Talk to me About Pre-E

[Sunflower223]

Okay ladies. I am about 22 weeks pregnant. My normal BP is about 90/65. Over the last few weeks, along with terrible headaches, it has been jumping up to 160/100 at sporadic times. Other times it is 115/70. Sometimes within an hour or so. My MW has gotten me to increase my salt, my protein, and my intake in general since I hadn't been eating a lot. I have never had any problem like this and this is my 6th pregnancy.

I haven't seen a backup OB yet and now I am afraid to start. I know that I have to see one to deal with this if it sticks around but I am scared. I think all the anxiety is making me stressed and the problem worse, not to mention I have been in some pretty stressful life situations lately.

I don't know much about pre-e. I have looked stuff up, but its hard to discern what's real and what is exaggerated. I know some of you have been through this. I want to know more about real experiences. Did anyone manage a HB with Pre-E? Has anyone had this problem and been able to corect and keep it corrected with dietary changes? Are there any herbs that have worked for you? Anything you have to offer would be greatly appreciated, positive or negative.

[Bokonon]

I'm not sure what information you've seen that you think is "exaggerated", but preeclampsia is a very serious condition that is responsible for many maternal and fetal deaths worldwide.

The Brewer Diet that you have probably been encouraged to follow is unsubstantiated and potentially harmful:
http://www.preeclampsia.org/forum/to...s=,brewer,diet

Your blood pressure would likely not hit 160/100 from stress alone. Has your midwife done a 24-hour urine test to see how much protein you are spilling? Checked your amniotic fluid levels or blood flow to the placenta? These can suffer with very high blood pressure, especially with such a low normal.

I had severe preeclampsia twice. I delivered my first at 32 weeks, when my blood pressure was 200/110 (my normal is 100/60) and I was spilling 6 grams of protein in my urine. I was fortunate that I had attentive care, because with blood pressures that high, I could have had a stroke or seizure, and/or placental abruption. As it was, my son was very sick at birth. Another day or two before delivering, and we could have lost him.

With my second, I developed severe headaches and visual disturbances when my BP started going up at 28 weeks. I made it to 34 weeks before delivery, with BPs of 190/105 while on hospital bedrest and blood pressure medication. It is now 19 months later and I STILL have a headache and visual disturbances. I'm just lucky that I didn't have any other organ damage, as many women with severe pre-e end up with.

Please take it seriously. At 22 weeks, you have a long way to go until term, and a good outcome is dependent on your symptoms staying stable and attentive care.

[geekgolightly]

Please see an a specialist in perinatology/materal fetal medicine with experience and interest in treating PIH and preeclampsia to get a second opinion.

I am in total agreement with the above poster.

[geekgolightly]

I attempted a homebirth, but when I was spilling 2+ in my urine, I went to hospital and was immediately put on mag and was induced. I was 36 weeks along but my son had severe IUGR. I was a nurse and couldn't get it through my thick head how serious this was. My pressures went high (150/110) at 22 weeks and I continued working my 12 hour shifts 4x/week until I was 32 weeks. Very stupid of me, looking back.

A pressure that high, even if only transitory suggests PIH at the very least and you might be heading towards preeclampsia. Now is the time to work with an MFM specialist in conjunction with your midwife. I wouldn't rule out home birth at this point, but I would definitely prepare myself for a chagne in plans.

[Bokonon]

I should also add that with blood pressure of 160/100, even if it goes down, you are already diagnostic for pregnancy-induced hypertension. If you are spilling at least 300mg of protein in a 24-hour urine sample, and have at least 2 readings of 160/100 or greater, then you are diagnostic for severe preeclampsia (which requires 2 readings of systolic over 160 and/or diastolic over 110).

The severe headache that many women with pre-e get is not just a nuisance - it can be a sign of cerebral edema, which can signify impending stroke or seizure. I had to have a CT scan and MRI at 32 weeks pregnant to rule out cerebral edema because of my central nervous system symptoms.

[Sunflower223]

I guess my first post did seem a little too breezy. Please don't think that I am not taking it seriously. I know it is serious. This has all happened pretty fast. The first reading I had that was that high was over the weekend and right after a heated argument, so for that reason I took it a bit less seriously than maybe I should have, but it has consumed my thoughts ever since.

I called my mw over the weekend, she said my diet was severely lacking in protein and she wanted me to up the protein (yes this is based on Brewer). I have done so but my BP is still all over the chart. Because of how quickly this happened and the fact that she is two hours away we haven't sat down and had a real talk about it and I haven't had any testing done yet. I was spilling protein at my first prenatal at 10 weeks but I haven't been checked since then.

