Preeclampsia at almost 30 weeks :( Anyone BTDT this early? (Update, he's here!!!)

[Vermillion]

So I'm 29w4d, and was just diagnosed with Pre E today My BP has always been on the higher side, but was actually pretty good the past few weeks! Midwife was happy with my numbers, but I get lab work & a 24 hour urine every so often and I did those Friday, and well, my 24 hour urine came back high for the protein for the first time this pregnancy. The stress of this shot my BP right up, and I was monitored in L&D for a few hours, put on meds, and had a NST & biophysical profile done. Thank Goddess everything looks great with the baby right now! He passed the BPP with flying colors and is growing well (I've had growth scans often this pregnancy), had good practice breathing, movement, fluid... So all good there! My kidneys and liver looked good on my labs from today. BP is stable for now...

Soooo.... right now it's just wait and watch. Bed rest, frequent visits, all that fun stuff!

My feelings are really mixed right now. I feel ok. I feel like things will be ok. I have to keep positive so that's what I'm going to do! Of course I'm hoping to buy some more time, but I feel like I'm in good hands and things will work out. I'm hoping for the best but preparing for the worst. Preparing myself for this little guy to come early. Just how early is to be seen. Ah. Well, I guess that's about it!

Anyone BTDT with some words of wisdom?

Edited by Vermillion - 12/16/11 at 1:54pm

[Bokonon]

Ugh.  Pre-e sucks.

I was diagnostic with my second at 28 weeks - borderline BPs after normal BP of 90/50-100/60, plus borderline protein and a severe headache and visual disturbances.

I had severe pre-e with my first and delivered at 32 weeks, so I was watched closely and freaking out.

I was in and out of the hospital and on strict bedrest for 6 weeks before delivering my daughter at 34 weeks due to uncontrollable blood pressure.  My labs were always fine and she did great on her tests, but she did have some growth restriction and was around 4 lbs. at birth (I had been on IV fluids and mag. sulfate for a week before she was delivered, so her actual birth weight was inflated and her lowest weight was 3lbs. 11oz.).

She spent 10 days in the NICU and came home tiny, but she was exclusively breastfeeding within a week and is a tall, brilliant, funny 2.5 year old now.  :)

You are going to have a tough few upcoming weeks.  I wish I could make it easier for you, but it sounds like you have attentive care, which is SO important.  I would highly recommend the forums at preeclampsia.org - they were indispensable to me during those 6 weeks when I was just "limping" along with preeclampsia, wondering when the next shoe would drop and if my baby and I would both be ok.

Best wishes - I will be stalking you to see if everything is ok!

[maryeliz]

 I was diagnosed at 27w and gave birth at 29w after 10 days of hospital bedrest ( they called it after HBP that couldn't be controlled, high liver enzymes, low platelets).

It sounds like you are pretty stable right now and your midwife is keeping a close eye on you-and both of those are good things.

I'm giving this advice based on my experience developng severe pre-e, so if you stay stable you might not need to know any of this (I hope!)

If you want to prepare for a severe pre-e situation, I would ask the following questions now:

1) At what point would your midwife turn over your care to an OB

2) Do you have an existing relationship with an OB, if not, can you chose an OB for backup care now (I was very lucky to have a MFM who is familar with and respectful of women who want a natural birth).

3) What are your options re: vaginal birth vs. c/s

4) Will you need to deliver on magnesium sulfate.  If you have to do a mag delivery, what are the hospitals policies post-birth (I was allowed to go up to the NICU about 8hrs after delivery while still on a mag drip, but I've heard from other women that many hospitals keep women on mag in bed for 48 hours and don't let them go to the NICU).

5) What are the NICU policies, when and under what circumstances can you expect to see your baby.

Good luck with everything!

[Vermillion]

Thank you so much for your helpful replies and experience. Every little bit of knowledge I get is helping me so much!

Bokonon, I'm so happy to hear how well your DD did! Stories like that make me really hopeful!

Maryeliz- 1) My midwife turned me over right away. I'm now seeing an OB in the women's health center (where my midwife practices) as well as a high risk OB 45 minutes away. I will deliver with the high risk OB at the big hospital with the excellent nicu 45 minutes away if I don't make it to 36 weeks. I'm pretty happy with both OBs so far (saw them both right away!) so I'm feeling good about my care right now.

I meet with both of the new OBs again next week, so thank you so much for "arming me" with some great questions to ask! My mind has been a little trying to settle in to this new situation.

Today my blood pressure has been behaving at 114/75. When I was being monitored in hospital my highest was I think 170ish/90something. Which it has gotten to in times of stress before, but of course never with high protein so they were right on top of things because of that.

I definitely want to prepare for a severe pre-e situation. Hoping like crazy it doesn't come to that, but always better to hope for the best while preparing for the worst, especially with a condition that is so unpredictable! I think that's the worst part... just not being able to get solid answers on likely scenarios, because nobody knows how it might go!

