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pregnancy & pots


lindaf
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my niece has had pots since September and is also pregnant.Is there anyone out there who has been pregnant and delivered with pots? She is pretty much bed ridden. She is a lawyer, mother of two girls(ages 9 & 11). She is very discouraged. Please reply. Thank You

:D;);)

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Hello lindaf

That's great that you are trying to find answers for your niece. I think you found a good place to post her questions! I know what she is going through only b/c I developed severe POTS symptoms in the 2nd half of my pregnancy. Is she bedridden due to POTS or on bed rest for a different reason? When was she diagnosed with POTS--prior to becoming pregnant? I wasn't diagnosed until after pregnancy even though I was so sick with it that I left work at 7 months.

I think everyone has such a different experience that it is hard to predict what your niece may experience at delivery. POTS patients are generally considered "high risk" pregnancies, but many of us have actually improved symptomatically during pregnancy and had very normal deliveries. It seems we may have a higher risk for developing pregnancy-induced hypertension and preeclampsia. During delivery, it is very important that she remain well-hydrated (probably by IV) since POTS patients tend to dehydrate and lose electrolytes much faster than someone without POTS. In fact, she may find that getting regular IV fluid (once a week?) during pregnancy will help her feel better. I had IV saline a few times (not b/c of a diagnosis unfortunately) and found I felt much better for at least several days afterwards.

Is she under the care of a POTS specialist? If not, does she have a physician who is at least knowledgable of the condition? Is she on any medications for POTS?

I had a very difficult delivery, but I don't know to what degree POTS played a role. I ended up having to have a c-section due to placental abruption. My ob-gyn said it was caused primarily by the very large fibroid that the placenta was partly attached to. Fortunately I was in the hospital when that started and they were able to do an emergency operation, so my child was never at any risk. I did lose enough blood that I had to have a transfusion. The other complication going on at delivery was moderately high blood pressure that started several days before my daughter was born.

The only other thought I have is that she may find post partum to be very challenging as well (as far as symptoms), especially if she has to have a c-section. Either way, she will need a lot more support, probably, that a new mother without POTS.

The good news is that most of us do recover to a good level of function eventually.

I wish her the best and would be glad to continue to "talk"/answer questions, if you want to.

Katherine

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my niece has had pots since September and is also pregnant.Is there anyone out there who has been pregnant and delivered with pots? She is pretty much bed ridden. She is a lawyer, mother of two girls(ages 9 & 11). She is very discouraged. Please reply. Thank You

:D  ;)  ;)

She was diagnosed with pots before she knew she was pregnant. She is not presently on any medication. Being bed ridden is from the pots. I really appreciate your input. Thank you. She is seeing a high risk ob and they are aware of her condition. She has seen many neurologists and a cardiologist, plus many other specialists. Thank You. Linda f

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my niece has had pots since September and is also pregnant.Is there anyone out there who has been pregnant and delivered with pots? She is pretty much bed ridden. She is a lawyer, mother of two girls(ages 9 & 11). She is very discouraged. Please reply. Thank You

:D  ;)  ;)

My niece had pots when she became pregnant. She is seeing a high risk ob and several neurologists and a cardiologist, plus primary care, etc. All are aware of her pots and at present do not feel she can go on medicine because of the pregnancy. They have told her she cannot have a csection because her blood pressure could drop even further, nor an epidural for the same reason. She is bed ridden because of the pots. The only treatment at this time is the compression stockings. Thank you so much for your input. Linda

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Hi Linda

I also responded to your personal e-mail, but to respond to your above statements--there are medications that are considered safe during pregnancy that are used to treat POTS--particularly after the first trimester. This would be a decision made between herself and her physician, as there are unknowns and therefore some level of risk. But, there are patients on this site who have used meds during pregnancy.

You stated her only treatment at this time is compression stockings. How about extra salt and fluids--particularly if her blood pressure is very low, that should help. It helped me a lot (recommended by my doctor even though he had no idea what was wrong with me). Although it may have brought on the eventual high blood pressure I developed in the last days of my pregnancy. Definitely she would want to talk to her doctor before starting a high salt diet, but it is just another suggestion.

Katherine

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Thanks for your input. She does use a shower char, because she couldn't stand long enough to shower. How did you deliver? Did you see a specialist during pregnancy? How long after the baby was born did it take you to feel better?I guess I am asking if she will ever be normal again, and I know there is no easy answer to this. It is so hard to see such a vibrant person who was never still a moment not able to do much but maybe get downstairs when the girls get home from school. She never sat still for a minute before she became sick last April. By September, she has been pretty much bed ridden. Thank you for your support.Linda

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I developed POTS three days after delivering my first daughter. Wish I had info for you re: outcomes and how to deal during pregnancy. Based on what I know about others who visit this board, it is very likely that your niece will do just fine during this pregancy; she'll likely be tired and her symptoms may get much better or much worse as the pregnancy progresses. It seems like POTS waxes and wanes just like autoimmune diseases do for women in pregnancy.

The one thing I would be careful about is blood pressure -- not just low, but high. Seems like several here who always have had low BP -- including myself -- ended up with high BP late in the pregnancy. So it's good that she is being monitored by a high-risk doc.

Your niece should definitely visit here, if she has a computer or access to one. This group is great for support.

Amy

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Hello! I have been through one pregnancy with POTS and I have another baby due in June. My story is a little different from the others who posted only because I have had uncomplicated pregnancies which actually helped me feel better, and gave me temporary relief from the POTS symptoms. WIth the first pregnancy I was on Florinef and a beta blocker, and with this one I was unable to stop all my meds and ended up back on the beta blocker at a low dose. So far it has helped me immensly in dealing with the tachycardia and I feel great at 6 months along. I delivered my son unmedicated with a midwife and am going to a birthing center to do the same again- I feel that the natural environment really helped my recovery and helped me stay relaxed about the whole labor and delivery. BUT I was also doing well during the pregnancies and that helped as well- I do always continue care with my cardiologist throughout the 9 months as a precaution, and follow up after the baby's birth as needed.

