Talk to me about preeclampsia, bedrest, and delivery - Page 2

[mediumcrunch]

My PE showed up at 38+2. Induced at 38+5 with admitting BP of 180/110 and kidneys in bad shape. Mag, pit, cathether....the whole kit and kaboodle. Had a vaginal birth. The cath was dc'd before I started pushing. The mag didn't hit me very hard in the muscle strength (I gave birth in a supported squat, almost hands and knees) but I was unable to get to the bathroom immediately postpartum without almost passing out so they straight cath'd me one time in L&D. They asked me to buzz them for help the first couple times I got out of bed in PP to make sure I was stable, and I was (and I had a broken foot too) I was kept on mag for 12 hours PP and heplock in for 24. DD was stuck every 4- hours for a mag level

A lot may depend on your hospital and doc SOP and how the mag affects you.

Miriam- the often need to counteract the effect of mag on the uterus by administering pit. it is an awful and delicate balancing act and contributes to the high rate of surgical birth among PE moms.

[mediumcrunch]

oh and I had PIH with the pregnancy following the PE pregnancy. It showed up at 25 weeks. I had every other week visits starting at 25 weeks and weekly NST's starting at 32 weeks. I felt awful at 36w6d and my home BP's were in the high 150's/high 90's and since I was 2-3 OB decided we'd better call it quits before it got any worse. My labs were OK at the hospital and as long as stayed in bed my BP's were OK so no mag \o/. Unfortunately, my baby had TTN and a pneumo and spent a week in the NICU.
I'm 20 weeks and my BP at my last visit was 96/57 yay me. I'm optimistic I will dodge the PIH/PE bullet this time since I only had NVP instead of HG in the first trimester so my nutrition wasn't as horrid as it usually is.

[Kailey's mom]

Originally Posted by PotreroHill

I was diagnosed a few days ago with mild preeclampsia. For the time being, it seems to be stable. I'm starting bedrest next week at 34 weeks along. Can anyone tell me their experiences with preeclampsia, bedrest, and delivering the baby? What's the criteria for hospitalization with pre-e? Were you hospitalized? Did you go to 40 weeks? Were you induced early? How did delivery go? Is there a higher risk of a csection with pre-e?

Thanks mamas

I was diagnosed a bit earlier than you, officially around 31 weeks. I was put on bedrest and bloodpressure meds at that time. I took my b/p's at home, and if it got too high, or if I was feeling ill, I would go to L&D to have them check and see how my dd was handling it. A lot of laying on my left side!!! At 34 weeks is when my blood pressure meds were not helping as much, my bloodpressure, at best, was around 155/90. I was having appts 2x/week to monitor the baby for an hour. My protein in the urine went from a plus 1 to a plus 2. I was then put on STRICT bedrest, and was told that I would have to be hospitalized if my b/p's got higher. At this point, the only reason my OB did not want to deliver, is because of lung development. I wasn't scared, and was sure the baby would be huge, because I was HUGE. I had an ultrasound at 35 weeks and 5 days. Baby wasn't huge, baby was measuring small, approx 32 weeks. My bloodpressure in the office was 192/110. It was time. I had also gained 5lbs in 2 days. I begged to wait until morning, and she was O.K. with that, but made my husband PROMISE that I only got up to pee, no bath even, and that we would come in early. We had a little "celebration" party the night before * I didn't follow doctors orders, oops* and went swimming. ( I wasn't worried as I was not even close to being dialated) 8am we were at the hospital. I already knew I was having a cesearian because of the placenta previa, baby was high and breech, and my body wasn't ready for labor) at 12:15 pm my baby girl was born The birth was amazing, and she stayed with us, until she was showing us, and the nurses, that she was ready to go to the NICU. My dh and family held her while I was being stitched up. I had no pain what so ever, no discomfort. We were so excited, and even got pictures of her birth She weighed 4lbs 14oz. She did have some preemi issues, and very low blood sugar. Once in the NICU, she was having a hard time with maintaining her body temp, jaundice, heart murmer, grunted breathing, and some feeding issues all due to prematurity. She was in the NICU a total of 6 days. I got to stay with her, I was just 2 rooms down from the NICU. The first day I was on Mag Sulfate so I was stuck to the bed, plus I was pretty drugged. They brought the baby to me from the NICU for feedings and whenever I wanted to see her, incubator and all! The hospital staff was amazing, the entire experience was just the best considering the pregnancy complications. I wish you the best and congrats!!!

