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Pre-Eclampsia Watch Dog on the loose. - Page 3

post #41 of 601
I went in last night and my doctor met me at the hospital. My blood work was all within normal ranges but slightly higher than it was last time they did it. My bp med dosage has been adjusted and I now have to have the blood work repeated every other day. Oddly, my headache went away when I threw up which I found pretty strange. My doc has me booked in on Monday to have a test where I wear a portable bp monitor all day long. The concern is that sometimes my pressure is totally normal and sometimes it's high. Basically if it's only going high when I'm up nad about, I'll be put on strict bedrest.
post #42 of 601
THanks for the update. Glad you and baby are hanging in there.
post #43 of 601
Yes, she's doing fine and had a blast attempting to kick the fetal monitor off my belly.
Oh, and for anyone who may be in the position I was in last night, before my doctor even did anything she said "If you have to wonder, just get yourself seen, if you don't you could be wondering horrible things the rest of your life"
post #44 of 601
Thread Starter 
Shannon, I am so glad you went to the hospital and thank you also for sharing your doctor's words of wisdom with us. Please keep us updated on your progress.
Gossamer
post #45 of 601
Thread Starter 
Shannon, how are you doing?
Gossamer
post #46 of 601
I'm doing much better, the new dose on my meds seems to have made a big difference. I've had to go into the hospital every day since that "incident" and it's been normal each time. Today I go in to get hooked up for the 24 hr test and should also get my 24 hr urine results back today.
Thanks for asking
post #47 of 601
Thread Starter 
I am glad the medicine is helping again. I am also thrilled you are being so compliant with their recommendations. I am keeping you in my prayers that everything goes well.

GOssamer
post #48 of 601
Thread Starter 
OnTheFence,
How are you doing? I am thinking about you.
Gossamer
post #49 of 601
With your story Gossamer, I couldn't help but be complient. That and my doctor has been so awesome through this entire pregnancy that I couldn't help but to take her advice on something so very important.
post #50 of 601
Thread Starter 
Yeah, I would really hate to have to come to your house and kick your butt to get you to the hospital. I just don't have that kindof energy right now. SO thank you for doing us both a favor. :LOL
Gossamer
post #51 of 601
Thread Starter 
Shannon, how are you doing now? How was your christmas? Are you ok?
How about you OnTheFence? Just a friendly check in. I will be out of the country for 2 weeks.
Gossamer
post #52 of 601
Hanging in Gossamer, being monitored extremely closely, it is looking like my c-section may get pushed up by one week, especially if I have another bp spike. Blood work is all still just fine and I have agreed to go on bedrest starting next week just as a precaution (the constant monitoring showed I never spiked while laying down) I have started to have some minor swelling, but of course we don't know for sure if the swelling is from my very out of control rhuematoid arthritis or from the blood pressure, or just the simple fact that I'm 34 weeks pregnant. Molly continues to be perfect during every NST and scan, they say she's a very co-operative baby
Enjoy your vacation!!!
post #53 of 601
So, here's a question for all of you experts... when I went in on Thursday my bp was strangly low (118/63), then on Friday it had dropped again to 109/58 my med dose was reduced back one level and I was asked to check bp 6 x a day. Went back to an almost normal level all day friday and on Sat morning when I went into the hospital. Last night I take it and it's dropped again to 116/61, this morning 102/56. Normally I'd just get into the hospital, but we had a nasty little ice storm here last night and there is a good 3 inches of ice coating everything and our roads. I called the hospital (of all days my OB is not available) they said they'd really like to see me but also said emerg was full of people from car accidents so I was safer at home until things get salted. The OB on call asked me to reduce my dose yet again (I'm feeling a little light headed) and he seemed a little puzzled.
Have any of you heard of this happening at 34 weeks??? My bp has been high since 14 weeks. At this rate I'm going to end up being off meds soon!
post #54 of 601
are you bleeding? do you have any pain? are you hydrated? have you had any changes lately- diet, bm, urine, are you drinking anything different, talking any herbs or vitamins?
post #55 of 601
Nope no bleeding, no additional meds. The only possible thing I can think of is that I really think the baby has dropped into position, I can suddenly eat again. Baby's movements have decreased, however, she's now head down and she was footling breech, so I really think the decrease has more to do with her new position and just different feeling movement (as in she is no longer pounding my cervix and bladder with her wee feet!) I listened to her with my stethascope this afternoon as I was a little worried but her heartrate is at 155 average and I hear accellerations and decels with movement.
Could her dropping have anything to do with a drop in blood pressure????
post #56 of 601
well the Oriental medicine folk I know would say yes, but they would think that something changed in the gallbladder/liver and it cooled down. I can think of how a big head being up near your near your organs- heart, lungs may have put some unusual pressure...
any way this is good news lower blood pressure is certainly a relief, good for you, and nice that the baby went head down, just reduces the complexity even for a planned c.
take care
post #57 of 601
Starting yesterday it went back up to its normal high levels, so my dose is being slowly moved back to where it was--and I'm back to being monitored to death
Nobody knows what caused it to drop, it's a big mystery.
post #58 of 601
Hi everyone, just received this through a clotting factor board I belong to and thought I'd share.

