Pre-Eclampsia Watch Dog on the loose.

[gossamer]

I just thought I would post a list of pre-eclampsia myths and challenge you mammas to learn the truth about this deadly disease. Just keep an eye out.

1. Women do not die in childbirth in this day and age.
Every year 585,000 women die in childbirth, most in developing countries. 13% (or 50-70,000) of those deaths are known to be from eclampsia alone. Research shows that more women actually die of preeclampsia than eclampsia. In the USA 18% of pregnancy-related deaths are due to the disease. (Approximately 180 women a year or 3 women a week...) Even women, who do not die experience trauma, lose babies and suffer lifelong disabilities including paralysis, blindness, permanent neurological impairment, hypertension, liver failure, kidney failure, etc…

2. Preeclampsia is rare.
Preeclampsia occurs in 5-10% of all pregnancies. Internationally this accounts for 6-8 million births a year, in the USA—approximately 200-400,000 pregnancies. Preeclampsia is as common in the USA as breast cancer. A woman’s risk of having a baby with Downs Syndrome is 1:250. A woman’s risk of having preeclampsia is 1:20. Preeclampsia is the most dangerous of the leading common complications of pregnancy.

3. Preeclampsia only happens once and only in the first pregnancies.
The leading risk factor for preeclampsia is actually a previous experience with preeclampsia. While rare, preeclampsia can occur in second pregnancies even if it did not happen in the first. It can occur in the first, then skip a pregnancy and reoccur in a third.

4. Only certain kinds of women (heavy, old, young, black, Hispanic, women with twins, etc…) get preeclampsia.
While women with a body mass index (BMI) of 30% or higher, of advanced maternal age (over 35), teenagers, African Americans, Hispanics and those expecting multiples are among those at an increased risk—studies show that these “risk factors” do not predict who will get the disease and to what severity with which it will occur.

5. You can prevent (or you caused) preeclampsia with “x” (diet, exercise, attitude, working/not working outside the home).
Preeclampsia occurs in every country in the world regardless of diet, body size, and lifestyle. No significant study has shown that any of these factors are the cause or the cure for preeclampsia. Women in famine torn Ethiopia experience preeclampsia as often as women in San Francisco.

6. Pregnant women do not need to know about preeclampsia because only 5-10 out of every 100 will get it.
Because we cannot safely predict who will and will not get preeclampsia—and of those women who will and will not lose a baby and/or die, all women, particularly those in their first pregnancy, or with known risk factors, should be warned about the complications and dangers of preeclampsia. Women are taught about Downs Syndrome, breast cancer self-exams, pap smears. Most women would rather know.

7. Once the baby is delivered—the mother is fine.
While it is true that delivery sets in motion the recovery process, most maternal deaths occur in the 24-48 hours after the birth of the baby. Preeclampsia, eclampsia and the complications from it can occur up to six weeks post-partum. Vigilant post-partum care could prevent many of these deaths.

8. Preeclampsia has little to no impact on the baby.
Preeclampsia can cause intrauterine growth restriction and is the #1 reason doctors choose to deliver early. Preeclampsia is the leading known cause of prematurity accounting for 15% of preterm births in the US or approximately 60,000 premature births. It is also a leading cause of neonatal and infant death.


GOssamer

[umefey]

I have to dissagree with one statement.. that it only happens on your first baby.
I just had an emergency c-cection with my second child because of preeclampsia/PIH.
My first pregnancy was really easy and had absolutley no problems, delivered her with midwives...
She's almost 2 now.
The doctors and nurses were really shocked, so i think that its probably quite rare, but absolutley possible to have preeclampsia with second child.

[gossamer]

This is the myth.
3. Preeclampsia only happens once and only in the first pregnancies.

What follows,
The leading risk factor for preeclampsia is actually a previous experience with preeclampsia. While rare, preeclampsia can occur in second pregnancies even if it did not happen in the first. It can occur in the first, then skip a pregnancy and reoccur in a third.

Is debunking the myth.

I hope this clarifies. I agree with you. Pre-eclampsia does not only happen with the first. I am so sorry you had such a scare with pre-eclampsia. Are you and your baby doing well?
Gossamer

[danaalex]

great research and post gossamer :). in my time working maternal child health, i have seen many women seize after (or die after) delivery due to pre e, or e. it is a frightening pregnancy induced disorder. thanks for sharing!

[ramlita]

it's dangerous, common, and there's nothing we can do about it?? :scratch

Have you researched the work of the Brewers? What are your thoughts on their efforts to use nutrition to combat E/P-E?

[gossamer]

I am sure that being on a high protein low sugar is beneficial for any pregnancy. But the leading research shows that one of the more common but less well known causes is actually a range of genetic blood clotting disorders. Such as Factor V Leiden, MUTHFR, Factor III etc., as well as autoimmune disorders such as Lupus and rheumatoid arthritis. PCOS is also a huge risk factor for pre-eclampsia.

More and more it is believed that pre-eclampsia is a disease of the placenta. Commonly autopsy reports will describe a smaller than average placenta, a placenta full of blood clots, blocked artery in the umbilical cord or a placenta that had a "heart attack". WHile there is no known cure for pre-eclampsia, other than delivery of the child, it may be possible for the disease to be managed until delivery. Several women take vitamin E, vitamin C and aspirin therapy. Others include daily shots of Heparin or Lovanox throughout the pregnancy to prevent blood clots. THere are therapies available.

My goal is to educate the women themselves. I had no idea what the symptoms of pre-eclampsia were or how dangerous it can be. Sometimes high bp can be the last symptom to manifest, after there has been significant damage to the kidneys and the baby. Pain on the right side under the ribs can be a sign of a damaged or enlarged liver. Minimal urine output relative to what you are drinking can be a sign of kidney damage, visual disturbances and the mother of all headaches can be a sign of high bp, nose bleeds can be a sign of dropping platelets. I didn't know any of these and I had all of these.

Pre-eclampsia gets it's name from the greek word for lightening because it can come on suddenly without warning. I had been feeling a little ill tuesday morning when I saw my cardiologist on July 29th, but he checked me out and said he thought everything was ok. At 2:45 I saw my high risk OB, by 5:30 I was in the hospital and my daughter was born at 10:21 that night.

