Thanks for posting on HCM,
Well it will be hard to tell if the lower abdominal pain
is related to contractions or not. If contractions then she might just be having mild contractions not related yet to start of labor. If the pain persist despite the pain med, she might be having a preterm labor
(which is possible given that she has an elevated BP).
Now my concern is the blood pressure which is elevated. I do not know if she has been hypertensive or not. If this is first time her BP elevated, then this likely a condition of pregnancy induced hypertension
specifically known as mild pre-eclampsia (given her BP value).
Since she has mild elevations in blood pressure (and if proteinue) but no evidence of severe signs or symptoms of preeclampsia
may be safely observed without immediate treatment or delivery as her doctor has done. Women with mild preeclampsia at term (37-40weeks gestation) should be considered candidates for induction of labor. Mild elevations in blood pressure (
Her initial evaluation should take place in the hospital with fetal monitoring, 24-hour urine collection and monitoring for progression of disease.
Since she is managed as outpatient, she should be instructed to contact her physician if any symptoms of severe pregnancy induced hypertension appear.
Follow-up should include tests for proteinuria
, blood pressure assessment, home health care nursing and frequent clinic visits until she reaches term.
Remember that this situation can worsen, so you need to inform your doctor if the BP rises or she develops signs of preeclampsia.
Hope this helps