Is preeclampsia hereditary?

[jennica]

I'm wondering because I heard of someone having a scheduled c-section because her mother had preeclampsia with her and got really sick and had to have a c-section. So her doctor told her she was high risk and therefore needed a c-section and scheduled one for two weeks before she was due. Her water broke on it's own before that, but her doctor went ahead with the c-section. I happen to know that she hated being pregnant, and wouldn't breastfeed because she thought it was gross. She didn't want to give birth vaginally and asked for the c-section. I don't want to think the worst of the situation, so I am hoping there is some kind of validity in her story, but I don't see why she needed a c-section, because noone ever said there was anything at all wrong with her.

[pamamidwife]

Nope.

[jennica]

Originally Posted by pamamidwife

Nope.

That's kind of what I thought. I guess it was either an elective c-section that they didn't want to admit to, or their doctor gave them misinformation to get her to have a c-section, which in this case would not take much persuation.

[dakotamidnight]

from what I understand being a female child of a pre-e pregnancy does increase your risk just slightly.

However this being said - my mother was in the hospital for 7 weeks with severe ecclampsia with me - and I had no signs of pre-e with DD.

[Hannah]

That is terrible! My mother had preeclampsia in 4 out of 5 pregnancies(and GD as well). She NEVER had a C-Section. My youngest sister is 13, so maybe that is why.
I've never had pre-e or GD.

[HappiLeigh]

I read that being the daughter of a mother who had pre-e does raise chances. My mother had pre-E with me and was induced (but still delivered vaginally) and I did not have pre-E.

[ckhagen]

Hm, interesting that it's not because I know one family where all three women (grandmother, mother, and daughter) had severe pre-e with all of their pregnancies and all of them ended prematurely. The daughter (youngest) just had her baby at 32 weeks after many months on bedrest, several hospital admissions, and near kidney failure on more than one occasion. All of the babies were born vaginally though. A scheduled c-section for *possible* pre-e is ridiculous! If you're not actually presenting symptoms... why woud you do that??

[pamamidwife]

it's interesting all the schools of thought. there is one school of thought that believes that the father strongly plays a role in pre-e. for instance, if a mother has pre-e with her first, but then has a different father for the next pregnancy her chances are greatly reduced...or increased, depending upon how you look at it.

[Arwyn]

Originally Posted by pamamidwife

it's interesting all the schools of thought. there is one school of thought that believes that the father strongly plays a role in pre-e. for instance, if a mother has pre-e with her first, but then has a different father for the next pregnancy her chances are greatly reduced.

Really? I seem to remember reading that first-time moms are at higher risk than with subsequent births BUT that having a long spacing (greater than 4-5 years between pregnancies, if I remember right) or having a baby with a different biological father reset the chances to the same as a primip.

Don't have any of my sources with me or I'd look it up.

[pamamidwife]

yeah, it is rarer to have pre-e again in subsequent pregnancies and with the same father. so in order to have a different dad, you'd have to have subsequent pregnancies, right? I'm not sure about the length of time between pregnancies...

something about the semen....

oh criminy. lol - now I need to go look it up....

ok, yeah, there is some research to show that in some women, their partners helps prevent pre-e. http://www.preeclampsia.org/forum/to...?TOPIC_ID=3122

so, I guess I'm pointing to the same thing. you, of course, have said it more eloquently and in the direction it should be. of course!

and then there's this study about ingesting semen: http://cat.inist.fr/?aModele=afficheN&cpsidt=1340021

[pookel]

Um ... so if she was at high risk for pre-eclampsia, why didn't they just monitor her for it? That's bizarre.

[mamaverdi]

PreE and HELLP Syndrome can be related to carrying a child with certain metabolic disorders...or having the metabolic disorders yourself. These disorders are carried genetically, so, in those cases it could be genetic.

[clavicula]

my mother had pre-e and i had too. we both delivered vaginally.

i tend to believe in what papamidwife said. i have no blood-clot disorders, but i do have kidney problem. i just hope this time around i can avoid pre-e.