I have scanned the internet, sometimes it is hard to tell what is real and what is not on the internet. I know it is serious, but considering dr. google has been my main source of info while waiting for a mw appt, I didn't know how much was a real concern and not. I guess I was looking for something more along the lines of "is it possible this is just a fluke?" It is a hard thing to go through. I very much wanted my homebirth and this has all been a hard shock to go in just a matter of days. I know my chances are slim for a HB and the more I read the more scared I am getting about even considering it anymore.

[geekgolightly]

Call your MW and see if she works in conjunction with any MFM specialists. Likely not, but it's worth seeing if she has a recommendation.

My mw for this pregnancy does not do HB, but she does have a birth center and has a close relationship with a MFM group. I am lucky to have that bc I hope to have a birth center birth.

Please do set up an appt with an MFM though. It's important and your pressure, even if induced, is exceedingly high. You may hear about higher BP's but anything 20 points above your baseline is cause for serious concern.

[Sunflower223]

MW is very frowned upon here. There are no birth centers. There are very few CNMs at hospitals. You basically have the choice of a OB or a DEM for a HB. There are no doctors that openly work in conjunction with them. I have a recommendation for an OB from the local LLL leader. I just made an appt with him a few minutes ago and we will go from there. It is going to be a week and a half though. I called my husband who is in TX right now and he wants me to call back and see if I can get in sooner. I am a bit skeptical of my personal BP cuff because the readings vary wildly from one minute to the next at times. Of course that could be just what is going on in me. This one is digital. I am going to buy a non-digital one and do it the old fashioned way once I get paid Wed. Either way, it was 121/79 ?? I think at my MW appt and that is pretty high compared to my baseline.

[maryeliz]

I had a pre-E scare last week. I was having high BP readings (I think my worst was 150/90) and then I got a killer twelve hour headache with vomiting. I called my mw the next morning and she sent me straight down to the lab and asked for rush results. Labs came in that afternoon and were actually normal, so high BP but no Pre-E. In my case I was pre-hypertensive before pregnancy, so it is not surprising that I'm having problems with my BP now. I felt so relieved after the tests to have some answers and my midwives are super relaxed, so I know they wouldn't have had me do the tests if they didn't think there was something potentially serious going on.

[Stayseeliz]

I agree that this is very serious and not something you want to "wait and see" on. My pre-e cropped up over night. My BP was fine then all the sudden it was high. I was 32 weeks when mine started with my youngest and they hospitalized me for it. Mostly to do blood work and monitor the baby but it was scary. I ended up going for weekly stress tests and 24 hour urine tests and delivered at 37 weeks. It was scary but I have a beautiful, healthy almost 3yo because my dr's were vigilant.

IMO you should get bloodwork and a 24 urine done NOW. If those numbers aren't great consider BP medicine. I know it's not "natural" but it can be lifesaving.

I'm 12+ weeks now and did a 24 hour urine to establish a baseline. I'd rather be safe than sorry.

Hang in there. I know this is tough and not what you were expecting but you can have a great outcome with good prenatal care!

[sonshine_rae]

Just to show the 'other side of the coin' ...... please don't give up on eating right, and eating tons of protein.. it DOES help and cannot hurt! Seeing your MW or another care provider soon however is a very good idea as well.

In my last pregnancy (albiet I was 8 months along then) I became very swollen with edema and started to just barely spill protein. We caught it early and I consumed huge amounts of protein......... by the time of my birth (at home I might add) I had stopped spilling protein and you could hardly tell I had ever been swollen.

It is serious.. and it is important to be careful, I was told though that since my blood pressure stayed low I had a higher chance of being successful treating it naturally. But I have heard of some even who had full blown symptoms putting a stop to it naturally.

[Sunflower223]

Maryeliz- I am kind of hoping it turns out to just be a scare for me too, but it isn't looking too hot at the moment.

Stayseeliz- I am working on getting in to see the OB sooner.

This is pretty devastating right now but I know that I will come to grips with it eventually, I just hope the outcome is a good one, even if not the one I wanted so much. I am just not destined to have an HB. I didn't have the opportunity with the first three because of the state I lived in. Now I probably won't have a chance with the last one because of this craziness. I know, now more than ever, that this isn't a wait and see sort of thing. I've spent all this time crying in fear about having to go back to the hospital and have them take my baby away for hours at a time, that is always so hard for me. It is unbearable. Now that I know that is the least of my worries I can't describe how I feel.

[Sunflower223]

sonshine - Thank you.

[maryeliz]

It is so scary and emotionally draining to be fine and then suddenly find out you are staring a high risk pregnancy in face. I really hope you get a good answer.

[Stayseeliz]

Originally Posted by Sunflower223

Maryeliz- I am kind of hoping it turns out to just be a scare for me too, but it isn't looking too hot at the moment.

