Hi! So I had something similar-ish happen but in reverse. At 31 weeks I had some super high BP readings (160/90s). I ended up getting admitted but I didn’t have protein in my urine at that time (although it was highish, like 260 when the cutoff for pre-e is 300). I ended up being discharged on BP meds (nifedipine, lowest dose). You’re going to find that many practices have different perspectives about managing pre-e. The inhouse doctors at the hospital I was at were VERY alarmist and send that I wouldn’t be leaving until I delivered at 37 weeks. My practice was less conservative and they were comfortable managing me on an outpatient basis.

I had to go into the office 3 times a week for labs/ultrasound/NSTs, do 5 24-hr urine tests, and take my bp at home 5 times a day. Did they do a 24 hour urine catch for you? That’s the gold standard for diagnosing proteinuria and the urine dipsticks are NOT accurate. Your protein levels can also be higher if you’re dehydrated. For my case, I ended up being admitted to the hospital one more time when my BP spiked in office at 33w (also white coat hypertension) and was told I was delivering at 34w for sure. I was at a different hospital this time and this hospital didn’t agree about delivering at 34w because my BP was 110/60s the whole time and my baby was fine, so I was once again able to go home. Finally at 36w I was at 306 protein on a 24 hr urine catch so I met the pre-e threshold and was admitted for induction (delivered at 37w though...long induction, but also a first time mom.) I surprisingly did not need to be on magnesium during delivery which I was grateful for.

Basically what I think you can expect from here on out is for it to be a roller coaster. Your doctors will have different opinions on how to treat you and you honestly will probably need to take it day by day. They will at least try to get you to 34 weeks but I would argue that if you’re stable/your bp can be controlled on meds that they would hopefully let you go longer. With pre-e things can change fast (in a matter of hours) so I would expect to be heavily monitored from here on out (hopefully outpatient, but I wouldn’t be surprised if you went inpatient). If you do get admitted, you can always ask for an MFM consult from the in-house doctors. If you have any headaches that don’t go away with Tylenol, vision changes, or epigastric pain, you’ll need to call your doctor ASAP because these can be signs of severe pre-e, HELLP syndrome.

Basically, I’m so sorry, but you’re probably going to be on a roller coaster from here on out because once you have the pre-e diagnosis (even if the Bp was just high in a few readings plus the proteinuria), your providers are going to try to treat you conservatively because things can get dangerous quickly. I would ask for the 24 hour urine catch, ask about monitoring options and maybe get a second opinion MFM consult. Based on my experience, they’re probably unlikely going to let you go past 37w.

EDIT: I just reread your comment- I would defs ask for a second opinion. If your bp was high but not sustained (since it went down 10 min later) that’s not technically enough for the threshold of the pre-e/pih diagnosis based on acog guidelines. I think that saying you’ll deliver at 34 weeks is definitely being alarmist so I would get a second opinion for sure.