U.S. Department of Health and Human Services

NATIONAL INSTITUTES OF HEALTH

NIH News

National Institute of Child Health
and Human Development (NICHD)
http://www.nichd.nih.gov/

EMBARGOED FOR RELEASE
Tuesday, January 4, 2005
4:00 p.m. ET

CONTACT:
Robert Bock or
Marianne Glass Duffy
301-496-5787

SUBSTANCE IN URINE PREDICTS DEVELOPMENT OF PREECLAMPSIA

A substance found in the urine of pregnant women can be
measured to predict the later development of preeclampsia,
according to research from the National Institute of Child
Health and Human Development of the National Institutes of
Health.

"We may have reached a turning point in the extensive
federal research investigation of this frequent, life-
threatening complication of pregnancy," said Duane
Alexander, M.D., Director of the NICHD. "This finding sets
the stage for the development of a test to screen women for
high risk of preeclampsia. Once these women are identified
through such a test, we can target studies to find
effective ways to prevent its progression or to keep the
most dangerous complications from occurring."

The researchers found women were highly likely to develop
preeclampsia if they had low levels of a substance known as
placental growth factor (PlGF) in their urine. PlGF works
in combination with a substance called vascular endothelial
growth factor (VEGF). Together, the two substances foster
the growth of new blood vessels, and maintain the health of
cells that line the inside of blood vessels, including
those in the placenta that support the developing fetus.
The researchers believe that the high blood pressure and
other symptoms characteristic of preeclampsia result from
low levels of PlGF and VEGF.

Researchers are making plans to refine the finding into an
accurate clinical test.

The study appears in the January 5 "Journal of the American
Medical Association". It was conducted by researchers at
the NICHD, Harvard University Medical School, the Harvard
School of Public Health, Beth Israel Deaconess Medical
Center, Allied Technology Group, and the University of
Cincinnati College of Medicine. Much of the funding for the
study was provided by the NICHD and another of the NIH
Institutes, the National Institute of Diabetes and
Digestive and Kidney Diseases.

A few women - such as those pregnant with more than one
baby or with long-term high blood pressure - are known to
be at high risk for preeclampsia, explained the study's
first author, Richard Levine, M.D., M.P.H., of NICHD's
Division of Epidemiology, Statistics, and Prevention
Research. However, the vast majority of cases strike
without warning, in first-time mothers. Usually, a pregnant
woman with preeclampsia develops dangerously high blood
pressure and begins excreting protein in the urine. In some
cases, the condition may progress to eclampsia, a series of
potentially fatal seizures. Although the high blood
pressure and seizures can be treated, the only cure for
preeclampsia is delivery of the baby. Combined estimates of
preeclampsia and other hypertension disorders during
pregnancy range from 5.9 to 8 percent of all pregnancies in
the United States.

In cases where the condition does not progress to
eclampsia, infants born to mothers with preeclampsia may be
extremely small for their gestational age or may be born
prematurely. These conditions, in turn, place the infants
at risk for a variety of other birth complications, among
them blindness, cerebral palsy, or mental retardation.

To conduct the study, the researchers analyzed stored urine
samples of 120 women who developed preeclampsia and
compared them to samples from 118 women who did not develop
preeclampsia. The analysis was performed on stored samples
collected at three intervals during the women's
pregnancies. The urine samples were collected as part of a
separate NICHD study published in 1997, which found that
pregnant women could not lower their chances of getting
preeclampsia by taking calcium supplements.

In the current study, urinary levels of PlGF were
significantly lower for the women who subsequently
developed preeclampsia than they were for the 118 women who
did not develop the condition. For the women who developed
preeclampsia, low levels of PlGF were apparent beginning at
the 25th through the 28th week of pregnancy. The
differences in P1GF levels grew more pronounced by the 29th
through the 36th week of pregnancy.

This study builds upon earlier findings by the last author,
S. Ananth Karumanchi, M.D., of the Renal Division at the
Beth Israel Deaconess Medical Center and Harvard Medical
School in Boston. Dr. Karumanchi and his coworkers had
previously discovered that a substance called soluble fms-
like tyrosine kinase 1 (sFlt-1) circulates in large
quantities in the bloodstreams of women with preeclampsia
and that sFlt-1 injected into the bloodstream of pregnant
rats caused a preeclampsia-like illness.

Last year, Drs. Levine, Karumanchi and their coworkers
reported that high levels of
sFlt-1 likely influenced the development of preeclampsia,
by binding to PlGF and VEGF. Because they were bound to
sFlt-1, the two substances could not be used by the blood
vessel cells that required them. A release describing that
study is available at
<http://www.nichd.nih.gov/new/releases/preeclampsia.cfm>.