[Bokonon]

Originally Posted by Vermillion 

I definitely want to prepare for a severe pre-e situation. Hoping like crazy it doesn't come to that, but always better to hope for the best while preparing for the worst, especially with a condition that is so unpredictable! I think that's the worst part... just not being able to get solid answers on likely scenarios, because nobody knows how it might go!

That was the most frustrating thing for me - the uncertainty, because every case is different.  At one point my OB said she was going to try to get me to 37 weeks, and I didn't even WANT that because my BPs were so crazy and with my headache I felt like a ticking time bomb!  It's definitely a balancing act.  I have a good friend who is a Maternal-Fetal Medicine specialist 3000 miles away from me, and she said she would have delivered me at 29 weeks when my headache and visual disturbances cropped up, considering my history.  And she definitely didn't want me home on bedrest because she felt I should be constantly monitored.  My OB felt differently, and there were times that I went to triage with BPs of 170/90 on Labetalol and got sent home!

I hope your situation is stable-ish enough that you can stay baking until 37 weeks, but I'm glad you are in good hands and preparing yourself mentally for an early delivery.  Another tip is to see if you can get a tour of the NICU, because if the first time you visit one is when you are visiting your own baby, it can be incredibly overwhelming and distressing.

With my first, he was taken to the NICU right away because he was a 32 weeker and needed lots of help.  I had been on mag. sulfate for 2 days already, and wasn't allowed to visit him until he was over a day old because my blood pressure was still very high (200/110) and he was so tiny that the docs knew seeing him would only make that worse.  It was very upsetting, but I was so out of it from the mag. that it was probably for the best.  I was on mag. for 4 more days and got to visit him when I was up to it, and the nurses were great about bringing me a pump.  He was in the NICU for 6 weeks and on expressed breastmilk the whole time, and transitioned to exclusive breastfeeding after a couple of months at home.

With my daughter, she was doing pretty well at birth and actually got to come up to the room with me after I got out of c-section recovery.  I got to nurse her and snuggle for a while, but when my husband had to go pick up our son at school, I let the nurse take her to the nursery because I was on mag. sulfate still and didn't trust myself being alone with such a tiny baby.  Unfortunately she had magnesium sulfate toxicity and started vomiting after she was sent to the nursery, and had some oxygen desaturations, so she was sent to the NICU.  She was pretty floppy and it took a few days to get that out of her system before she could start taking feedings.  Then it was the typical preemie jaundice and learning how to eat - but again, 10 days was nothing compared to the 42 days my son was there!

Hang in there and keep us posted!  You and your baby are in my thoughts!

[Milk8shake]

OMG. Liz. Thinking of you and bubs

[Tear78]

Liz We were pre-e and it was reassuring to know my docs were taking it seriously. It sounds like yours are too, so that takes away a lot of my worry. They'll keep an eye on you and if things turn bad they'll induce and labor is then usually quick. I hope your bub is able to stay in there a long time yet! Are you on magnesium sulphate? That stuff made me feel yucky. Thinking of you!

[Vermillion]

Thanks again everyone for the thoughts & support!!!

A little update on me- I just had an appointment with one of the two doctors that I'll now be seeing weekly. Got a lot of questions answered and I'm feeling pretty good! So at the moment my pre-e is considered mild and everything is stable for now. BP is pretty good with the labetalol, labs have looked good (I'll be getting another set this week, bloodwork in kidneys and liver and 24 hour urine) and the baby looks great! I'm not spilling protein in my little pee in the cup tests, which I guess is good, and my last 24 hour protein was 300, so right at the cut off.

I had another NST today, and the baby cooperated beautifully and did great. They gave me the first of 2 steroid shots just in case things change in the couple of weeks, so that makes me feel a little better should he need to come soon... Hmm... what else? I'll being seeing my doctor up here weekly, as well as the high risk doctor at the big hospital weekly. Weekly NSTs, ultrasounds, and lab work. And... I think that's about it for now!

Tear- No talk of mag sulfate yet, though maybe when it's time to deliver?

[Bokonon]

That all sounds great, pretty much as good as you can hope for!

If your BP becomes too high, you might be admitted to the hospital and put on a mag. sulfate drip.  It helps prevent eclampsia - stroke or seizure.  It's not pleasant stuff.  It burns going in, and might make you feel flushed, woozy, and out of it.  It's not something you really want, but if your blood pressure is uncontrollable, it's lifesaving medicine.  But don't worry about it now, because it may not even be an issue for you if you stay stable for many more weeks.  :)

[Vermillion]

I've heard the mag sulfate is no fun at all, but I'm totally open to anything that will help me and my nugget!

I just got back from getting my second steroid shot for the baby's lungs. Even though things look good now and I could go quite a bit longer, I feel very thankful that I had the time to get these shots done, just in case! Hopefully he doesn't come early enough to need them, but just in case he does, it's a big relief!

