Originally Posted by sparklett
SORRY for the legnth of this message, but I am so exited to have finally found a place where I might get some answers!!
I can't believe that after dealing with pre-e/HELLP seven months ago, I am only just now finding this thread!
Here's my dilemma.....
I developed pre-e at 33 weeks and DS was delivered via emergency c-section and was in the NICU for 33 weeks. Up until three days before the c-section, I was fine, except for a tiny spike in BP only once and constant swelling. In the end, my BP was 117/174 and I had +3 protein in my urine, severe swelling, hyperreflexia (sp?) and abdominal pain. I was on two different hypertension meds for 3 months after the delivery. (See my siggie for the whole gory story.)
I was seeing a midwife and OB, and my midwife was the one who caught it and sent me to the hospital. I thought I had the flu!
DH and I are going to TTC again in October and it seems like it is going to take me until then to find a good OB. We have moved, and I need to find an OB, but don't know what to look for. I was planning on interviewing OBs over the next several months, but what should I ask them about how they would treat me once I explain my history? Would I be considered high risk? What kind of answers should I expect to hear re: pre-e "prevention", testing, and monitoring? Should I priortize my search based on which OB can deliver at a hopital with a level III NICU? I really want to find an OB who will help me catch any problems early. I want to find an OB now becuase I want to at least have some sort of relationship in place before prenatal care begins and so that I can be sure my insurance will cover their services.
What should I be doing now, before I get pregnant, that might help me avoid a second round of pre-e? I am very overweight, so I plan on loosing the weight before we TTC again, and I'm making good progress! But what else should I be doing?
I have read over and over again that one risk factor for pre-e is having a new partner. Why? I might have another question about this.
I must say that before I found this thread, I was more concerned about having a VBAC than I was about pre-e. Now, the VBAC is on the back burner and I am more concerned about getting to full term with my next babe.
Thanks so much!!!
1) yes, you will be considered high-risk. It's not the end of the world. It's just a label. Some providers will home-birth a woman with a history of pre-e because the risk is so much lower for multips.
You want a perinatologist for a consult. You don't have to see them for PNC, you don't even need an OB (our midwives see women with histories of PE regularly) but a perinate (and one who specifically deals with hypertensive disorders of pregnancy) will be up on the current research and, frankly, less likely to freak out about a history of pre-e. They see truly sick people, not just people who might get sick, if you see what I mean, and OBs in general practice can freak out about things a perinate wouldn't care about.
2) there is some interesting work being done at the UW about reduction of risk of pre-e with using beta blockers and diuretics in pregnancy. The Brewer diet (in fact, diet interventions in general) have not been shown to work. Weight reduction is good, but skinny people get pre-e too. If you have any history of PCOS, consider treating during pregnancy with metformin. Remember too that pre-e is a multisystem disease, not caused by high blood pressure, but with high blood pressure as a symptom. Treating hypertension does not treat or necessarily prevent pre-eclampsia, but can be very important for other reasons.
3) The theory behind the new-partner hypothesis is that pre-e is at least in part an immune reaction to a new antigen (new partner's DNA in baby). The data are very mixed on this.www.preeclampsia.org
is a good resource.