I just want to get the word out and help educate as many mommas as possible about this horrible disease that stole the life of my beloved Mary Rose.

Gossamer

[mezzaluna]

thanks for this reminder... i've been keeping a close eye on my health since i have multiple risk factors for pre-e. i was showing slight symptoms from 37-39 weeks, but am back to normal now and holding at 40w1d. multiple u/s's and NSTs show my baby healthy as far as we can tell, but the doctors still want to induce by 41 weeks. i'm going to try acupuncture tomorrow, but i haven't decided yet what i will or won't consent to at 41 weeks... if things start to deteriorate again, i will go ahead with it... i'm just still conflicted about what to do if everything looks normal.

i have been doing vitamins E, C, and calcium, and in the 1st trimester only - baby aspirin. since mid-2nd trimester i've been making a real effort to get sufficient protein. i think these measures may have helped me escape the worst of it. the aspirin in particular was intended to help the blood vessels into the placenta establish themselves well.

i was born to a mom with pre-eclampsia, and my name is rosemary... so i send you a special :hug for you and the memory of Mary Rose.

[veggiemommy]

What a great post Gossamer. There are definitely a lot of misunderstandngs about preeclampsia and definitely NOT enough known about it either.

I had HELLP syndrome which is described as a severe form of eclampsia where your organs start shutting down--you are essentially "allergic" to your baby.

It was REALLY hard to find information about it at the time and it was REALLY scary. It came on SO suddenly with my first--I had pain that I thought was gas all of a sudden one day (at 33 weeks) which turned out to be my liver shutting down. Of course my bp was skyrocketing as well but it took the doctors days to figure out what was wrong with me. I was put on hospital bedrest (couldn't leave the bed AT ALL) and at 35 weeks they decided that they had to deliver my son as I was getting so sick.

My son is fine now-we were very lucky--he was severly jaundiced, took 5 weeks to get him nursing properly and had an inguinal hernia that needed an operation but has been great ever since!

I was watched VERY closely with my last pregnancy and with moderated bedrest from week 26 on, I made it through okay (bp went up a little and had swelling but it didn't get any worse from there.) My specialist decided to do an amnio at 36 weeks and I had a c-section at 37--it was SO nice to get to nurse my daughter in the delivery room and have everything be normal (getting to have her room in with me etc. right from the beginning!)

I am pregnant with my third now and am being watched very closely again. I am on aspirin therapy and have been on moderated bedrest for about 6 weeks (I'm now 28 weeks). My specialist hopes to do an amnio at 36 weeks and deliver at 37 again as long as everything goes okay. I get tests done all the time to make sure my platelets, liver function, blood pressure, weight, and urine are all okay but it's worth it as it seemed to work last time!

Anyway--just wanted to share my story--I wish that I knew some of the signs ahead of time before my first baby--my first sign was a horrible headache before the pain in my liver--but I get migraines so just thought that it was that.

By the way--I don't fit into ANY of the "higher risk groups" for preeclampsia--I was 26 when I was pregnant with my first, was at a normal weight, exercised (weights and cardio) up until the day I ended up in the hospital, ate a very healthy lacto-ovo vegetarian diet.... It's so frustrating to have people say that diet is the cause - I felt so guilty when it happened as if it was something I could prevent but the truth is that they just don't know enough about it. I'm just glad that I had good hospital care--if it was 50 years ago, both of us would have died I'm sure--or if I was in a different area that doesn't have the resources that we have--scary to think about that!

Anyway I'll stop rambling--thanks for bringing this up--it's DEFINITELY important for people to know more!

Holly

[natashaccat]

So aside from bp...how can this be diagnosed? I've had chronic headaches throughout this pg but my bp has been normal at every MW visit. Should I ask for further testing?

[shannon0218]

Gossamer, your words from the past have echoed wtih me throughout this pregnancy. I've had highish bp since about 13 weeks and have been monitored extremely closely!! My OB said to me today that she was relieved I took the precautions for pre-e so very seriously--she said many come in and say they forgot to do any urine dips this week or what have you. So far all is well with Molly and I but I know from the way we are watching it and from how careful my doc is that if anything begins to go wrong we will catch it right away. Mary Rose leaves such a legacy and I'm sure her story will go on to save many lives.

[pamamidwife]

Simone, one of the main symptoms is high blood pressure - some say even if the bottom number is 20 points above your baseline or early preg readings.

Headaches are often caused by either dehydration, stress or a hormonal shift. Have you tried increasing your water intake?

I wish that the Brewer diet was the cure. Unfortunately, it's not. I think there's more to it than just a crazy load of protein intake during pregnancy. After all, if it was evidence-based (and I'm not talking Dr Brewer's "evidence", which is purely case studies, not a good randomized controlled trial) wouldn't it be the first thing to try? I know many docs and midwives who are rightly scared of pre-e. If protein intake was the cure, it would have been so easy to save so many lives.

The only surefire way to diagnose pre-e is to do a liver panel and complete blood count. High blood pressure in and of itself does not equal pre-eclampsia, protein in the urine is often a late sign of pre-ecl (and quite often shows up because of dehydration or normal stress on the kidneys) - not early, and swelling in pregnancy to a degree is normal (hands/feet), however excessive swelling (not going down in the hands, neck and face especially) is not.

[gossamer]

Thank you for adding your input pam, I really appreciate it. High bp should not be measured just by numbers, but by numbers relative to what your normal blood pressure is. For example, if your normal bp is 90/60 and during your pregnancy it goes up to 120/85, that by itself is not a high bp, but compared to your normalit has gone up 30/25 points. That is high.

Also as pam mentioned swelling in the hands, neck and face are signs as well as excessive weight gain in a short amount of time like 6 pounds in a week, that can mean you are retaining water because your kidneys are shutting down.

Veggiemommy,
I also had HELLP syndrome. I had liver pain for 10 days and was told by 3 doctors that it was just gas or constipation. Little did I know that my liver was in danger of rupturing. I had to have an emergency C-section and because my platelets were so low, I couldn't have an epidural. They were afraid I would bleed into my spinal column and wind up paralyzed. They also told me they might not be able to stop the bleeding and may have to do a hystorectomy. SO they put my to sleep and took my baby. She died before I woke up, so I never got to see her alive. She survived for an hour trying to breathe, but her little lungs were too small. Because of the pre-eclampsia, she had dropped to 3 weeks behind schedule.

