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Pre-Eclampsia Watch Dog on the loose. - Page 22

post #421 of 601
Could you please find me some examples of studies that showed an increased morbidity?

I've been on bedrest for pre-e before. And while they always said they weren't sure how much good it did, they also said that "it didn't hurt."

I would be interested in that information.
post #422 of 601
Quote:
Originally Posted by maxmama
I would ask why the bedrest, period. Ask for some studies that show it actually does anything for preeclampsia, because there's any number of studies showing significant morbidity associated with bedrest. My perinates are nationally known PE researchers, and don't do bedrest at all in their clinical practice.
Very interesting. I haven't seen any of those studies, can you point me in the right direction so that I can read them?

She said I could be up but I couldn't do anything strenous like grocery shopping or laundry. So I'm thinking it seems like she's worried about me over exerting myself.

I'm not going to do anything to put me or baby at risk. But if outright bedrest is also a risk I'd like to discuss that with her too.
Thanks,
Jen
post #423 of 601
The morbidities weren't PE related; they're nonspecific to bedrest in general. They include loss of muscle mass, loss of cardiovascular function, increased risk of DVT and pulmonary embolus and depression. One interesting one is an increased risk of colic in newborns (see Bellieni, et al.).

Bed rest is used extensively in the US but not in Europe, where very few women are put on bed rest. Here, approximately 20% are placed on bed rest at some point, but there is no data that shows it changes outcomes.

I think that if your doc wants to use any intervention with risks (and bed rest does have risks), then s/he needs to show you data it actually makes a difference.

I've told my OB and my perinates that I won't be going on bedrest this time, and they agree that it's not evidence-based practice to place women on bed rest for PE.

References:

Lyndon A.Preterm labor and birth: where are we now? Journal of Perinatal and Neonatal Nursing. 2006 Jan-Mar;20(1):82-4.


Bellieni CV, Odent M, Cordelli FM, Cordelli DM, Bagnoli F, Perrone S, Buonocore G. Ante partum bed rest and unexplained infantile crying. Minerva Pediatrics. 2005 Aug;57(4):163-6.


Maloni JA, Park S.Postpartum symptoms after antepartum bed rest.Journal of Obstetric, Gynecologic and Neonatal Nursing. 2005 Mar-Apr;34(2):163-71.

Danilenko-Dixon DR, Heit JA, Silverstein MD, Yawn BP, Petterson TM, Lohse CM, Melton LJ 3rd.Risk factors for deep vein thrombosis and pulmonary embolism during pregnancy or post partum: a population-based, case-control study. American Journal of Obstetrics and Gynecology. 2001 Jan;184(2):104-10.

Goldenberg RL, Cliver SP, Bronstein J, Cutter GR, Andrews WW, Mennemeyer ST. Bed rest in pregnancy. Obstetrics and Gynecology. 1994 Jul;84(1):131-6.
post #424 of 601
Thanks maxmama!!!
post #425 of 601
New update!

Dr called today and my 24hr urine that I just turned in Sat. was now only 330.

I have no idea what my body is doing but I'm glad that it was down this time. I know it's still not great but I'm trying to be positive about it.

eta: Had my u/s today. She said he's about 3.5 lbs (give or take a lb either way, lol). He was also heads up which explains the bump between my ribs but he's got time to flip.
post #426 of 601
Well, I did a 3rd 24 hr urine and it was 348. I know it's still not great but much better than the first. My bp is still within normal limits. I'm seeing the ob every Friday from now on. So now we just wait to see where we go from here.
post #427 of 601
Oh Jen, the waiting game is SO hard isn't it.
I know I and I know Gossemer as well felt so much better when we passed 28 weeks. No it's not a great time to be born but more babies make it then than not.
Out of curiosity, have you been tested for clotting problems?? There is a significant increase in the thought that clotting issues (both genetic and aquired) play a major role in pre-e. Since you've had pre-e before, it may be worth checking out.
Some of the tests are less reliabe in pregnancy but maybe they could at least get a general idea of whether you're over clotting or not. Any history of stroke or DVT's in your family???
post #428 of 601
Quote:
Originally Posted by shannon0218
Oh Jen, the waiting game is SO hard isn't it.
I know I and I know Gossemer as well felt so much better when we passed 28 weeks. No it's not a great time to be born but more babies make it then than not.
Out of curiosity, have you been tested for clotting problems?? There is a significant increase in the thought that clotting issues (both genetic and aquired) play a major role in pre-e. Since you've had pre-e before, it may be worth checking out.
Some of the tests are less reliabe in pregnancy but maybe they could at least get a general idea of whether you're over clotting or not. Any history of stroke or DVT's in your family???
I am happy to be at 32 wks. My dd was born at 35 so I will feel even better then.