Stayseeliz- I am working on getting in to see the OB sooner.

This is pretty devastating right now but I know that I will come to grips with it eventually, I just hope the outcome is a good one, even if not the one I wanted so much. I am just not destined to have an HB. I didn't have the opportunity with the first three because of the state I lived in. Now I probably won't have a chance with the last one because of this craziness. I know, now more than ever, that this isn't a wait and see sort of thing. I've spent all this time crying in fear about having to go back to the hospital and have them take my baby away for hours at a time, that is always so hard for me. It is unbearable. Now that I know that is the least of my worries I can't describe how I feel.

Oh hon, it will be okay. I know it's not what you want and that it's hard. I cried so much during the 6 weeks I was on bedrest with pre-e that it was insane. And people kept saying they felt sorry for the kids and DH but not me because I was getting to rest all the time. YEAH RIGHT! It was stress and nothing else.

BUT every bit of it was worth it. I have the most amazing daughter and she is one of the greatest joys of my life. My pregnant and birth were not ideal but that all pales in comparison to the amazing little person she is and the bond we have. Once we were settled in our room, the hospital stay was amazing and she latched right on and nursed like a champ. It was perfect after that. I am so thankful for a vigilant dr then and glad to be seeing him again. I'm hoping to avoid pre-e this time but I'm realistic about it and I know whatever I have to go through will be worth it in the end.

I do agree about eating right and adding lots of protein! As soon as the morning sickness is gone I plan on sticking as close to the Brewer Diet as I can.

Hang in there. It's all worth it in the end!!

[Bokonon]

Originally Posted by maryeliz

I had a pre-E scare last week. I was having high BP readings (I think my worst was 150/90) and then I got a killer twelve hour headache with vomiting. I called my mw the next morning and she sent me straight down to the lab and asked for rush results. Labs came in that afternoon and were actually normal, so high BP but no Pre-E. In my case I was pre-hypertensive before pregnancy, so it is not surprising that I'm having problems with my BP now. I felt so relieved after the tests to have some answers and my midwives are super relaxed, so I know they wouldn't have had me do the tests if they didn't think there was something potentially serious going on.

FWIW, you can have normal labs and still have pre-e - I did with both my pregnancies. The labs are more diagnostic for HELLP syndrome.

[Smokering]

I know, it sucks. Really. I had pre-e - at term, but it still nixed my chances of a homebirth. I'm really glad my midwives were attentive, though - DD and I were fine, and my BP started dropping several hours after the birth.

[karen1968]

I had pre-e with my last pregnancy and did a lot of research before this pg on what to do to help prevent recurrance. The thing that stood out for me more than protein was CALCIUM. there have been peer reviewed studies showing calcium reduces the recurrance rate (and while the Brewer results were never duplicated, looking at the amount of dairy recommended, you can see why it might have worked). If I were you, I would be getting a lot of that additional protein from milk, yogurt and cheese, AND adding a good cal/mag supplement (above whatever is on your prenatal). And when people talk about eating a lot of protein to help, they mean A LOT. my mw told me one of her clients brought her blood pressure back down by eating a rotisserie chicken and a dozen eggs in 24-36 hours. Yeah, that much protein!

I do hope you are able to get things under control. Early diagnosis and medical management can make a huge difference with pre-e.

And FWIW, I fully understand your fear and your grief at potentially losing your home birth. I just found out at 32w that my placenta previa hasn't shifted, and I mat need a c-section at 37w rather than the home waterbirth I had planned.

[pregnant@40]

If this is preeclampsia, you are in a state of protein excess and spilling protein into your urine & causing your kidneys to work harder; eating more protein right now can even cause damage to your kidneys depending on what it happening w/ your body right now. The Brewer diet was constructed w/ information obtained from an ancient study that has since been disputed. There have been studies on women w/ pre-eclampsia who increased protein intake, and it confered no benefit (though potential harm) to the mother and fetus.

Additionally, if this is preeclampsia, this would mean that there is placental insufficiency (placenta not getting enough blood flow/nutrients), which can lead to growth restriction of the fetus. Also, it has the potential to suddenly (without warning) develop into a true emergency for yourself and the baby.

If it's not preeclampsia but something else, like gestational hypertension, you may still be able to have a homebirth. You just need a little extra care right now, and a medical assessment asap.

[pregnant@40]

Resources:

http://www.preeclampsia.org/
http://emedicine.medscape.com/article/796690-overview
http://emedicine.medscape.com/article/1476919-overview
http://emedicine.medscape.com/article/261435-overview

You can also find recent studies on Science Daily (examples):
http://www.sciencedaily.com/releases...0406125721.htm
http://www.sciencedaily.com/releases...0315161011.htm