Dr. Levine noted that a screening test for PlGF would
probably need to be used in conjunction with other
measures. He explained that a few of the 118 women who did
not develop preeclampsia also had low levels of PlGF. To
confirm that preeclampsia is present, women with low levels
of PlGF could be referred for a blood test to measure their
blood levels of sFlt-1.

A urinary test for PlGF could probably be performed less
expensively than could a blood test for sFlt-1, because it
wouldn't require the services of a medical professional to
draw blood. Moreover, a urine sample could conceivably be
collected at home, and then brought into a medical lab for
testing. This would be an advantage over a blood test,
especially in countries lacking trained medical staff to
draw blood.

Currently, Dr. Levine is planning an additional study to
more accurately predict the development of preeclampsia by
measuring urinary levels of PlGF. The current study
obtained urine samples from pregnant women only on 3
occasions during their pregnancies. In the planned study,
researchers would measure urinary PlGF levels throughout
pregnancy, in an effort to pinpoint precisely when levels
of PlGF begin to drop. Similarly, another study is
measuring urinary PlGF levels in a much larger number of
women, to gain a better understanding of individual
variations in PlGF levels.
Dr. Levine estimates that, pending the results of these
studies, a urine test to screen for preeclampsia could be
available in 4 to 5 years.

He added that it also might be possible to develop a
treatment for preeclampsia, by supplying at risk women with
additional PlGF and VEGF. Theoretically, these substances
would bind to sFlt-1, allowing the PlGF and VEGF made by
the body to be used by the blood vessel cells that require
them.

Since the early 1990's, the NIH has funded numerous studies
of preeclampsia. In addition to the study that tested
calcium to prevent the condition, other studies have tested
aspirin, magnesium, and fish oil, with no success.

The NICHD is part of the National Institutes of Health
(NIH), the biomedical research arm of the federal
government. NIH is an agency of the U.S. Department of
Health and Human Services. The NICHD sponsors research on
development, before and after birth; maternal, child, and
family health; reproductive biology and population issues;
and medical rehabilitation.

##

This NIH News Release is available online at:
http://www.nih.gov/news/pr/jan2005/nichd-04.htm.

To subscribe (or unsubscribe) from this list, go to
http://list.nih.gov/cgi-bin/wa?SUBED1=nihpress&A=1.

Pretty interesting, I just wish the test was going to be available earlier!
post #59 of 601
Thank you Gossamer for starting this thread- you are really helping a lot of women take pre-e seriously and understand that just because we don't have risk factors we can't put pre-e out of our minds.

I posted a few days ago about my blood pressure being slightly elevated and Shannon told me to check out this thread. I hadn't been taking my BP very seriously until I read your story.

Although my BP has been in the normal to high range for me I went out and bought a BP monitor so that I can keep a close check on it and see any fluctuations. I am 29 weeks and my normal BP is around 120/70. At the Dr.s office it has been around 138/90 (but I get really anxious around Dr.s and nurses so I think that may have something to do with it). I have been taking it at home and it is staying around 125/75 (sometimes lower, sometimes as high as 130/80). So far I don't seem to have any other signs of pre-e- no protein in urine, no swelling, no headaches, no nosebleeds, etc. Just slightly elevated BP.

Before I read your thread I had no idea pre-e could come on so fast and without warning sometimes- that's why I am now checking my BP religiously. Luckily my midwife is keeping a close check on me as well and I am being seen every week- they will probably do the lab work if my BP keeps getting higher.

I was wondering if you know how accurate home blood pressure monitors are? I bought mine at Eckerd (it's one of those manual inflating, digital ones).

Thank you for sharing your experience with all of us and helping us protect ourselves and our babies from pre-e.
post #60 of 601
Jen, I'm glad you checked out the thread, Gossamer is away right now but I did quite a bit of research before buying my home monitor. The primary things to consider are to go with an upper arm cuff that is the appropriate size, measure your bicep, most regular cuffs are good to 13", I just last week had to go buy a larger cuff cause my arm was right at that 13" mark and I was getting some screwy readings. I have no idea if there is any danger to using a cuff that is too big, but I suspect not. The wrist and forearm monitors do not work as well and are not nearly as reliable.
The other thing I was warned of was to either get one that plugs in or really, really watch your batteries. I bought an OMRON after all my shopping and I've been really pleased with it, it does plug in, but I generally use it with the batteries and occaisionally plug it in to compare readings.
The biggest and most important thing to do is to take it in to one of your appts and have your midwife or doctor measure your pressure with your home unit and with their unit, the levels should be very close to one and another, if they are, you know your machine is accurate, if not, it may mean your monitor is not so accurate. (unless your doc is using a cuff that is not big enough--this happens more than you'd think)
High blood pressure certainly doesn't have to mean pre-e, but it's definitely worth watching closely. Gossamer's story is so very tragic and when my mother had me, she went from completely fine to being in a coma in a matter of hours, neither my mother nor I was supposed to have lived.
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