Pots And Pregnancy

[dizzydaze]

Hello. My husband and I will be trying to conceive another child soon and I worry how I might feel during and after pregnancy. I had mild symptoms of POTS (just the odd faint and heart palpitations) but since having my first child by c section the symtpoms have got worse ( constant dizziness and tiredness and nausea as well).

What does research say about POTS and pregnancy and what were your experiences? I am an older mother (37) so I am behind the eight ball already.

Is the POTS likely to get worse? Why does it get worse during pregnancy? Does it get better for some people?

Is it just the sleep deprivation that triggers something?

I see from some old forums that some of you were told "you cant have children" . Is that because of POTS doing something to your reproductive system or that you just wouldnt be able to cope?

Please help.

Thank you.

[sstephan]

Hi,

I have a one and a half year old daughter and was not diagnosed officially until after she was born, My pregnancy was both up an down. Some of this due to the fact that I was sick before I got pregnant and never had a diagnosis other than syncope problems. (which I had for years) I also had what turned out to be gallbladder problems during my pregnancy. First trimester was okay- just tired all the time. Second trimester I was in the emergency room several times for gallbladder pain, tachy, low blood pressure, faintness etc. Third trimester was up and down depending upon my blood pressure, GI problems, and fast heart rate. I think if I had a diagnosis before pregnancy things would have been better. They did not know what was wrong with me and so every time I was in the ER I would be admitted to labor and delivery even though I knew I was not in labor!! I was terrified of delivery since I didn't know what was wrong. However, my cardiologist was on call and the labor went just fine and was uneventful. I would like to get pregnant again, however, I feel it would be better this time because I know what is wrong with me. The blood pressure must really be monitored as mine got really really low and an epidural lowers your blood pressure anyway. They have to give you meds to counteract it. Also the heart rate increases when you are pregnant anyway so I would follow with a cardio. I was on a lot of meds when I was pregnant, however, I know you are not supposed to be on Midodrine. I would also reccommend seeing a high risk specialist which they will probably send you to anyway. All in all, I had a difficult pregnancy at times. Would I do it again? Yes because the outcome is worth it to me. Yes I was scared a lot of the time but my daughter is what keeps me going now and gives me such joy I wouldn't trade it for the world. My only fear about having another child is can I handle it after the child is born. I don't want my children to have a sick mommy all the time. All the best- POTS takes enough from our lives. If you want to have children, don't let it rob you of this. Just find yourself a good doctor, take care of yourself and your baby, and remember mindset is everything.

Susan

[calypso]

I think it's different for every woman who has POTS in terms of what the outcome will be. Because this illness can take many forms and symptoms, you have to try and figure out what your most disabling symptoms are and figure out how they might be affected or changed by pregnancy.

I did not have POTS and never heard of it before my first pregnancy. I developed it within days of delivery. I guess it's common for POTS to develop in the postpartum period, I suspect because of all the blood volume changes and blood pressure changes that occur post-pregnancy, and because of the increased cardiac demand (postpartum period is the most stressful time on a childbearing woman's body because of all the circulatory functions stabilizing, the production of breastmilk, etc.).

I am trying to conceive as we speak. This was the first month we tried, so I don't know how things will go. I got pregnant on the first try the first time, but obviously my body is completely different now. I have ongoing problems with high heart rate, my BP runs higher now (but still in normal range), my blood sugar is a little higher than it used to be (in the 90s but not abnormal ... yet), I am weaker, more tired, don't breathe as well as I used to or as naturally, etc., etc. But I feel I can function without meds and can suck it up for the rewards of having another child. Many here simply cannot do it. I consider myself very fortunate in this respect.

I think you should aim for trying to be med-free, but if you need to take a beta blocker, my OB said it is not absolutely out of the question. The drugs do reduce circulation to the fetus a bit, but not drastically. You can be on a low dose if your heart rate is out of control. However, he told me unless my heart rate is consistently over 150, it's more for comfort than anything. He said my body would be OK for nine months with a higher heart rate. And I never go that high; I tend to have a heart rate of 100-120 off meds while standing.

Feel free to ask me any questions you might have. I don't know a lot of the answers but can offer my experience. Good luck!

Amy

[Guest dionna]

i too am concerned about what having a baby will be like. i don't plan on trying for atleast another year or two but i am still very concerned about it. dr. goldstein at NIH told me that most women get better because the body's fluids increase or whatever. i forgot what he said... that was almost a year ago, but i also read a study that was done and it said that the women got really sick and had to be on IVs. i am more than willing to do whatever is neccessary to have a baby. i lost my first one at 17- i was beaten so i had to have a D&C/DNC whatever. that i would say is the worst thing that ever happen to me and i really want to so badly have a baby. i want to know what it is like. i don't care how sick i get! i will stay in bed the entire 9 months! i do that pretty much all the time now anyway.

INTRODUCTION: Postural orthostatic tachycardia syndrome (POTS) is a rare disease characterized by syncope, sinus tachycardia, and orthostasis due to autonomic dysfunction. METHODS AND RESULTS: Two women aged 26 and 24 years with severe POTS became pregnant. Both women experienced hyperemesis gravidarum with subsequent marked improvement in their POTS symptoms until 6 months gestation, when their syncope and sinus tachycardia caused clinical decompensation. Both patients delivered healthy babies at 37 weeks by elective cesarean section. CONCLUSION: In long-term follow-up, both women reported improvement in their prepartum symptoms. We describe the first report, to our knowledge, of two successful pregnancy outcomes in severe POTS, including the first report of midodrine use in pregnant women.

i found this article by googling pregnancy and POTS.

i wish you good luck and i also wish Amy good luck.

dionna

[Sunfish]

hi dizzy -

this has been discussed a good number of times so you may want to do a search for a wide variety of responses. i don't have personal experience but the bottom line answer is that it is different for everyone.

all the best,

melissa

[MightyMouse]

I'm with Melissa on this one-- folks have reported both scenarios: feeling way better and feeling way worse while pregnant---and everything in-between.

I would think that you'd probably have a similar experience to your previous pregnancy(ies), but your concerns are worthy of discussion with your doctor. Also, some meds for POTS are okay for during an entire pregnancy and others are not--AND not all docs agree on which ones! (just to keep it interesting )

Nina

[MomtoGiuliana]

hi dizzy daze...

There is a broad range of experience with pregnancy on this forum alone, and not much research on this topic, so there is not one answer for how POTS would affect pregnancy. Specialists generally recommend that a patient be stable off all meds before attempting pregnancy. As others have said some meds are considered ok with pregnancy others not, and as Nina said, docs often don't agree. It would be advisable to be under the care of both an ob/gyn and a autonomic dysfunction specialist during a pregnancy. My experience with POTS and pregnancy was not good--I had worsening symptoms from week 23 or so to the end, with a bit of improvement in the final month. It did not affect the health of my child, apparently, but I was quite incapacitated for almost a year...as the symptoms got even worse after c-section. I saw a new ob-gyn recently who feels strongly that I would have a better experience with a second pregnancy only b/c I would be diagnosed--I was undiagnosed until my daughter was 4 months old. She feels some meds could be used during pregnancy if needed--particularly after the 1st trimester.

Good luck with your decision.

Katherine