Preventing Pre-eclampsia?

[JTA Mom]

Sorry for the multiple threads.

Last pregnancy, I developed pre-eclampsia. At 36.5 weeks, I had protein levels of 500 (cut off is 200/300 I believe?). Anyways, my bp was 140/90. If it helps, it was a summer pregnancy and I just wasn't drinking enough. Don't know if that helps or not.

This time around, I want to do what I can to prevent it. I'm still 5lbs from pre-pregnancy weight from the last pregnancy, but unlike last time I hope to either gain no weight/minimal weight. Last pregnancy I gained nearly 40lbs.

I also hope to be more active this pregnancy. Last pregnancy I was on & off bedrest, mostly because we were trying to figure out why I lost my first pregnancy so 'oddly'. There was a lot of stress too. Don't know if that contributes.

I am also eating a lot more protein this time around. No grains nor dairy. Allergic to dairy and grains don't work with dh.

Is there anything I can do the increase my chances of a healthy pregnancy?

Thanks!

Ami

[mama kk]

I know there is some information on this in Susun Weed's childbearing years book. I googled it quickly and only came up with THIS link, which if you scroll down has some information from Susun's book.
Good luck!

[JTA Mom]

Originally Posted by mama kk

I know there is some information on this in Susun Weed's childbearing years book. I googled it quickly and only came up with THIS link, which if you scroll down has some information from Susun's book.
Good luck!

WOW! That's an awesome link.

I am definitely eating differently this pregnancy. A LOT more protein. Oddly enough, my nausea is calmed with protein.

My last pregnancy was so stressful. This one hopefully won't be. For one, I know now that I can carry a pregnancy to term and what happened with Joseph was a 'fluke'.

Thanks again!

Ami

[CorasMama]

avoid salty or fried foods. Drink PLENTY of water. Rest as much as you can. Stay in close touch with your health care provider.

[gentlestrengths]

Eat a ton of green vegetables. One midwife I know swears by getting blood pressure back on track by green salads, and green juicing. Protein is important, so keep up on that, but don't forget to enjoy the greens every day!

[briome]

I think it is statistically more likely in a first pregnancy so don't think you are destined to repeat that! I was called 'almost pre-eclampic' by my medwife my first pregnancy but it was likely her odd behavior that drove up my BP!
Brewers Diet (very dedicated 2nd pregnancy..FORCED myself to eat enough protein as I am not fond of it) Really helped over all.

Some links to more links!
http://icanwesternmd.blogspot.com/20...iewpoints.html

[mischievium]

My perinatologist has me taking low dose aspirin throughout the pregnancy as there is some evidence that it can decrease the risk of developing preeclampsia, but that is something to discuss with your care provider before starting it. The Brewer's Diet is controversial at best and there are plenty of people who report following it to the letter and still develop preeclampsia. I mention this, not because I don't think people should pay attention to their diet and try to eat healthily, but because it can set women up to self-blame when, really, so far there is no concrete evidence that diet effects who ends up with preeclampsia and who doesn't. A good place to ask for more info about this would be on the preeclampsia foundation forums.

There is a good thread on there that offers the clearest lay (as in, not requiring a PhD in Embryology) explanation of the current understanding of the cause(s) of preeclampsia (especially the 6th post down by Caryn and the 9th post down by Catherine) that I've yet to find. Also, a couple of good, and relatively easy to understand, articles on the current understanding of the cause(s) of preeclampsia are here and here.

[JTA Mom]

Originally Posted by mischievium

My perinatologist has me taking low dose aspirin throughout the pregnancy as there is some evidence that it can decrease the risk of developing preeclampsia, but that is something to discuss with your care provider before starting it. The Brewer's Diet is controversial at best and there are plenty of people who report following it to the letter and still develop preeclampsia. I mention this, not because I don't think people should pay attention to their diet and try to eat healthily, but because it can set women up to self-blame when, really, so far there is no concrete evidence that diet effects who ends up with preeclampsia and who doesn't. A good place to ask for more info about this would be on the preeclampsia foundation forums.

There is a good thread on there that offers the clearest lay (as in, not requiring a PhD in Embryology) explanation of the current understanding of the cause(s) of preeclampsia (especially the 6th post down by Caryn and the 9th post down by Catherine) that I've yet to find. Also, a couple of good, and relatively easy to understand, articles on the current understanding of the cause(s) of preeclampsia are here and here.

First off, . I am so sorry for your loss. I lost my first child too. Seems that the loss affects all other pregnancies. Even though I didn't have an 'early' loss (before 12 weeks), I still freak myself out a bit each time I go to the bathroom. Again, !

And thank you for those links!

Definitely enlightening. That board is a bit scary though. The cases there were really bad. Honestly, other than elevated BP (140/90), protein in urine (500 when the cut off is 300) and some 'floaties' in my vision, I had nothing. No symptoms. Just the regular swelling of pregnancy (nothing HUGE, well within late 3rd trimester limits) a bit of heartburn. I did have some pubic issues, but that started in the 2nd trimester and was probably not related to pre-e. And I wasn't diagnosed until 36/37 weeks. So mild pre-e occurring late.

I started reading through there, then had to stop. Just way too scary. And heartbreaking, reading their signatures.

It's interesting your doctor has you on aspirin. Do you have any blood clotting factors? I just found out last year after my Aunt died of 2 embolisms that apparently my mom's side has blood clotting issues. Interesting, and definitely something I will mention to my midwife/doctor.