I never had any clotting issues testing. In fact, I knew nothing about it before I found this thread after I was already pg. As far as I know, there is no family history in my family at least back to my grandparents. I'll ask my dr tomorrow.
post #429 of 601
I know this is a rather old thread but I wanted to bump to ask a question. Has anyone dealt with significant kidney disease (prior to pregnancy) and pre-e/pih? Specifically, a disease that would rule out a high protein diet?
post #430 of 601
I don't have personal experience w/ kidney disease, but I did want to say that I'm pretty sure the high protein diets don't prevent Pre-e, etc. There's a lot of hype, but no real data. Someone please correct me if I'm wrong.
post #431 of 601
Quote:
Originally Posted by acrathbun
I don't have personal experience w/ kidney disease, but I did want to say that I'm pretty sure the high protein diets don't prevent Pre-e, etc. There's a lot of hype, but no real data. Someone please correct me if I'm wrong.
That's true. The data supporting the Brewer diet, etc., all are from small studies done many years ago, and despite numerous studies, have never been successfully replicated.
post #432 of 601
Hi all,

Just an update. I'm now 34 wks. At my appt on Friday my bp was the lowest it's been yet. Yay!! My protien is holding steady in the mid 300s. Things are looking good. I even lost weight this week, odd since I felt like I had gained a ton, lol. Anyway, just wanted to keep you all posted and let you know we are still laying low and doing fine.
post #433 of 601
Oh Jen, that's so great!!!
post #434 of 601
Is there anything I can do to help my poor friend?

She gave birth at the end of April. It was a scheduled c-section that was moved up a few days because of signs of p-e. Little did I (or she) know how advanced the illness was, and I cannot believe how negligent her Dr. was....

Early on in the pregnancy, she had headaches and nosebleeds. I had read this thread and told her to mention these symptoms to her Dr. because they were both signs of p-e. She told me that her Dr. said he'd never heard of nosebleeds being related to p-e and besides, p-e couldn't be Dx this early in a pregnancy anyway (this was probably late in her 1st tri or early in the second tri).

What she didn't tell me was that toward the end of her pg, her b/p had crept up. Normally hers is quite low, so of course it wasn't "high" by Dr. standards, but it was high relative to her norm. She also was showing protein in her urine. The week it was a 2, her Dr. told her to just come back the next week (she was still working full-time). The next week it was a 3, and that's when he moved the c/s up (TO TWO DAYS LATER). Had she told me all of this, I might have been able to put the pieces together and urge her to demand more urgent action, but she didn't know and she trusted her Dr. implicitly....

My poor friend gave birth to a healthy baby. After 5 days in the hospital with complications, she was sent home. 2 days later, she was in the ER with a massive infection. She had numerous surgeries, had much of her colon and large intestine removed because it was ravaged by infection. She was in the hospital for around 6 weeks and came close to death before being sent home again. 5 days later she was in the hospital again. More surgeries, more of her body cut away. It has been almost two and a half months. She has harldy seen her baby and her older child. As I write this, she is still fighting to survive. Her body is so weak. Her immune system is so depleted, and this infection seems relentless.