ETA: the protein in my urine at 35 weeks was at a plus 4. My bloodpressure actually got worse after the delivery, but finally at 6 weeks postpartum, the pre eclampsia was gone!

[SashaBear]

I never went full blown pre-e just PIH but I was on bedrest. I didn't have to have magnesium. For me labor didn't progress well because I was in bed the whole time. Then it became the normal course of intervention. had back labor, Pitocin, epidural, break my waters. They forgot to add a catheter and drain my bladder. Vacuum extraction, episiotomy. Normal awful stuff.

[MyZymurgy]

Originally Posted by miriam

Magnesium is a muscle relaxant. How can they give you that during labor?

It's magnesium sulfate, specifically. It's to prevent seizures. It can, at least theoretically, slow down labor. I hated the stuff. Some women do just fine with it. It made me very hot and nauseous. It's standard practice in hospitals (at least in the US, as far as I know) to give it to pre-e women.

[JTA Mom]

Originally Posted by miriam

Magnesium is a muscle relaxant. How can they give you that during labor?

It's also used to stall/stop pre-term labor. It is the only thing that prevents seizures. I believe it is the MAJOR reason why I ended up with a c/s. I had to be induced and it was such conflicting signals in my body--pitocin and mag, start/stop. But it's better than seizing and causing damage to the baby/mom.

Originally Posted by MyZymurgy

It's magnesium sulfate, specifically. It's to prevent seizures. It can, at least theoretically, slow down labor. I hated the stuff. Some women do just fine with it. It made me very hot and nauseous. It's standard practice in hospitals (at least in the US, as far as I know) to give it to pre-e women.

I didn't care for it either. I felt a bit hot too, but that's it. I get nauseated during labor anyways, so no difference there. What I hated the most was the catheter. My contractions would start putting pressure on my bladder, so I could feel the stupid catheter even more. It felt like I had a knife up there.

Ami

[member234098]

magnesium sulfate = epsom salts.

[MyZymurgy]

Originally Posted by miriam

magnesium sulfate = epsom salts.

It's a chemical compound with a lot of uses (both medical and non-medical from what I have heard).

You first posted "Magnesium is a muscle relaxant. How can they give you that during labor?" and I think you got good answers. Now you are stating it's epsom salts... so I'm just curious if you have an anti-mag axe to grind... or... maybe I'm not getting the point?

Sorry to be so thick, but I don't quite get where you are coming from or what you are trying to say.

[womenswisdom]

Originally Posted by miriam

magnesium sulfate = epsom salts.

Same chemical, given by IV.

[ILovePie]

Yes, Mag sulfate = epsom salts.
Yes, Mag sulfate = used to stop pre-term labor.
Yes, Mag sulfate = muscle relaxant (that's how is stops pre-term labor - relaxes the uterus). It pretty much relaxes everything - dilates blood vessels to reduce likelihood of maternal seizures.

I was Dx'ed with pre-e while in labor (after 9 weeks of side-lying bedrest for labile blood pressure). Mag (icky, icky mag...)stopped my contractions from being effective, so I had pitocin (brutal stuff!!!!)


I actually attended a symposium for patients and survivors that the Preeclampsia Foundation organized this past October. It was fascinating!

There looks to be a very promising blood test that I believe they said may be approved for use in 2011. It essentially looks at proteins and protein receptors that arise in the creation of the placenta. This would be a very good way to diagnose - as there is currently no diagnostic test for pre-e, only a group of clinical indicators.

For example, I spill 5+ grams of protein when not pregnant and my blood pressure is slightly elevated. I freaked out OB nurses all the time when pregnant and my nephrologist chuckled when I was asked to do a 24 hour urine collection (for me it's pointless, because I basically have all the clinical indicators for pre-e when I'm NOT PREGNANT!). The only reason I was dx'ed with pre-e in labor was that my blood pressure shot up and would not come down, no matter what was done.

[babygirlie]

I despise mag. I also don't get the muscle relaxant with a muscle contractant. Can we deny mag?

What is the difference between mild medium and severe pre e. It all sounds horrific.