I am so glad to see that some of you are taking pre-e more seriously and keeping such a vigilant eye out for symptoms. If our story can save one woman and child, then Mary Rose will not have suffered in vain.
Gossamer

[veggiemommy]

Oh I'm SO sorry to hear your story Gossamer--I know that I was SO lucky.
I don't remember a lot of what happened to me as I was so drugged up to prevent the seizures I was having etc. I had an emergency c-section but was very lucky that it wasn't until 35 weeks so my son was okay. I was able to have a spinal though and I had my own personal nurse in my room for about a week - looking back I realize how serious that is but after hearing other stories from HELLP survivors, I realize how lucky I was (and am). Again, I am SO SO sorry for your loss--good for you for trying to help others in her name.

As far symptoms-bp and swelling are just two and don't necessarily mean you have (or will get) preeclampsia. My friend's bp was going up during her last pregnancy and she couldn't get shoes on as her feet were shaped like potatoes because they were so swollen but she never developed preeclampsia or anything else.

Anyway--gaining weight suddenly is another sign to watch for--my specialist wants to know if I gain 3 lbs or more in a week (which I have this time around a couple of times but everything is okay so far) but is just another sign. As are headaches--especially really severe ones. I've also been told to tell the specialist if I see spots, have pain in the upper right quadrant (just under my ribs as that is where the pain was with my liver last time) especially if the pain radiates up into your shoulder (which I had as well). Because of my history I get regular blood tests to check for platelet counts and everytime you go to the dr they check for protein in your urine as that is another bad sign.

My specialist insists that I rest as much as possible on the couch with my feet up (preferebly lying down) and I have to contat him if I get any of the symptoms just so they can run tests and make sure it is not happening. He takes it VERY seriously (as he should!) so I trust him--he was the only one that could figure out what was wrong with me when I got it with my son. (He said that he heard 'something' when taking my blood pressure?!?!

Okay again I've rambled enough but hope that info helps a bit--I'm here on the couch with a laptop--SO glad I have a laptop this time around--it certainly helps pass the time!!

Holly

[gossamer]

These are all signs and symptoms of pre-eclampsia.

*None
High blood pressure is a silent killer. Oftentimes, women diagnosed with preeclampsia do not feel sick. Many signs and symptoms of preeclampsia mirror other "normal" effects of pregnancy on your body. Women diagnosed with preeclampsia may feel frustrated when prescribed bedrest because they feel fine. If you feel fine, it may be hard for you or your partner to appreciate that preeclampsia is a serious condition.

*Hypertension
High blood pressure is defined as blood pressure of 140/90 or greater as measured on two separate occasions within six hours. However, a woman who normally has a low baseline blood pressure, such as 90/60, could be considered hypertensive at a blood pressure of less than that - especially if she has other symptoms. A rise in the diastolic (lower number) of 15 degrees or more, or a rise in the systolic (upper number) of 30 degrees or more is cause for concern.

*Swelling or Edema
A certain amount of swelling during pregnancy is normal. Edema is the accumulation of excess fluid. It is particularly concerning when it accumulates in the face (eyes) or hands. It is normal to have trouble wearing rings throughout pregnancy.

*Proteinuria
Proteinuria is the result of proteins, normally confined to the blood, spilling into your urine because the small blood vessels in the kidneys become damaged. A simple dipstick test of your urine at each prenatal check-up can screen for proteinuria.

*Sudden Weight Gain
A gain of more than 2 pounds in a week or 6 pounds in a month could be cause for concern.

*Headache
Dull, throbbing headaches, often described as migraine-like that just won't go away.

*Nausea or Vomiting
Nausea or vomiting is particularly significant when the onset is sudden and in the second or third trimesters.

*Changes in Vision
Vision changes include temporary loss of vision, sensations of flashing lights, auras, light sensitivity, and blurry vision or spots. For some women who are farsighted, vision may actually improve.

*Racing pulse, mental confusion, heightened anxiety, trouble catching your breath
If these symptoms are new to you, they could indicate an elevated blood pressure.

*Stomach or Right Shoulder Pain
This type of stomach pain, called epigastric pain by the medical profession, is usually under the right-side ribs. It can be confused with heartburn, gallbladder problems, flu, indigestion or pain from the baby kicking. Shoulder pain is often called referral pain because it radiates from the liver under the right ribs. Lower back pain is different from muscle strain common to pregnancy. It is usually more acute and specific. All may be a sign of HELLP Syndrome or a related problem in the liver. Shoulder pain can feel like someone is deeply pinching you along the bra strap, or it can be painful to lie on your right side.

*Lower back pain
Lower back pain is a very common complaint of pregnancy. However, sometimes it may indicate a problem with the liver, especially if it accompanies other symptoms or preeclampsia.

*Hyperreflexia
Hyperreflexia is when your reflexes are so strong that when they are checked, your leg bounces back hard.

I hope this is helpful to someone.

Gossamer

[crazy_eights]

Gossamer - I would add about the BP that failure of the BP to drop in the second trimester is a warning sign. Normal course of pregnancy, there is a 'baseline' BP which is the BP of the mom in early pregnancy. With the blood volume expansion of the second trimester, the BP should drop. The blood pressure will generally rise slowly near term to what the 'baseline' BP of early pregnancy was.

Remember, while pre-eclampsia/eclampsia can come on suddenly, the underlying pathology is set in the first trimester.

[natashaccat]

When does your basline bp need to be taken? My mw don't do first check ups until 12 wks and mine was high then because we talked about something that I was feeling much stress and anger about (prenatal care during last pg). At next visit (14 wks for US consultation) it was "normal" however I'm one of those low bp types.

Is 14 wks soon enough for baseline bp?

[OnTheFence]

Gossamer Thank You for your post!

