Hello doctor, My sister gave birth around 10 days ago. She is 26 and it was her first pregnancy. She was discharged from the hospital within a few days and everything seemed normal. Last Friday night, a little less than a week after the birth, she went to the ER and was admitted back into the hospital with blood pressure at 171/117 and blurry vision. In these three days, her blood pressure has been going up and down, from over 200/120, down to 139/79. They have diagnosed her with postpartum preeclampsia. Last night her blood pressure spiked again, at around 1 AM, they moved her into the ICU. Her vision is still blurry, and it seems to have taken them hours to get the pressure back down. My main question is, is it typical for her blood pressure to still be fluctuating after three days in the hospital? Is it understandable for the doctors to be having trouble keeping the blood pressure down? My mom has been unable to see my sister since they took her to the ICU, because my mom cannot take the newborn, there. The only way my mom has gotten information is through my sister texting her. Even though my mom is still in the hospital, she says no doctor has talked to her since they moved my sister, and my sister is not in a great condition to make decisions right now. Is all of this normal?
Hello. She has developed postpartum preeclampsia. It is rare but possible that the patients could develop hypertensive crisis from preeclampsia. If that happened the patient will need to be closely monitored in ICU and due to the medications used to control BPs might drop her BPs too low therefore she needs to be in ICU until her BPs are stabilized. I would not contemplate transferring her when she is still in critical condition. Since the cause of preeclampsia has been removed (the baby and the placenta), we just need to wait until her BPs return to the normal state. Besides giving her medication they are trying to remove anything that could possibly stimulate her BPs such as stress. It takes time so please be patient. They are doing the right things.