Hi there
I'm new here...26 weeks pregnant and under a blood pressure specialist taking labetalol 3x day. Testing BP at home and seems fine nothing over 130/80 then I go to the doctor and it's 140/85 which is high and then 5 minutes later 125/70 so they say it's unstable. They've increased my meds to 150mg 3x day and it drops to 110/60 and feels too low/dizzy. Does white coat syndrome mean anything or is this really a problem when they see 140/85 just at the appointment?
White coat syndrome has been studied and determined to be a real thing. My BP is always high when taken in a medical setting, but I’m a bloke in my late 30s: the complicating factor with you will be that you’re pregnant, and if you have genuinely high bp, it’s a serious concern that could potentially harm or even kill both of you. How often are you checking it, and have you been properly recording your blood pressures to have something to show to the doctors? If you can demonstrate that your BP is consistently fine at home, but elevates when at the GP/hospital, then that may change their view. BP should also be checked after sitting for a few minutes, not after moving around or doing anything, so if (for argument’s sake) they weigh you then sit you down and immediately check your BP, that would potentially explain why it’s fine 5 minutes later. However, it’s possible that you do have unstable blood pressure as they say, so I think it’s important that you have these conversations with the medics looking after you.
Ask to have a 24 hour bp monitor fitted so they can see what it does during a normal day. I have white coat syndrome and only reason I escaped bp meds was because the monitor showed my bp was normal.
Hi HannahB10,
Are you seeing an Obsterican and Midwife too?
Pre eclampsia is a concern and is a combination of raised blood pressure, protein in your urine and liver, kidney function changes in the blood.
Pre eclampsia can if untreated lead to problems during pregnancy.
Major problems are rare in the UK as it is usually picked up and treated appropriately.
This is why at every Antenatal visit the midwife checks your BP and urine.
Many midwives will wait towards the end of the appointment to check a woman' s blood pressure and take 2 readings if the first reading is raised.
It's very common for a person's blood pressure to be raised just by walking into a clinic but lower when monitored at home. ' White coat syndrome ' is very real
It is possible to have your blood pressure continuously monitored for 24 hours and I suggest you ask for a 24 hour monitoring of your BP at home and then discuss your results with an Obsterican/ Midwife and BP specialist.
You should have a Midwife and I suggest you get in contact with them too to discuss your concerns.
I agree the Bp should be checked twice in a visit if it's elevated.
Also double check your home cuff reading with the office cuff at least once to be sure the readings are the same.
It may also depend on the timing of your medication. If you are due for your Med it maybe higher then come down post medication. That could be why you see varied numbers at home. Document when you take the Med on your BP recording sheet.
Congratulations on your pregnancy ❤️
🐬
Thanks all...appreciate the experience you all have!
A 24 hour cuff is a good idea to ask about. They've sent me home with one but when I take it in there to clinic they check it against there's but don't check the prior readings on my monitor (which is pretty close)....which is why I thought they gave it to me to use to see how it is at home!
I'm seeing a midwife but have yet to see a obstetrician tho.
I'm sure it is a white coat syndrome....I race there on the train, sit in their waiting area on hard chairs in a hot stuffy hallway, which can sometimes be up to an hour and they wonder why my BP is elevated. Slightly different to the home setting where I'm relaxed. Do trust doctors and what they're are doing but they don't seem to believe me when I say I don't see BP over 130/80 at home!
Your monitor may not be accurate unless its new or been calibrated recently so they will probably only take notice of their own readings. At least a 24 hr monitor will record everything and takes away the possible anxiety factor !
Have you had your BP monitored continously by having to wear the BP cuff on your arm for 24 hours and the readings are taken every hour day and night automatically?
This is the best way to get an accurate reading of your blood pressure.
What's your BP reading when you see the Midwife? Often it is lower if you feel less stressed.
Have you been given an appointment to see an Obsterican when you are 28 weeks into your pregnancy?
As you have raised BP you will usually be under the joint care of an Obsterican and your Midwife.
No haven't had the continuous 24 monitor you are speaking about, just a regular blood pressure cuff what they've given me.