I had pre-e in my second pregnancy. I did everything "right".
I've read all about the Brewer Diet, and while it may help, its not a cure. I think the whole thing is a false hope for women with this serious problems. It also saddens me when people judge women based on what they think they know about pre-e and blame them because they must have had a bad diet, too fat, too thin, or this or that while pregnant.
My OB said to me last time, "Its BS, pre-e can just happen. No diet, no voodoo in the world, herbs, or even prayer can stop it if its going to happen." She told me to stop stressing over having it and that I had not done anything wrong.
I hope I don't get pre-e this time. I only had it in the last trimester with my last pregnancy. Maybe this time I will get skipped over!

[gossamer]

Dear Kim,
I hope you get skipped over. In this day and age too many people want to say, well if you do this......you won't get it. The reality is you can do everything right or everything wrong and nobody know who will get it or when or how severely.

We don't like to hear that there is uncertainty in the world of medecine, but I think the time has come to stop accepting pre-eclampsia as something that just happens sometimes and start educating ourselves, our doctor's, our families and our children. Pre-eclampsia isn't something that happens to someone else, it can happen to you or your sister or your daughter.

The following are risk factors for pre-eclampsia:

*Previous history of preeclampsia, particularly if onset is before the third trimester

*History of chronic high blood pressure, diabetes or kidney disorder

*Family history of the disorder (i.e., a mother, sister, grandmother or aunt who had the disorder)

*Women with greater than 30% Body Mass Index (BMI). To determine your BMI, click on the following link http://nhlbisupport.com/bmi/bmicalc.htm and follow the instructions there.

*Multiple gestation

*Over 40 or under 18 years of age

*Polycystic ovarian syndrome

*Lupus or other autoimmune disorders such as rheumatoid arthritis, sarcoidosis or MS.

*Diabetes, sickle cell disorder, hyperthyroidism, kidney disorder, etc.

*Genetic Blood clotting disorders like Protein C Deficiency, Protein S Deficiency, Thrombophilia, Antithrombin III deficiency, Giant Platelet Syndrome

*First pregnancy with a new partner/husband



natashacat, I don't think 14 weeks is too soon, if at all possible, you should find a bp you had taken before you got pregnant. If you can't find one, then just keep an eye on how high it gets and does it drop in the 2nd trimester. SInce you are already in week 14, you should see a drop from what it was last time. You can also go to some drug stores and test it there, although I wouldn't bet on the accuracy of those machines, I have a little $50 bp monitor at home, and it is worth every single penny, for me.

Well, I am getting sleepy. So go forth and educate, I know everyone here knows somebody who is or is trying to get pg. Spread the news ladies, save a life.
Gossamer

[Quirky]

:bow I think this thread should be made into a sticky at the top of the forum. I'm going to ask one of the mods to do it. This is way too important to get buried in threads about name polls, questions about baby gear, etc.

[Stone Fence]

Thank you Gossamer. This being my first, I am worried about everything. I can be proactive about the looking for the signs of PE.

[gossamer]

Just a friendly bump for all of our pregnant mommas. And thank you Quirky, I never got the kowtow smilie before. :)

Gossamer

[elyice]

thank thank you thank you

My Mika, My best friend in the world, soul sister and lifelong running mate is gone.
She was a HEALTHY, THIN, COLLEGE EDUCATED,WELL NOURISHED, MOTHER OF 2. She died in her 3rd pregnancy at 36 weeks along. Baby Mariah also died.
This was her 2nd time with Eclampsia. symptoms came on Sunday, she was dead Monday night. She had a MIGRAINE, SWELLING and Protein in her urine (tested a few days prior). She called the doctor and told her about the migraine and the doctor told her "it's not a migraine, take a tylenol and ride it out" had she gone to the ER and gotten her blood pressure checked she and her beautiful daughter would be here today. Instead many people have a hole in our hearts and spirits that can never be filled.
She woke in the emiddle of the night to go to the restroom, fell to the floor seized and was found the next morning. I cannot imagine what her full term baby endured.
here is a website I created in her memory. Please take care of yourselves mommas. Eclampsia death Tamika Winston (http://www.rememberingtamika.com)

[laralou]

Stuck!

[AmyB]

I wish that the Brewer diet was the cure. Unfortunately, it's not. I think there's more to it than just a crazy load of protein intake during pregnancy. After all, if it was evidence-based (and I'm not talking Dr Brewer's "evidence", which is purely case studies, not a good randomized controlled trial) wouldn't it be the first thing to try? I know many docs and midwives who are rightly scared of pre-e. If protein intake was the cure, it would have been so easy to save so many lives..

There's a lot of good info in this thread, but I must quibble with this. In my search of medical literature I could not find evidence that any researchers had ever tried to test the hypothesis that diet might help lower rates of pre-ecalmpsia. It's my understanding that randomized controlled studies of the health effects of diet are pretty much never done because diet is too hard to control and people are known to lie on self-report forms.

Obviously, diet might affect other body chemistry, so even if researchers are finding other chemical indicators or warning siganals it still wouldn't prove that diet has no possible effect.

However, since there is only "case study" evidence that diet might do some good, doctors aren't reccommending diet as a possible preventive to women with other risk factors.

It's hard to see how cutting out junk food and eating more eggs could actually be harmful, and while there isn't hard evidence that it will help, there is also zero evidnece that it won't help since it's never been tested.

From a consumer standpoint, the obvious best course of action is to eat more eggs even if only for the placebo effect AND keep checking your blood pressure and watching for symptoms.

--AmyB

[gossamer]

Of course a healthy diet is always the best course of action, but world wide there is a stable occurence of pre-eclampsia regardless of diet. Healthy unprocessed foods are always better than highly processed sugary foods, and I do not doubt that poor diet exacerbate a tendancy to pre-eclampsia, in the same way that poor diet could exacerbate a tendancy to gestational diabetes.

Naturally I advocate a healthy diet, but I don't want people to get the idea that a specific diet protects you from pre-eclampsia. Just because you are eating a specific diet does not mean you should not keep an eye out for warning signs and symptoms of pre-eclampsia. No-one is immune at any time.

Thank you lori for putting this as a sticky.

Gossamer

[crazy_eights]

ACtually, I did a research paper on PE and the Brewer diet a few years ago. There have been a few people that tried monitoring/supplementing different dietary supplements including people that are impoverished and haven't been able to alter the rates of PE. One study just kept track of how much protein a mother was consuming and found that those with the highest protein intakes actually had higher rates of PE than those with lower intakes.