[wifeandmom]

Being the daughter of a woman who had pre-eclampsia DOES increase your risk of developing the disease, HOWEVER I'm truly baffled as to why that fact alone would necessitate scheduling a section from a medical standpoint.

Other factors that increase your risk include: first pg, subsequent pg in a woman with prior pre-e, being overweight (the more overweight the greater the risk), and a whole lot of other things. But the increased risk alone does NOT mean you'll get it for sure, just that you need to be vigilant in watching and checking for symptoms.

Whether or not baby needs to be born by section vs. vaginal delivery attempted is a decision much like in every other woman. If mom and/or baby's condition is such that delivery is indicated but induction is not a good idea (mom's blood pressure already through the roof, baby showing clear signs of distress, etc), then c-section may be the safest option.

Even if a woman has had a previous pg complicated with severe pre-e, it doesn't make sense to automatically assume she'll get it again. I *can* see intervening much earlier if she appears to be heading down the same path as a previous pre-e pg, but no signs AT ALL??

It sounds like this particular woman WANTS a section for whatever reason and perhaps her doc is coming up with a 'reason' that will appease her insurance company.

[jennica]

Originally Posted by wifeandmom

It sounds like this particular woman WANTS a section for whatever reason and perhaps her doc is coming up with a 'reason' that will appease her insurance company.

Well this woman hated being pregnant, thought breastfeeding was gross, and didn't want to give birth vaginally because she thought then her uterus would fall out when she got older. She barely ate anything while pregnant because she didn't want to gain weight, she got sick to her stomach when the baby would move because she thought it was gross, and I guess she kept telling everyone how sick of being pregnant she was and she wanted to reach up there and pull the baby out.

Her mother told us about the planned c-section, and she said "her doctor is really good, he's not gonna let her go through all that stuff that I did." I'm not sure if it was simply an elective c-section that the mother put her own spin on, or if the doctor had something to do with the decision. But I didn't think of the insurance company thing, that is a good point.

[wifeandmom]

Originally Posted by jennica

Well this woman hated being pregnant, thought breastfeeding was gross, and didn't want to give birth vaginally because she thought then her uterus would fall out when she got older. She barely ate anything while pregnant because she didn't want to gain weight, she got sick to her stomach when the baby would move because she thought it was gross, and I guess she kept telling everyone how sick of being pregnant she was and she wanted to reach up there and pull the baby out.

That's really strange. Why on earth would she even get pg to begin with, assuming of course this was a planned pg. :

[jennica]

Originally Posted by wifeandmom

That's really strange. Why on earth would she even get pg to begin with, assuming of course this was a planned pg. :

I thought it was strange and very upsetting. I saw this attitude as a huge warning sign for bad things to come when the baby arrived, but we just saw her at the baby shower and she was happy as can be, and seemed to be bonded to the baby. The baby was bottle fed. The pregnancy was planned. Perhaps she has body image issues and wasn't prepared for how being pregnant would upset that. It seems like she was bordering on anerexia during pregnancy, and planned to start working out immediatly after the c-section, and said she didn't care if her stitches burst open. Sounded pretty irrational to me, but when we saw her she seemed just fine.

[pamamidwife]

I guess what's interesting about this whole thread is how little we really know about pre-e, what causes it and what we can do to stop it.

[mamaverdi]

True Pam, so true.

[maxmama]

There is some very interesting research being done by Tom Easterling and Darcy Carr at the UW looking at insulin resistance, endothelial function and hemodynamics as risk factors for preeclampsia. One of their new protocols uses atenolol and lasix in women with a history of pre-e and increased cardiac output. I had HELLP with my first (early onset of PIH, then PE/HELLP at 36 weeks) and had no problems with kidney/liver function or HTN in this pregnancy on the atenolol protocol. The study is ongoing, so I don't know what their data look like, but anecdotally they say it looks promising for some women. The problem with pre-e is that it's probably multifactorial and will end up having multiple treatments.

Also, a possible inherited predisposition to PE is just about the worst reason for an elective section I've ever heard.