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cma

Third Trimester And Pots Symptoms

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Hello everyone,

I was wondering has anyone experienced elevated standing heart rate during the last pregnancy month and got better after delivery?

I'm 36 weeks pregnant, second trimester was wonderful, but now my standing heart rate goes up to 140bpm and feels very uncomfortable. Doctors don't know anything about POTS here and are treating my pregnancy as normal. Before pregnancy my standing heart rate was about 120bpm. From everything that I've read blood volume is increased during pregnancy, so I should get a relief from POTS symptoms, shouldn't I?

I don't know what I should do, should I ask to be put on beta-blockers, or should I just hang in there and wait until the delivery?

Elevated standing heart rate is the only POTS symptom I'm having at the moment.

Would love to hear what other moms think.

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Yes, the first and last trimesters were so difficult - my heart went crazy. The increased blood volume did nothing for me - I felt much worse the whole time. My Dr. tried me on Mestinon, but it made me feel really weird and I was scared it could affect the baby. I decided to try and tough it out and not go for anymore meds. At around 37 or 38 weeks I couldn't take it anymore - I had no help and a 4 year to take care of. My OBGYN agreed to induce me a little early (like 10 days early or so) and things definitely calmed down right after she was born. Is there a POTS Dr. you can talk to about this? Hang in there - you're in the homestretch!

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I got worse as pregnancy progressed. I think you are fortunate that your only symptom is tachycardia! Although I definitely know how uncomfortable that is. By the last two months I could not work anymore, I was too exhausted all the time for full time work.

I was undiagnosed at the time and no dr was concerned about my symptoms including my high heart rate. I did not take any meds for the symptoms as a result.

I was even sicker post partum, pretty much unable to stand or function normally most days for months until diagnosis and treatment started. Most days I was able to breastfeed, that was about it. Hopefully you will recover more quickly.

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Thank you so much Naomi and MomtoGiuliana for sharing your experience.

I don't have POTS doctor or any doctor, who understands what POTS is and they are too lazy to do any research. My OB/GYN thinks that everything is normal, my blood pressure is low, I don't have any swelling and no protein in the urine and that's the end of the story, my pregnancy is considered normal. I don't think they even measured my heart rate at the clinic. I am concerned about my delivery, I don't know which route should I take, should I opt for the natural delivery, epidural or C section.

I'm feeling frustrated and sad, because of the lack of understanding from the medical community. I just hope that there won't be any negative outcome, and they'll know how to handle the situation, if something goes wrong.

I guess I can be sure about one thing, that my POTS is not caused by low blood volume, because if it was, then during pregnancy I would have felt normal.

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I don't know which route should I take, should I opt for the natural delivery, epidural or C section.

I was worried about this too. I thought an epidural could cause problems, so I had a consult with the anesthesiologist and explained the situation. I also had a letter from a POTS Dr./researcher to the OBGYN explaining things. Here's part of what he wrote:

"There are no specific recommendations for pregnancy in the literature although volume loading is often helpful. From an anesthetic point of view BP can also be sustained with phenylephrine if not otherwise contraindicated. Between volume loading and phenylephrine things should be quite manageable."

I ended up with the epidural and did totally fine - no BP or heartrate issues and didn't need any sort of intervention. Keep us posted. Your baby will be here soon - how exciting! :D :D :D

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I didn't experience any symptom relief during any of my pregnancies. It's true that your blood volume increases when you're pregnant, but there are a whole host of other physiological changes taking place :). For the last two and a half months of my last pregnancy (when I was in the worst shape), I went for weekly IVs, and it helped with some of the symptoms for the day or so following the IV. At the suggestion of my cardio, I didn't take any meds until after I was done breastfeeding my youngest - I'm very glad I went that route, as the meds didn't work anyways :). As for labour, I found the biggest hurdle during my first was fatigue. I had a very long labour without sleep, and I finally asked for an epidural so I could have a nap. After I slept for a couple of hours, the delivery went smoothly. I didn't have an epidural with my second and third, and found that I recovered SO much faster than I did with my first. The hardest part for me was not being able to stand while labouring, as I experienced presyncope every time I tried :) I was having some awful pelvic issues and couldn't sit, but you might find a birthing/yoga ball to be helpful. And lots of IV fluids :).

I think an important thing to consider is a point Naomi touched on - you might need a lot of help after the little one arrives. Since my youngest was born 22 months ago, we have required full time help with our kids. Please make sure you have at least the first week or two covered with someone who can give you a lot of help, and to ensure that you can get as much sleep as possible!

Enjoy the last few weeks of pregnancy - you'll miss all of those kicks as soon as the baby arrives :)

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I don't know which route should I take, should I opt for the natural delivery, epidural or C section.

I think the reality is that you don't know what will happen during delivery and any of these options may be needed. So it would be good for your ob/gyn and anyone else caring for you in the hospital to be aware of your diagnosis. Many women w POTS on this forum have delivered healthy babies--under all three options you list above. Having had an emergency C-section my opinion would be that a c-section is not something I would have opted for. I think it made my POTS much worse. However, it was needed to save my life and my child's.

It sounds like overall you are doing well. Hang in there!

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My pots actually started during the third trimester of pregnancy so I agree the increased volume didn't help me either. I also got much worse after delivery and then slowly improved

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Thank you Naomi for the information. I will discuss anesthesia with my OB/GYN and will mention phenylephrine. I think he'll think I'm mad :D :D I've noticed that doctors don't like patients, who are trying to be proactive doing research and all that stuff. My GP to this day thinks that all I have is anxiety although I was officially diagnosed. The way she explained blood pooling was " oh this is a problem for most tall women" :rolleyes::D

Naomi do you know, if phenylephrine was used in your situation?

Frugalmama thank you for chiming in :) I don't want to take meds either, I'll just try to suck it up, because it's only a month ( or maybe less) left. How was your experience with epidural. Any problems with your hr or bp?

I'm not sure, if they'll give me IV fluids, because my bp in stressful situations ( going to doctors always is stressful for me) is not very low. Last time at my antenatal check up it was 127/75. So it's considered perfect. I guess I'll just have to trust them.

You're right MomtoGuliana overall I'm not doing bad at all. I'm not bed bound, I don't faint and I'm extremely grateful for that.

One more question. Has pain significantly increased your heart rates during delivery? I've read that during contractions women experience increased heart rate.

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I was just diagnosed with POTS around a year and a half after I had a baby, but I definitely had POTS-like tendencies earlier on in life.(Nothing major, though). But I definitely experienced a BP drop and dizziness when I had an epidural. (I would definitely prefer to have some dizziness than transition contractions though! :))

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Naomi do you know, if phenylephrine was used in your situation?

You know, after making very sure the OBGYN and the anesthesiologist were well aware of my situation, I don't even recall them monitoring my BP or heartrate during the whole thing (maybe they did-I just don't remember it?) - but everything went totally fine (no BP drops, no crazy heartrates), even with the epidural. I didn't need any sort of intervention - no medication, nothing.

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I recieved the epidural also and felt very dizzy and VERY hot. However they said that was common symptoms in labor. I did horrible in my third trimester as well. My heart rate was actually higher than my daughters was during labor...the nurses were pretty shocked lol. I actually did great after birth but slowly started declining. By 6 months pp I was bed bound. Going into my pregnancy my POTS was very mild.

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