[mwherbs]

an over all good reminder-
here is a quote from published guidelines
"In the past it has been recommended that an increment of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure be used as a diagnostic criterion, even when absolute values are below 140/90 mm Hg. This definition has not been included in the current guideline because the only available evidence shows that women in this group are not likely to suffer increased adverse outcomes. Nonetheless, it is the collective clinical opinion of the guideline panel that women who have a rise of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure warrant close observation, especially if proteinuria and hyperuricemia (uric acid greater than or equal to 6 mg/dL) are also present"

This is a web page for the complete document down loadable as a pdf

http://www.nhlbi.nih.gov/health/prof/heart/hbp/hbp_preg.htm

or a summary-
http://www.guideline.gov/summary/summary.aspx?doc_id=1478

I might add that in the guidelines 2 separate BPs are taken but that does not include a recumbent bp.

[cwaddick]

I'm an environmental health specialist so I tend to see everything in terms of everyday toxic exposures [If you have a hammer, you mostly see nails.] .... I suspect that

The cause of pre-eclampsia has to do with women's toxic exposures. Most individuals in the US have over 200 toxic exposures per day. Women consume a remarkable number of consumer products that are virtually unregulated, though we consider them "safe" because they are so common. These consumer products and exposures include: shampoo, conditioner, soap, lotion, cosmetics, laundry detergents, dishwashing liquid, chlorine bleach, cleaning supplies, furniture, carpets, building materials, pesticides sprayed in or around the house as many as 30 years prior to the date of exposure, ... ambient outdoor air, etc. Many of our everyday toxic exposures are difficult to control.

Our bodies mediate our toxic exposures in many ways. A very high quality diet can help the body to remove toxins from our body. However, diets can also be a source of toxins, such as pesticide residues on apples or synthetic additives in prepared foods. .... So, any study on the relationship of diet to pre-eclampsia would have to account for many aspects of diet and control for sources of toxic exposure.

I learned so much from this thread. Thank you all.

-- Caitlin

[acrathbun]

I also wanted to say thank you for this thread.

I have had four children.

Spencer, severe pre-e, c/s at 32 weeks.

Sarah & Megan, mild pre-e vbac's (Megan was an hbac). But it turned really bad after the girls were born. My bp went through the roof. But at least my girls were full-term.

Thomas, severe pre-e, which turned into HELLP at 31 weeks. Emerg c/s.

I will say that I did the Brewer diet w/ the last three. I was convinced that it helped w/ the girls...but clearly it didn't help w/ Thomas

It's hard to try and live in the Natural Family Living world and occaisionally be judged for not having done things the "right way". Thank you for starting this thread. And thank you to whomever made it a sticky:)

[gossamer]

acrathbun,
Thank you for sharing your story with us.
Gossamer

[OnTheFence]

Gossamer,

I have a question. I hope you can answer it or at least point me in the right direction. I had PE before, not until the last trimester however. Right now at 10.5 weeks my BP is 124/82. I am a plus size chic.
Anyway, I was wondering about HCG levels in reference to developing PE. My HCG levels for the gestational week I was in was really high (and its not multiples) It was in the normal range, but "high" for a singelton. I had read some "layman" thread on the net that higher HCG levels can be an indicator of future PE. However I wasnt sure if that meant for later in pregnancy when hcg levels are supposed todrop or early on.
Right now I am trying to eat right, and eliminate some stress. :)

[gossamer]

My first question would be what is your normal bp? Although certain factors can be indications of whether or not you will get pre-e, there is nothing I know of that can indicate when you will get it other than your previous experience. Because you got it in the third trimester, it is more likely that you are prone to third trimester pre-e. Not certain, but likely. Do you have additional risk factors for pre-e? How severe was your previous experience? Do you have a family history? These questions will help give a bigger all around picture of your pre-e risk. There have been so many studies recently about causes of pre-e including high AFP, blood clotting idsorders and even the implantation of the zygote. I would hesitate to take one factor (high Hcg) and determine your risk. Does any of that make sense?
Gossamer

[OnTheFence]

My first question would be what is your normal bp? Although certain factors can be indications of whether or not you will get pre-e, there is nothing I know of that can indicate when you will get it other than your previous experience. Because you got it in the third trimester, it is more likely that you are prone to third trimester pre-e. Not certain, but likely. Do you have additional risk factors for pre-e? How severe was your previous experience? Do you have a family history? These questions will help give a bigger all around picture of your pre-e risk. There have been so many studies recently about causes of pre-e including high AFP, blood clotting idsorders and even the implantation of the zygote. I would hesitate to take one factor (high Hcg) and determine your risk. Does any of that make sense?
Gossamer


Yes, it does make sense.
I have no family history of Pre-e on either side. I am over weight by at least 80lbs. The good thing for me is I am tall.
My first pregnancy -- Female fetus, no pre-e at all. My blood pressure was 120/over 70something most of my pregnancy.
My second full term pregnancy. Starting having high BP around week 28/29. I had no swelling at all but I did start spilling protein around week 32. My blood pressure gradually got higher and I delivered at week 38. My pressure the day of my csection was perfect though. I dont know if this make a difference but I had a boy in this pregnancy.
I do have stressed induced hypertension when not pregnant.

[gossamer]

How high did your BP get? Were you induced to deliver or did you deliver on yoiur own time? WHen your bp started oging up, what remedies did the dr. prescribe (bedrest, bp meds, diet)?
Gossamer

[OnTheFence]

How high did your BP get? Were you induced to deliver or did you deliver on yoiur own time? WHen your bp started oging up, what remedies did the dr. prescribe (bedrest, bp meds, diet)?
Gossamer

The day we scheduled my csection it was 178/90. I scheduled it for the following Friday. She told me to go home, avoid stress and keep my arse parked on the couch. We decided to go ahead and schedule the csection rather than waiting another 2-3 weeks.