Ami

[Bokonon]

Originally Posted by JTA Mom

First off, . I am so sorry for your loss. I lost my first child too. Seems that the loss affects all other pregnancies. Even though I didn't have an 'early' loss (before 12 weeks), I still freak myself out a bit each time I go to the bathroom. Again, !

And thank you for those links!

Definitely enlightening. That board is a bit scary though. The cases there were really bad. Honestly, other than elevated BP (140/90), protein in urine (500 when the cut off is 300) and some 'floaties' in my vision, I had nothing. No symptoms. Just the regular swelling of pregnancy (nothing HUGE, well within late 3rd trimester limits) a bit of heartburn. I did have some pubic issues, but that started in the 2nd trimester and was probably not related to pre-e. And I wasn't diagnosed until 36/37 weeks. So mild pre-e occurring late.

I started reading through there, then had to stop. Just way too scary. And heartbreaking, reading their signatures.

It's interesting your doctor has you on aspirin. Do you have any blood clotting factors? I just found out last year after my Aunt died of 2 embolisms that apparently my mom's side has blood clotting issues. Interesting, and definitely something I will mention to my midwife/doctor.


Ami

Low-dose aspirin isn't typically recommended for women with a history of later, mild preeclampsia like you had. I have read that in general, if pre-e does reoccur, it will be later and milder, though there are always exceptions (myself included - severe pre-e in both pregnancies that started around the same gestation).

I was on low-dose aspirin in my last pregnancy because my first was severe pre-e (BPs of 200/110, 6 grams of protein in my urine over 24 hours, pitting edema, and FWIW, I felt FINE) and early onset with delivery at 32 weeks. I tested negative for clotting disorders, but even on aspirin, I still developed severe pre-e, which came on at around 28 weeks (140/90+ BPs, 300mg of protein, severe headaches and floaters) and I made it to 34 weeks before delivering for BPs of 190s/110s on beta blockers and hospital bedrest on magnesium sulfate.

The Preeclampsia Foundation forums are a wonderful resource. It is heartbreaking to see how tragically this disease effects so many, but it is a good reminder that there are no guarantees in even the healthiest of pregnancies, and there is no way to prevent it, and no cure. But there are more success stories than tragedies!

Best wishes for a happy, healthy, and PE-free 9 months!

[Bokonon]

Oh, and with the family history of clotting disorders, I would definitely recommend seeing an MFM (maternal-fetal medicine specialist) and having blood tests to rule out such disorders. If it is found that you have one, you would probably be put on Lovenox, which could make a difference!

[mischievium]

*

[JTA Mom]

Thank you both for clarifying things a bit more for me. And thank you for the links, Mischievium.

Alison, whatever 'clotting' issue it is, it's not a bad one from what I was able to find out. My grandmother got it after having surgery. My aunt was overweight and spent a lot of time in a car with her husband who is a heavy smoker. So it's hard to say if there is a clotting disorder or if my family is just more susceptible to getting embolisms with the 'right' environmental factors. My sister was tested and was negative (she's on hormonal bc). I can ask for a test, but I don't think it's strong enough to need Lovenox. Well, okay, I hope it's not strong enough to need Lovenox.

You know it's interesting, because while perusing the pre-e site, I've read that high BP and spilling protein do not always indicate pre-e. Which is interesting for a few reasons, actually.

My BP jumped at 36 weeks, they had me do the 24hr urine and a couple NST. NSTs came back fine, ds was moving & groving. His size is either due to 1) genetics (my family has small babies, and half of dh's family has small babies--aka 6lbs is the 'norm) or 2) wrong dates/prematurity, since I was induced. The doctors felt that ds was more rightly sized/muscle testing to 35 weeks. However, because he was on Magnesium sulfate for 23 hours at that point, they don't know if the muscle testing was weak due to that or prematurity, and once they found out the 'regular' size of babies in our families, well 3 weeks is long enough to gain at least a lb and an inch to make him well within 'normal'. I'm leaning with Magnesium, because as soon as that was out of his system he jumped in almost everything--breathing rate, strength, etc.

Because I had high BP and because I was spilling protein and because I was 37 weeks, the doctors decided to be very safe, putting me on Magnesium, then inducing. Btw, I didn't mind the Magnesium. The catheter on the other hand.

Once the results came in from the urine test, I was 37 weeks and told to come in. They induced me that day. However, all my blood tests during labor came back normal--no elevated liver stuff, platelets steady, etc. I did ask my OB at my 6 week checkup about any physical repercussions (I'd read about kidney and liver damage) and she said from my results there was no damage and I would be fine. Now I'm wondering if I had PIH and non-pre-e related proteinuria? They even checked the placenta and it was fine. Perfectly normal sized, especially compared to the size of ds. I think I asked that of every OB on the floor afterwards, and my OB at the 6 wk checkup.

Due to financial issues this time around, we qualify for MediCal. I don't know if I can see an MFM through that or not. If not, do you know where I might find an MFM to do a consultation with? As serious as this issue is, I'd at least like a specialist to look at my tests and tell me if I'm high/low risk, etc. Even if paying out of pocket (ouch).

And Mischievium, I am so sorry you went through that with Soren. I lost Joseph in a similar 'fine one minute, crashing the next' way. For me, the trauma of losing my child was just further compounded by the dramatic way it happened. I'm really, really, really hoping that both of use have nice, healthy uneventful term pregnancies with healthy, living babies at the end.

Ami