My blood pressure is consistently higher when I visit my OB's office (any doctor's office for that matter).  They insist on taking it first thing in the appointment (which drives me crazy because it does come down at the end of the appointment) and then when it's high they do take it again when I insist.  The second reading has ALWAYS been below 140/90-  most of the time it settles around 130/76.

I take my BP daily at home (both with a manual cuff and an automated cuff) and I stick between 120-130 over 72-82.

In my OB practice of 4 OBs, there is one OB in particular that doesn't care that my BP is good at home and that it hasn't gone up at all this entire pregnancy.  I just entered the third trimester.

Unfortunately I saw the less-than-considerate OB this last time (24 weeks) and she put in my chart that they need to do bloodwork (CBC, CMP, uric acid)  EVERY appointment from here on out.  It's not dependent on what my BP is (even if it's below 140/90), nor protein in my urine (which there has never been even trace), nor additional symptom evaluation (such as swelling, headache, sudden weight gain, visual symptoms, etc.).

Is this testing supported by best practice/literature?  I don't take pre-eclampsia lightly, but I do think it's overkill to be running blood tests every visit with nothing other than a borderline blood pressure (which seems to be white coat hypertension more than anything else).

I think this is a question best answered by the OB who isn't alarmed by your initial reading so long as your readings at home are fine. (BTW, there is a name for people who spike high BP in the doctor's office but not otherwise: "white-coat hypertension.") Here is a page on the Childbirth Connection website that has info and tips about getting the information you need to make an informed decision. It should help with discussions with your OBs whether it be the relaxed one or the up tight one.

~ Henci