[shannon0218]

Maybe someone could provide some insight on this little issue. I'm being monitored very closely for pre-e. I'm on blood pressure meds, so far all has been fine.
Yesterday my doc wanted to do blood work and another 24 hr urine catch because I have started to throw up again at 31 weeks and my bp while not horribly high has been hovering at 130/90. I'll get the blood results back tomorrow. (I guess today now)
Anyway, I've had a nagging headache since late this afternoon. My bp has been between 120/86 - 140/92, kind of all over the place. Anyway, I was just in the bathroom, if I strain in any way to have a bm the headache gets severe and throbbing over my left eye and I feel light headed.
Should this worry me???

[crazy_eights]

Yes, this should worry you. Put in a call to your OB.

[acrathbun]

well, it would worry me. I would call your doc when they open in the a.m. and ask for a NST (non-stress test) If they aren't doing those already, you may want to start. I was on weekly NST's by 28 weeks w/ this last baby.

[crazy_eights]

No, I would not wait until morning. You need to call your OB or go to the hospital for an evaluation.

[gossamer]

I agree with CHava. Call your Dr. right now and go to the hospital.
Please keep us updated.
Gossamer

[shannon0218]

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.

[crazy_eights]

THanks for the update. Glad you and baby are hanging in there.

[shannon0218]

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"

[gossamer]

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

[gossamer]

Shannon, how are you doing?
Gossamer

[shannon0218]

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 :)

[gossamer]

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

[gossamer]

OnTheFence,
How are you doing? I am thinking about you.
Gossamer

[shannon0218]

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.

[gossamer]

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

[gossamer]

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

[shannon0218]

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!!!

[shannon0218]

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!

[mwherbs]

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?

[shannon0218]

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????

[mwherbs]

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

[shannon0218]

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.

[shannon0218]

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!

[LoveChild421]

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. :hug

[shannon0218]

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.

[LoveChild421]

Wow Shannon that is so scary- I am so glad I found MDC because I had never known that pre-e could come on so fast! Gossamer's experience is so tragic- her Mary Rose was so beautiful- it breaks my heart. In her pictures she really looks like an angel.

I am so glad she is able to help prevent this from happening to others by getting us educated and taking it seriously!

I'm glad that most at home monitors are fairly accurate- I do have one that runs on batteries so I will have have to check them and change them often. I think the cuff is ok- I'm really petite so I hope it isn't too big- I can usually tighten it enough to get it snug. I will take it with me to my next appt. Thanks!

[Sarasein]

Thanks for posting this. I had pre-e with my DD and I am keeping a close eye on everything this pg. If it does come back, when should I start seeing signs? With DD I started swelling up to my eye balls by 32 weeks. By 36 weeks I had gained 20 lb in 2 weeks and was spilling protein in my urine. I was then put on strict bed rest and send home to collect my urine. I was induced 2 days later and Alexis was born at 1:51 am on July 4th. She was 37w, 2 d gestation and was 20 in long, weighing 8 lb, 2 oz. She did have severe jaundice that put her back in the hospital at 6 days old. I had my bp spike back up when she was 3 days old and was on med for that for 6 weeks after she was born.

I am currently almost 20 weeks. I have seen no swelling and my bp is staying steady where it should. But I am so scared this is going to set in again. I was seeing a midwife with Alexis and I had to dip that test strip my self. I liked that cause I always knew I was ok. I was the one that discovered the rapid weight gain and the protein in my urine. This time I have to see a dr and they don't tell me that stuff. I always have to ask what my bp was.

[shannon0218]

Sarah, I think really that it can hit at any time. I know my mother was basically term when it hit her and she had no warning signs at all leading up to it (she had no problems at all with my younger brother)
I would mention to your OB that you would like to know the numbers after he takes it--let him know you are concerned and you are trying to watch out for any signs.
You can buy the sticks to test protein and glucose from the drug store, maybe it would put your mind at ease if you had a bottle of them at home? Just remember that a little bit (or trace) amount of protein is really no big deal.
Take care and try not to stress about it but do keep an eye on it and advocate for yourself with your doctor.

[Sarasein]

Just remember that a little bit (or trace) amount of protein is really no big deal.


I know a trace is not much, but it was the straw that broke the camel’s back with Alexis. That was the last thing that happened before the final diagnosis for her. I guess that is why I am so worried about it. I might have to look and see how much the strips are. Right now, I am not too worried, because I have no signs. But, I also see that it can still be a problem. I guess I am just scared. Her birth was horrible and I don't want a repeat of that. Anything and everything I did not want for her birth, happened. It has taken me a long time to come to terms with everything.

[LoveChild421]

I just wanted to report some good news- I went to my midwife for my 30 weeks appt. and my BP was normal 125/82 (even in their office- amazing!) and my BP monitor was right on with theirs so I know it's accurate.

I have been doing everything I can to keep my BP down and stay healthy- I've been drinking a gallon of water a day, eating lots of protein with each meal, limiting refined sugars and processed meats, taking calcuim, etc. I am keeping a close watch on my BP still since it was a little high and even though it was probably from anxiety I still know from Gossamer's story and your mom's Shannon that pre-e can come on fast and aggressively.

Cross your fingers I won't have anymore BP problems!

[gossamer]

Hi ladies, I am back from ENgland. whew, I am so glad to be home.

Shannon, How are you doing? How is Molly?

Sarasein, I am not a doctor, but i would reccomend you talk to your OB about your pre-e experience. I would ask for a baseline 24 hour urine so you know what your normal urine protein content is. I fyou have to ask, you have to ask, but you ant to know those numbers every visit. If you are worried or in doubt, ask or call your ob. As someone else mentioned, it is better to call than look back and wish you had.

Gotta go, I will write more later.

Has anybody heard how OnTheFence is doing?
Gossamer

[shannon0218]

Well, we are still technically alright, however last night and today my pressure has been high, blood work today was still normal and her NST while normal showed she wasn't quite as active as she's been on previous ones. I am to take my bp hourly (every 2 hours during the night-have to set alarm) and go in tomorrow morning for another NST, more blood work and an U/S. Decisions will be made then whether to deliver her early (I'm 36w, 2d right now)
So we could use some good thoughts so far tonight it hasn't gone up at all but hasn't gone down either (if it goes up by more than 5 more points I have to go in right away)

[gossamer]

Lovechild, everything is looking good so far, let keep our fingers crossed.