My blood pressure last at midwife was 145/85 and then the second one was 125/80...so they're calling it unstable. They're speaking of changing my medication to nefedpine if it's still not normal next week only thing that concerns me is it looks ok at home!
I'll have to ask about the obstetrician appt when I go on Tuesday, don't think I've been given an appointment yet tho I do have one assigned to me.
It's called ambulatory blood pressure monitoring.
nhs.uk/conditions/blood-pre...
It's a useful way to check what's really going on with your blood pressure. You may hear the word 'liable' to describe your blood pressure.
You do need your blood pressure treating well during your pregnancy however neither do you want to be over treated.
It's a fine balance you want to be able to enjoy your pregnancy without any undue worry either.
I have white coat syndrome too, whenever I go to clinic my BP and heart rate is raised. I end up needing an ECG and have been admitted because my angina has become unstable as a result. I don't like hospitals!
The solution was to have my BP monitored this way at home. It helped my Cardiologist prescribe the best medication for me.
Do ask the Midwives and doctors to explain everything to you.
Thanks milkfairy, that's very useful info. Got a few questions up my sleeve now for Tuesday...so see what they say!
Hi Hannah I was like this when I was pregnant some of us are more prone to bp issues when we are pregnant I’m sure it will all resolve itself after baby is born just look after yourself feet up when your can avoid salt as being pregnant I think plays havoc with balancing your fluid and yes! White coat hypertension does exist having worked in general practice this was definitely a feature with a lot of patients the only way to truly establish your blood pressure would be a 24 hour monitor but when you have your bp taken as you say usually after the first reading the second one is always better take care look after yourself 😊x
Lots of excellent advice here. Looking forward, once you do have your baby, please keep an eye on your bp over the years. High BP damages arteries and this can lead to serious disease. If your bP is on the higher side you can do something about it earlier; rather than leaving it until the damage is done.
Take care.
White coat syndrome is very real. My GP now asks me to keep a week of home BP readings which he then averages out. He won't even check my BP in the surgery. However if you are pregnant they must keep a check on it for pre eclampsia which could kill you and the baby. Another sign is protein in your urine so you need a urine test. My mum had full blown eclampsia when having me. She was lucky to survive. She lost a second baby for the same reason and it damaged her heart permanently. Her sister died in pregnancy because of eclampsia. (Remember that was 73 years ago). I also had pre eclampsia. I spent 2 months on bed rest in hospital; when they let me home at weekends my GP called every Sunday to check my BP. My son had to be born by C section at 31 weeks because I was going into organ failure. I was kept sedated and it was a week before I saw my baby. When the midwife saw me in baby ICU she didn't recognise me as I'd lost the massive amount of fluid that had built up. Keep doing that home check, 3 times a day after resting for 10 minutes; write it down and give a week's record to the doctor.
Qualipop,
It so good to know that the care pregnant women now receive means that they remain healthy and take their baby's home with them even if they develop pre eclampsia.
Women very very rarely die nor lose their babies these days due to preeclampsia or eclampsia.
The chances in the UK of a woman having an eclampsia fit is very low. The amazing developments in intensive neonatal care means babies who who would have not survived now do.
Midwives check a pregnant woman's blood pressure and test the woman's urine sample for protein at every clinic visit.
Most maternity units have a Maternity Day Unit where woman are more closely monitored by the midwives and doctors if any problems develop during a woman's pregnancy.
That's why I pointed out that my mum and her sister were 73 years ago. Mine was actually 33 years ago now. Things have improved tremendously which is why it's so important to keep a check on BP and urine. A nice ending to the story is that my aunt's baby survived but her husband moved away and our family never saw the baby again until 6 years ago, when after years of searching, I found him again online. Talk about long lost family!
Can I please ask what is the issue with your heart??
Raised blood pressure is a disorder of the cardiovascular system.
Untreated high blood pressure increases your risks of experiencing a heart attack or stroke.
Thanks for the insight into you condition and good luck for the future 👍
Mine always goes up when I go to the doctors (White coat symdrome) Lol 😂, But I keep a book with my every other day B/P notes , so I can take with me when I visit the doctor.
defining “normal” blood pressure
Blood pressure monitor
Blood Pressure Readings
Very high blood pressure