Just took my BP after running around to get my business done, 117/68, so I'm happy about that! Especially because at it's highest at the beginning of all of this, was like 188/90something. So I'm feeling good! My meds seem to be working well on the starting dose of 100x2 labetalol, the highest BP I've had this week was 132/77 and that was at the beginning of treatment. So... I'm still getting myself as prepared as I can for anything, but at the same time that I may hold steady for a while!!

[CorgiMommy]

Hi there Vermillion, I was looking for you and found out your news hear.  i am so glad that you are doing better and I hope that all goes well in the following weeks to come.  Cant wait to see you little baby pics when he arrives.  Come and pop in to the Hoping & Healing graduates tread again!

[MadelinesMama]

My son was born on Oct 17th at 27w5d due to my sever pre-e.  The mag was not as bad as I expected, but still it wasn't fun.  You can totally make it through it, it's not unbearable.  It sounds like you are doing well.  If that changes or you have any specific questions feel free to pm me.

[Vermillion]

Ooh I've been bumped up

A lil update on me & baby. 31 weeks yesterday and still hanging on at stable and mild. My BP has crept up a *little* but not too high. If if goes up again we'll discuss increasing meds next weeks. Liver and kidney labs looked fine yesterday.  24 hour protein went up a little, 300-500 in 2 weeks, but they aren't concerned about that number. Had my weekly NST yesterday and baby passed beautifully. He is in a very cooperative mood lately and goes right to town as soon as I'm hooked up! Weekly BPP u/s tomorrow +growth scan (they only measure his growth every 2 weeks) and hmm... I don't think I upsated after last week's BPP, but he looked great. Lots of movement and practice breathing.

I feel pretty good at the moment. Thankful for every day my little ones get to bake. I'm afraid at the thought of having him early and leaving him in the nicu, but I'm getting over that. I just want him healthy and safe, even if it's on the outside sooner than anticipated! Taking each day as it comes!

[Vermillion]

It's been a while so I wanted to come and update! We're still hanging out at mild pre-e AND I am 36 weeks today!!!! Induction is set for 38 weeks as long as everything continues to stay stable.

Baby looks great every week on NST and BPP, blood work is staying normal, BP has been under control, protein creeping up very slowly... Things are about as good as can be hoped for with pre-e and my doctors are both shocked and elated that I've made it this far!

Man, after being diagnosed at 29 weeks, getting the steroids and preparing myself for the good possibility of a very early baby with a nicu stay... I am freakin OVER the moon to be here today. So beyond thankful!!!!

[parsley]

What a wonderful update!  So glad to hear you are doing well.  Good luck holding out a few more weeks.

[Lovebeingamidwife]

Yay Vermillion! Love the positive attitude and gratefulness!! Have/Had you changed your diet at all?? On bed rest or normal active?? I'm so curious about Pre-e!

[Vermillion]

No real change in my diet, which is usually pretty healthy but I do give in to whatever treats I want when I'm pregnant! I didn't do the whole high protein thing like some suggest because I read it can worsen preexisting kidney and liver problems, and I will be doing a full kidney work up after the baby is born because there has been some question on whether or not something might have been going on with them before, and I didn't want to put any extra stress on them with the pre-e... So anyway, yeah, pretty basic diet, nothing special. LOTS of water though!!! I can't really get enough!

I haven't needed strict bedrest but I'm definitely not terribly active either, which I think has helped a lot. I stay home with my older son, so I rest as needed throughout the day. I lay down for a few hours throughout the day and beyond that just normal, at home activity with a few errands (quick trips to the grocery store, date night with hubby out to eat...) a few times a week.

That's about it! I've been very lucky in that not a whole lot has changed other than a lot of trips to my OB and the high risk specialists over the last several weeks. I'm so thankful as I know it could have gone so much worse!!!

[Bokonon]

I'm so happy to read this!  You have had the best case scenario it seems, and I am so glad for you and your baby!

[Lovebeingamidwife]

Awesome! Glad you're one of the lucky ones!

[Vermillion]

I just wanted to thank you all for the great advice and support these past couple of months! Here's my final update!

My little man was born on Wednesday at 38 weeks, 2 days and is as perfect and healthy as I could have ever hoped for!!! 7.7lbs 19.75inches and was born screaming! (good lungs! :D)

It was a tough couple of months worrying about how things might turn out, but we made it, and I am soooo thankful!

Delivery for me went as well as could be expected for a pre-e induction. My BP stayed good the whole time and I never even came close to needing the mag. It was a 15 hour relatively comfortable/easy labor and he was out in about 25 minutes of pushing. No tearing and because pushing went pretty fast I don't even really feel like I gave birth at all! All in all a good experience for what it was.

Well, without further ado, here he is!