Did I mention I hate mag? I also hate pitocin :P I was induced and on mag for 3 days but the first day was a med to soften the cervix.

Next time can i deny the mag and cant they just be happy with watching for a seizure?

[ILovePie]

Originally Posted by babygirlie

I despise mag. I also don't get the muscle relaxant with a muscle contractant. Can we deny mag?

What is the difference between mild medium and severe pre e. It all sounds horrific.

Did I mention I hate mag? I also hate pitocin :P I was induced and on mag for 3 days but the first day was a med to soften the cervix.

Next time can i deny the mag and cant they just be happy with watching for a seizure?

You'd be watching for seizure, stroke, and fetal distress. I know it seems like it doesn't make sense - and I agree it's an odd combination because a published side effect of Pitocin is raising blood pressure - but I wouldn't decline the mag.

[MyZymurgy]

Originally Posted by babygirlie

I despise mag. I also don't get the muscle relaxant with a muscle contractant. Can we deny mag?

What is the difference between mild medium and severe pre e. It all sounds horrific.

Did I mention I hate mag? I also hate pitocin :P I was induced and on mag for 3 days but the first day was a med to soften the cervix.

Next time can i deny the mag and cant they just be happy with watching for a seizure?

I understand not liking mag... for a lot of women, it's not a pleasant drug.

HOWEVER, this is one situation where this drug is life saving. They can't just "watch for a seizure" because it happens so quickly. Once you are seizing, the possibility serious damage is already being done to you and your baby. That's like saying "can't they just watch for death"? Well, yeah, they can... but rather than try to resuscitate you, it's better to try to prevent death in the first place.

Believe me... I'm not big on modern medicine in a lot of ways either. I don't think doctors or hospitals are perfect by any stretch of the imagination. However, if you have pre-e, you've got to take the condition as seriously as it warrants. Medical interventions for a pre-e patient during delivery saves lives.

Visit the Pre-Eclampsia Foundation. You'll find a lot of information and support there. You'll also, sadly, find many grim reminders of how serious pre-e is. Many mamas there have lots there babies to pre-e... and there are several husbands that post on that board that lost their wives to eclamptic seizures.

Having said all of that... it's your legal right to deny any kind of medication or treatment (as far as I know). So, yes, you could deny mag. BUT you may have a really hard time finding a hospital or doctor who would be willing to attend your birth if you were refusing mag. And if you have pre-e, your not going to find any midwives worth their salt willing to deliver you at home either.

I know this feels like all your choices are stripped away when you have pre-e. But... that's life. No one wants to get pre-e, and no one is excited about the mag either. But if I accidentally cut my thumb off slicing a bagel, I couldn't just refuse to seek medical treatment because I didn't like stitches and expect to somehow come out of this with my thumb intact. KWIM? Life is unfair. Pre-e is unfair. And if we want to come through this with the highest chance of survival for ourselves and our babies, we have to suck it up and do treatments we don't necessarily like.

I hope that made some sense.

[ILovePie]

Originally Posted by MyZymurgy

I understand not liking mag... for a lot of women, it's not a pleasant drug.

HOWEVER, this is one situation where this drug is life saving. They can't just "watch for a seizure" because it happens so quickly. Once you are seizing, the possibility serious damage is already being done to you and your baby. That's like saying "can't they just watch for death"? Well, yeah, they can... but rather than try to resuscitate you, it's better to try to prevent death in the first place.

Believe me... I'm not big on modern medicine in a lot of ways either. I don't think doctors or hospitals are perfect by any stretch of the imagination. However, if you have pre-e, you've got to take the condition as seriously as it warrants. Medical interventions for a pre-e patient during delivery saves lives.

Visit the Pre-Eclampsia Foundation. You'll find a lot of information and support there. You'll also, sadly, find many grim reminders of how serious pre-e is. Many mamas there have lots there babies to pre-e... and there are several husbands that post on that board that lost their wives to eclamptic seizures.

Having said all of that... it's your legal right to deny any kind of medication or treatment (as far as I know). So, yes, you could deny mag. BUT you may have a really hard time finding a hospital or doctor who would be willing to attend your birth if you were refusing mag. And if you have pre-e, your not going to find any midwives worth their salt willing to deliver you at home either.