I feel so helpless. She is my very best friend, and our relationship is like no other that I have. I would be lost without her, as would her family and countless other friends. Is there anything that I can do beside pray? Why didn't her Dr. take the signs more seriously? Is there hope?
post #435 of 601
I'm sorry about your friend, I'm not sure what you can do now, other than when she's better to encourage her to ask some serious questions and demand some hard answers.
I almost died after a d&c, my ob/gyn was awesome but I went into DIC and the internists at this hospital SUCKED. They sent me home in a full out addison's crisis that was textbook, they told me I was depressed and to go see my ob. My heartrate was in the high 170's. I did see my OB and she called the internist, I heard her on the phone saying "NO, she is not fine, I've seen her through 3 miscarriages and she is NOT fine. What do you mean you won't see her again??" She insisited I go to a different hospital where I was in a rescussitation room shortly after arriving. She strongly encouraged me to fight the hospital. She printed out the forms for me to make a complaint to the college. She got me the phone #'s and "titles" of every person at her own hospital that she thought needed to know about this. It's helping to validate things for me. Ultimately, what I want is for that ass of a doctor to look at my daughter and then explain to me why he sent me home to die (had my ob not seen me that Friday afternoon, they figure I'd have been dead no later than early evening--they actually can't believe I lived long enough to see her) I know that will never happen and I still have dreams about going into emerg when I see his car in the parking lot (small hospital and I've seen him around town...I know what he drives) and confronting him. I may still, I'm not giving up on that idea.
post #436 of 601

Help

I just got the results form my triple quad screen and it showed elevated hormone levels.. genetic counselor seems to think that it is more related to hypertension/possible placental problems/risk for preterm labor.. anyone with this expereince? HELP
post #437 of 601
Thread Starter 
Sarah,
What hormones are elevated? I am not sure I understand correctly? My triple screen cam back high for Mary Rose on the Spina Bifida end and I was told that I was at higher risk for IUGR and pre-term labor. IF your levels came back high, I would strongly suggest keeping on your doctor about monitoring your urine via 24 hour test, your blood pressure and your liver enzymes. ALso possibly frequent ultrasounds to measure your babies growth.
Gossamer
post #438 of 601
I had learned in my Bradley birth classes of a doctor who had virtually no incidence of preeclampsia with his patients, and he told them to get at least 100 grams of protein a day. I stayed at home and got this amount with my second one since I kept a nutrition chart, and I had BP that was 90/60 and no birth complications. With my first, I was working full time and not keeping tabs on my nutrition and showing BP of 140/80 and protein in the urine, but it dissipated by my next doctor visit. Most people don't get enough nutrition, so I think this may actually point to the cause. I do think stress is a major factor---if the body and mind have to deal with too many stressors in the environment, I think it feels forced to reject the pregnancy as an auto-immunological response, with devastating effects on the mother and baby. We can look at pregnant animals, too---for example, livebearing fish will abort their brood if moved by hand too close to their 'delivery' date, and a mother bird will abandon her eggs if she can scent another animal on them. I don't think humans realize that the pregnancy needs to be nurtured, and that a smaller dose of everyday life combined with rest and relaxation would probably reduce the incidence of this horrible disease----just my theory, gals.
post #439 of 601
Quote:
Originally Posted by sarah9774
I just got the results form my triple quad screen and it showed elevated hormone levels.. genetic counselor seems to think that it is more related to hypertension/possible placental problems/risk for preterm labor.. anyone with this expereince? HELP
Hi, I had an increased chance of Spina Bifida with dd too. Luckily u/s showed no signs of it and I declined the amnio. I did end up with high bp, slightly elevated protein (still under 300), and gave birth 5 wks early. Baby was fine though. Nobody seemed to know if the AFP results had anything to do with all that happened later.

I'd ask a whole lot of questions. Watch yourself carefully (do you know pre-e warning signs?) and call your dr if you are worried about anything. Pre-e is definately something to take seriously and not take a wait and see approach. An hour can be the difference between everything being ok or not.

Jennifer
post #440 of 601
Thread Starter 
Quote:
Originally Posted by bradleybirth2mom
I had learned in my Bradley birth classes of a doctor who had virtually no incidence of preeclampsia with his patients, and he told them to get at least 100 grams of protein a day. I stayed at home and got this amount with my second one since I kept a nutrition chart, and I had BP that was 90/60 and no birth complications. With my first, I was working full time and not keeping tabs on my nutrition and showing BP of 140/80 and protein in the urine, but it dissipated by my next doctor visit. Most people don't get enough nutrition, so I think this may actually point to the cause.
Of course good nutrition is always important during pregnancy, but more and more they are discovering that pre-eclampsia is a disease of placenta with many different causes, including genetic blood clotting disorders and possibly even an autoimmune disorder. Please take your symptoms and your doctor seriously, regardless of the cause, pre-eclampsia kills mothers and babies and is the number one reason for premature birth.
Gossamer
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