I saw a mom just last week with quite elevated blood pressure and
considerable swelling in ankles who had had an unmedicated child birth.  No
pitocin induction, and got to hospt. so late in the game there was no iv.
Several pushes and out popped baby.

 The issue of postpartum hypertension is complex.  I just glanced at an
article on Medscape this week about a large increased risk in developing
hypertension pp in fertility patients  receiving human menopausal
gonadotropin therapy who also had polycystic ovaries.  If the mother had
polycystic ovarian disease (PCOD) and received this treatment in order to
induce ovulation, she had a 31.8% risk compared to a 3.7% risk in control
mothers who received the same hormonal inducement but who DID NOT have PCOD.
So I don't think we can generalize that fluid loading is always the
mechanism.  From this study, it would appear that hormonal issues (either as
the result of tx or perhaps the woman's own situation) can influence this
situation.

The ref. is:   Kashyap S, and Claman P: J Reproductive Med 2000, 45:991-994.

As usual, when I see the hypertension and the swelling, I also observe a
concurrent suppression (either mild or severe) of early lactation
performance.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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