I know this feels like all your choices are stripped away when you have pre-e. But... that's life. No one wants to get pre-e, and no one is excited about the mag either. But if I accidentally cut my thumb off slicing a bagel, I couldn't just refuse to seek medical treatment because I didn't like stitches and expect to somehow come out of this with my thumb intact. KWIM? Life is unfair. Pre-e is unfair. And if we want to come through this with the highest chance of survival for ourselves and our babies, we have to suck it up and do treatments we don't necessarily like.

I hope that made some sense.

This is well-put. Pre-eclampsia is an extremely scary and poorly-understood condition. There is no cure and the only treatment is delivery. Magnesium clearly prevents seizures. I'm all for unmedicalized birth and would homebirth if I could, but I think it would be irresponsible not to deliver in a hospital because I am at such high risk for pre-eclampsia.

Explore the preeclampsia.org information and forums. Many of the moms there are incredibly knowledgeable - I could never explain pree as well as some of them can!

[Bokonon]

Originally Posted by MyZymurgy

I understand not liking mag... for a lot of women, it's not a pleasant drug.

HOWEVER, this is one situation where this drug is life saving. They can't just "watch for a seizure" because it happens so quickly. Once you are seizing, the possibility serious damage is already being done to you and your baby. That's like saying "can't they just watch for death"? Well, yeah, they can... but rather than try to resuscitate you, it's better to try to prevent death in the first place.

Believe me... I'm not big on modern medicine in a lot of ways either. I don't think doctors or hospitals are perfect by any stretch of the imagination. However, if you have pre-e, you've got to take the condition as seriously as it warrants. Medical interventions for a pre-e patient during delivery saves lives.

Visit the Pre-Eclampsia Foundation. You'll find a lot of information and support there. You'll also, sadly, find many grim reminders of how serious pre-e is. Many mamas there have lots there babies to pre-e... and there are several husbands that post on that board that lost their wives to eclamptic seizures.

Having said all of that... it's your legal right to deny any kind of medication or treatment (as far as I know). So, yes, you could deny mag. BUT you may have a really hard time finding a hospital or doctor who would be willing to attend your birth if you were refusing mag. And if you have pre-e, your not going to find any midwives worth their salt willing to deliver you at home either.

I know this feels like all your choices are stripped away when you have pre-e. But... that's life. No one wants to get pre-e, and no one is excited about the mag either. But if I accidentally cut my thumb off slicing a bagel, I couldn't just refuse to seek medical treatment because I didn't like stitches and expect to somehow come out of this with my thumb intact. KWIM? Life is unfair. Pre-e is unfair. And if we want to come through this with the highest chance of survival for ourselves and our babies, we have to suck it up and do treatments we don't necessarily like.

I hope that made some sense.

I practically begged to be admitted to the hospital and put on mag during my last pregnancy. My BP was scary high and I was terrified that I would seize in the middle of the night and my baby and I would die.

Mag. sulfate saves lives. Taking a bath in epsom salts is not the same thing. Mag. sulfate is given intravenously. No, it's not pleasant stuff to be on. But it is extremely effective, and IMO, refusing it when being on it is medically indicated would be foolish and risky.

[Bokonon]

Originally Posted by babygirlie

I despise mag. I also don't get the muscle relaxant with a muscle contractant. Can we deny mag?

What is the difference between mild medium and severe pre e. It all sounds horrific.

Did I mention I hate mag? I also hate pitocin :P I was induced and on mag for 3 days but the first day was a med to soften the cervix.

Next time can i deny the mag and cant they just be happy with watching for a seizure?

Mild preeclampsia is defined as 2 blood pressure readings of at least 140/90, taken at least 6 hours apart, and at least 300mg of protein in a 24-hour urine specimen.

Severe preeclampsia is BP of 140/90 or more plus at least 5 grams of protein; OR 300mg+ of protein plus BPs of 160/100, and/or other symptoms such as severe headaches not relieved by Tylenol, severe hyperreflexia, clonus, visual disturbances, and a few other symptoms I can't recall off the top of my head.

There is no medium preeclampsia.

It is horrific. Babies die from preeclampsia. Mothers die from it. The only cure is delivery of the placenta, but a mother can develop preeclampsia up to 6 weeks postpartum. A father recently visited the Preeclampsia Foundation forums after his wife died from postpartum eclampsia despite never having preeclampsia.

[mischievium]

*