Inclusion Criteria:  Nulliparous (no previous pregnancy greater than 20 weeks) Gestational age of pregnancy between 12 and 16 weeks  Exclusion Criteria:  Known fetal anomaly or chromosomal abnormality Early fetal growth restriction Fetal demise or planned termination Participation in another study that may influence this study Known maternal kidney disease Known maternal electrolyte imbalance Known allergies to study interventions Preexisting hypertension (chronic hypertension) Known gastric ulcer Incarcerated status Planned delivery at non-UTMB hospital Known lactose intolerance