Shannon, it sound slike you are teetering on the brink here. Stay vigilant, count those kicks and don't be afraid to take your self in if you need to. I am praying for you.
Gossamer

[LoveChild421]

Thanks Gossamer! I really appreciate you looking out for all of us here! My BP was great today (120/65) so hopefully things will be ok- keeping my fingers tightly crossed.

Shannon, I am sending some prayers your way too- I'm glad you're 36 weeks already just in case Molly does need to come a little early.

[gossamer]

Ok ladies, it has been a couple of days, how ar ehtings going? How are the bloodpressures looking? Are you doing your kick counts? ANy headaches, inability to urinate, upper quadrent pain? Don't keep me in suspense.
Gossamer

[shannon0218]

Well....I've been in hospital since Sunday night. My blood work remains normal (it's being done every morning) and my blood pressures are now semi-stable. The headaches I'm having seem too severe for the blood pressure I have, so we're unsure if they are stress related or what is going on with them but I had one again last night after 3 days without. Unfortunately, when the headache is that bad, I start with violent puking so I've pulled muscles just about everywhere. NST's are being done 3x a day and Molly looks perfect with all of them now--on Sunday night when I was admitted, my bp was really high and she was quite still with an average heartrate of 130, but as my bp came down her heartrate went back to normal and she started to squirm again (it was a stressfull few hours)
They have moved my section date up to Monday, so just 2 more days!!!

[gossamer]

I am so glad you are being watched so carefully. I will definitely be praying for monday to come around. We want to see pictures asap. Take care of yourself. Don't stop being vigilent.
Gossamer

[LoveChild421]

Yay! Molly's coming tomorrow! I'm so glad you and Molly have made it through all of this and are being watched closely. I know you can't wait to hold her! I can't wait to see pics too!

Everything's trucking along with me- BP is staying low and Grey has been pretty active (he's pretty mellow most of the day though except the mornings). No headaches or pains of any kind. Feeling great and counting down the weeks! Still praying that all goes well and I am able to have my homebirth!

I hope you all are doing well!

[KaDeDiD]

I would just like to add that in my third pregnacy At 30 weeks i was admitted to the hospital with pre-e and with a soaring bp i was going into liver and kidney failure and my brain was bleeding, loose'n my sight they finally induced where i had my son and almost Died from lose of blood i think this is a very serious issuse and it needs to be Addressed Good Job on the research from aLL :D ..... Son was 5 pounds and healthy

[mtm]

Gossamer, just wanted to thank you for all your posts on this thread. Your signs and symptoms post rang a bunch of alarm bells in me a few weeks ago and made me talk to my doc about all the weird little symptoms I was having (rapid heart beat, high pulse, constant dull headaches). Initially they weren't worried as my blood pressure wasn't too high (130/80 this week which is high as its normally low) but as its creeped up, my docs have taken it a lot more seriously. My blood draws are coming back slightly elevated with some protein spilling in the urine and a 2 pound weight gain last week so I'm now in every week for poking and prodding. Thankfully I'm 34 weeks already. I'm not sure they would have taken it so seriosly had i not gone in armed with all your info, esp on the dull headaches.

My question for those of you with pre-e, are you having trouble differentiated between common pg things and danger signs? I often get headaches and visual disturbances so don't want to rush in for everything but don't want to miss something either.

Also any suggestions on how much vit e and c to be taking?

[gossamer]

mtm,
I am so glad you went to be seen and are being closely watched. My best advice is that it is better to go in and be seen, than wish you had when it is too late. pre-eclampsia got it's name from the Greek word for lightening because it can come on suddenly. You can go from being ok to on death's door within hours. The day Mary Rose was born, I had gone to my cardiologist that morning at 9:00 am, I saw my high risk OB at 2:45 pm and I was in theo perating room and Mary Rose was born at 10:22 pm. That is how quickly things can go wrong.

My dr. has suggested 1000 mg of vit. C and 800 iu of Vitamin E. I actually usually take about 2000 mg of VIt C because it is water soluble and whatever my body doesn't need, it flushes out. I am much more conservative with vitamin E because iti s fat soluble, so I actually take only 400 iu.

I hope that helps and I hope the rest of your pregnancy is uneventful. ANd I hope you know that having you take this seriously and being monitored warms my heart and hlep me to know that some good things can come out of the death of my daughter.

Gossamer

[mtm]

Hi Gossamer, weent to the doc's this morning. It was a good news/bad news appt. In good news, my blood pressure is holding stable, my liver and kidney numbers are up but only slightly so they still consider me borderline for pre-eclampsia.

In bad news, I'm spilling proteins at a higher rate, have low protein in my blood tests, and they lost the 24 hour urine so I have to do it again. From my u/s on Tues they are worried about ds's position, he's head down but his head is way over to the side. They talked about a version but given my blood pressure are unsure. Most likely a c-sec if he doesn't move on his own. I'm off to a high risk ob next week to check on the protein and talk about delivery options. They were pretty vague about if they thought I could hold out to term (March 10) but seemed to think 37 weeks (2 weeks away) was doable. YAY. Michelle

[gossamer]

I am sorry. It is a bummer that your enzymes are elevating and your kidneys are sputtering. I am so glad that you are keeping such a close eye on this though. 37 weeks is great!!!!!!!! I will pray that all goes well until then. I hope you don't have to have a C-Section, but if you do, remember that bringing the baby home is the most important factor of the whole being pregnant thing. :)
Gossamer

[shannon0218]

mtm, my daughter was born on Jan 24 at 37 weeks (by c-section) for borderline pre-e and she's just perfect.
All willl be ok and I too am glad you are keeping such a close eye on it.

[mtm]

went in yesterday with a bad headache and spots. Spent a few hours being monitored and my blood pressure was okay, no protein in my urine either! Baby still looks good, doc figures it was just a migraine brought on my exhaustion (ds had that fever/cough combo and wasn't sleeping the last few days). today I have more energy than I've had in a while. Hosp was great, reassured me that I did the right thing going in to be monitored.

