighed any risks. And so the pregnancy continued with heavy monitoring. I was lucky, I had no problems until 39 weeks when my blood pressure crept up and induction loomed and the toddler terror was born, a little on the small side from the drugs, but here to tell the tale.
Fast forward to now, and I am on the same journey again. This time, slightly more weary, definitely more prepared, and no longer in the UK so starting the journey with a healthcare system that I am not familiar with.
First steps, a preconception appointment with my OBGYN to establish my medication was pregnancy safe (moving out to Dubai had meant a move from Labetelol) and confirmation that it was not. Cue a referral to a cardiologist again and the panic set in even before pregnancy happened.
Once again, a blank slate with no notes, so my cardiologist ordered an echocardiogram. Which is basically an ultrasound of the heart. And found that my heart muscle had thickened to the top end of normal (12-13mm) so leaving with the advise to get pregnant quickly and a prescription for pregnancy safe Labetelol, alongside the instruction to take baby aspirin once a day, once again I rushed home to tell the husband. And panic him obviously. And myself.
My good news, was that this time, I was on half the dose of Labetelol than I was in pregnancy with the toddler terror. And it was managing my blood pressure. I upped my exercise, I ran, I did circuits, I changed my diet to clean eating. My blood pressure maintained and even dipped. I did all this for 3 months. Then got pregnant. And lazy. And nauseous. And so so exhausted. I let the exercise slip.
I went to my OBGYN and all was good with baby. And I went to my cardiologist who ordered another echocardiogram with the impending words of doom “if your heart muscle has thickened then it will mean close observation and medication as soon as baby is born” an anxious wait to 20 weeks. And the day arrived. And got cancelled. And then arrived again.
The best news? I was discharged from my cardiologist! Not only had my heart muscle remained steady at 12mm, my blood pressure had also remained stable and so I am no longer under his care (unless something drastic happens) and I can remain solely under the care of my OBGYN.
Jump forward to 27 weeks, and so far, touch wood, so good. I am still on 100mg of Labetelol twice a day and a dose of baby aspirin, alongside the prenatal vitamins and extra folic acid dose. And my blood pressure remains steady and I remain hopeful that I can get to the end of pregnancy and go on to have the natural delivery that I missed out on last time. Though if you want the spoiler – jump to the birth story….