I feel for your neice because I had only been diagnosed for 4 months when I found out I was pregnant with my son, and I was absolutely terrified. My first trimester in both pregnancies was very hard, but then it seems to get easier. I also gain 80 lbs. last time and 40 so far this time. I wish her the best, and please feel free to e-mail any of us if you ever need more info- there are several moms on this board who have delivered with POTS and are happy to put advice in.

I am just curious- how far along is she now?

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My niece is about 6months along, but the plan is to induce her a month early if everything goes as planned. She will be delivering naturally without medication. Her blood pressure is extremely low, so they are really going to have to keep an eye on her. Thank you for your input. linda

Edited by MightyMouse
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Hi:

I've had POTS all my life....and I have delivered two healthy boys....both pregnancies were difficult and considered "high-risk".

My bp was very low and I fainted a lot. I did go in for regular IV infusions because I was constatntly dehydrating....it did help and was very necessary....w/ my second child I actually went into premature labor due to dehydration, so I can't stress enough that hydration is very important. (They were able to stop the early labor luckily!)

As far as my deliveries went....I had scheduled inductions both times....the idea was tthat it would be easier to coordinate all my docs schedules so they could be on hand if need be. (Actually for my second, I went into labor naturally on the day I was to be induced). I too was told that c-section was not desirable and could make things worse....however, I did have epidurals both times....with no problem....she should definitely consider one....especially because pain can trigger the autonomic nervous system to go haywire. she should be as "comfortable" as possible.

I too was bedridden for periods of time....I would encourage any kind of movement, as staying completely immobile can make things worse too...keeping the bp very low. How about massage at least?

Good luck!

Kristen

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I have had pots for 4 years. I just had a baby last month. I didn't have any problems with my pregnancy. I was on florinef and zoloft the entire time. My cardiologist didn't think that it would be good for me or the baby if I went off. In fact, my bp actually normalized while I was pregnant. I gained 30lbs most of it water weight. I had a normal delivery and a normal weight baby. They told me that I could have an epidural if I wanted one but when I got to the hospital I was 9 1/2 cm so no pain medication for me. She is 5 weeks old and I feel great. Still have pots symptoms but I feel like I am recovering well. Good luck.

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Hi:

I've had POTS all my life....and I have delivered two healthy boys....both pregnancies were difficult and considered "high-risk". 

My bp was very low and I fainted a lot.  I did go in for regular IV infusions because I was constatntly dehydrating....it did help and was very necessary....w/ my second child I actually went into premature labor due to dehydration, so I can't stress enough that hydration is very important.  (They were able to stop the early labor luckily!)

As far as my deliveries went....I had scheduled inductions both times....the idea was tthat it would be easier to coordinate all my docs schedules so they could be on hand if need be.  (Actually for my second, I went into labor naturally on the day I was to be induced).  I too was told that c-section was not desirable and could make things worse....however, I did have epidurals both times....with no problem....she should definitely consider one....especially because pain can trigger the autonomic nervous system to go haywire.  she should be as "comfortable" as possible. 

I too was bedridden for periods of time....I would encourage any kind of movement, as staying completely immobile can make things worse too...keeping the bp very low.  How about massage at least?

Good luck!

Kristen

Hi Kristen, My niece was told that an epidural would lower her blood pressure even more and would not be safe. Did yours lower during the epidural? Kim is walking around the house a little more since she went on zoloft about ten days ago. It is the only drug they are willing to use while pregnant. It does something to the autonomic nervous system(spelling may be off), but I am not quite clear what it does. She also went to her daughter's play last weekend. This is the most she has been able to do since last September. Her husband dropped her off at the door and picked her up at the door. A friend has a chair waiting inside and she had to rest before she went into the auditorium. But she lasted through three hours of sitting and was only very tired. She was almost hyperactive before this illness started. She is being induced a month early if everything goes accordingly. I will suggest massage to her. Thank you for your information. Linda

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An SSRI (zoloft is one of them) did wonders for me post partum. I was also bedridden at times late pregnancy through post partum. (I think I would have been better without the trauma of the c-section.) My daughter's pediatrician said no to breastfeeding and the SSRI, so I stopped breastfeeding at 4 months when I started the SSRI. In retrospect I wish I had done more research on my own before making that decision, since my electrophysiologist disagreed and said I could continue with low risk to my daughter.

Anyway, glad to hear that she is improving with zoloft. That is great news.

Katherine

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Hi Linda:

I was not told specifically that the epidural would lower my bp even more. I did have some dips in bp, but they seemed to be more associated with big contractions. As far as my docs were concerned, they didn't want my body to to have to try to respond to extreme pain because that can make the POTS symptoms much worse. It worked for me. Also, they carefully monitored how much epidural they gave me as to cut the pain but not completely remove all feeling.

I really recommend that she experiment with posture (sitting, lying down, etc, while in labor...it really helped me when trying to get my bp to stabilize.)

Also, I don't know if I mentioned, but I did not do any pushing....again because any type of straining can trigger symptoms....(some people with POTS even faint when they strain to have a bowel movement.) they allowed the baby to travel down himself until he was far enough down the birth canal to be pulled out. With my first child she used forceps to pull him out...it wasn't necessary for my second.

Good luck! She can do it! I really do recommend the epidural though....sudden extremes of anything....pain...even emotion can trigger symptoms.

Kristen

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