[shannon0218]

I'm so glad they reassured you it was best to be monitored! Really, that made all the difference for me, I knew I was being properly monitored so we'd know early if things started a downhill slide. My doctor told me the tell tale signs are there in the blood work and urine usually for a good week and at least for 48 hrs before the symptoms tell us something is wrong so with careful monitoring you should be able to avoid an emergency situation--now if all docs were like your's and mine and took these things as seriously as they should a story like Gossamers would be far more rare.

[mtm]

Shan and Gossamer, my hands and feet don't look more swollen but are sort of painful this morning. I've tried walking around for a bit but it doesn't seem to help. All my blood work and urine on Friday looked good, better than earlier tests. Is this something to worry about? I've also got a cold, don't know if that would make a difference.

[gossamer]

THe thing to really watch for is swelling of hands and face. Are you drinking lots of water? It could just be body ache from the cold, but if you have any concerns, call your doctor. It is always better to be safe than sorry. I am glad to hear your blood work and urine look better. That must be encouraging. I am so glad your doctors are monitoring you so closely.
Gossamer

[sarajane]

Has anyone heard of a high pulse being a sign of a problem? My pressure is low and my pulse is high....? Wierd.

[gossamer]

YEs. I know several women who have had what is called high cardiac output. HIgh pulse and your heart working too hard to pump. A racing pulse is one of the signs and symptoms on www.preeclampsia.org. As I have said before, sometimes high blood pressure is the last symptom to appear. I hope that helps.
Gossamer

[crazy_eights]

I think sometimes people with low blood pressure get a racing pulse to compensate for the low bp. I have to run but will post more later.

[Serenityone]

I came across this thread via another pregnancy forum community member, who suggested I read it and maybe pose my problem/delema to you smart ladies.

I will, on Thursday, be 37weeks. About 4 weeks ago I was told that I'd developed pre-e.

My Blood Pressure was consistantly running 150's-160's/90's-100's when it had previously been normal.
I started getting headaches with dancing lights
My swelling (which previously had been minimal) became insane, in fact, as I type this my hands are so swollen that all the nerves in them have been pinched off and I can't feel them from my palms to my fingertips (they estimate based on weight gain in the last month that I'm carrying around 25lbs of water that simply will not flush out of my body)
I'm spilling some (although not tons apparently) of protien in my urine.

I was placed on bedrest three weeks ago. And honestly it hasn't done a thing for any of this...

On Saturday (2-12-05) I was hospitalized because I'd gotten extremely warm and dizzy, suddenly got a headache, saw those dancing lights and fainted to the floor. When I went in my BP was 171/111, and though it decreased during my stay, it never went below 137/86 even when they took it in the morning right after I woke up.

The OB on duty wasn't the midwife who normally sees me at my prenatals/NSTs, nor was he the OB that my midwife reports to. He decided that I don't have it at all... that the symptoms are all a coinincidence (he said the headaches are migraines, for which he tried to give me Motrin IB which I was told NOT to take, the swelling is simply that I eat too much salt -which I avoid-... etc...)
And he said that my BP is a "bit high" but will come down with bedrest.
And he didn't draw my blood to do bloodwork... I'm not even sure he looked at my chart all that closely.
It kind of felt like he was trying to tell me something I wanted to hear rather than truly evaluating what was going on...

He's also gone ahead and made me extremely nervous since he decided to cancel the induction I was supposed to get on Friday, and I won't see my midwife until Thursday next week because she's out of town at a conference.

I don't understand how I can have it, and then suddenly not have it, and I feel as if this doctor is brushing it off. By no means do I WANT to have it, but if I do I'd like it to be taken seriously. He seems very much like he wants to give out a quick solution, and after reading the original post and the following replies I fear that something very severe could happen to me and/or my child simply because this guy has decided he knows better than the woman who has been providing care for me because she's "just a midwife".

So I guess my problem/question is... can pre-e just "go away" without delivery? I've never heard of this happening before... If it's not possible that it just went away on it's own, how to do I confront the hospital about this without damaging the relationships between me and the people who may end up being there when I deliver my child? I feel like I'm on thin-ice here... but I also don't feel like I was taken seriously.

Any suggestions/replies/ideas/anything would be extremely welcome!



Amandalynn

[crazy_eights]

I'm pretty shocked that an OB would make such a diagnosis without drawing any labs. Pre-e would not 'go away' with anything but delivery and it sounds as if you have gotten worse, not better. I think you need a second opinion post-haste.

[shannon0218]

I'll second Chava, you need to see another doctor and without delay, go to emerg, if they don't take you seriously, go to another emerg--I can't believe they didn't induce you when you came in at 171/111--my bp NEVER went that high and alot of people were very worried, you need blood work done right away and NO pre-e can't just "go away", it can be temporarily controlled, it doesn't go away until the baby is delivered--and since my bp just shot back up to 145/92, sometimes it takes a few weeks to get totally under control.
Please see someone else right away and let us know what happens.
I wish you the best.

[gossamer]

Amandalynn,
I cannot begin to emphasise how important it is for you to go back to the hospital immediately. Go to the ER. Unfortunately your baby is at risk right now. Pre-e does not go away unless you have delivered your baby. If you can, call the OB your midwife reports to and tell them what happened. But you must be seen immediately!!!!!!!!!!
Gossamer

[Houdini]

I am not sure if this was asked earlier, I haven't read all the posts. Does low platelet count go along with Pre-eclampsia?

[gossamer]

Low platelet count goes with a complication of pre-eclampsia called HELLP syndrome. HELLP syndrome is life threatening to mother and child. WHy do you ask?
Gossamer

[Houdini]

I had sudden on-set severe pre-eclampsia with HELLP syndrome with my second pregnancy. I was life flighted and my son was born via emergency c-section six weeks early. He was healthy and did well.
The reason I wondered was I had thrombocytopenia (low platelet) during my other three pregnancies to varying degrees. I was never diagnosed with HELLP again. I had low platelets and slight high blood pressure with pregnancies three and four. I had low platelets only with pregnancy number five. My platelets ranged from 74,000 to 32,000 depending on the pregnancy.

On an interesting side note: My daughter (#3) was born with low platelet count as well. I wondered if this would pre-dispose her to problems during her pregnancies if she decides to have kids.

[gossamer]

Pretty much anything lower than 150,000 is considered HELLP. I don't know why you weren't diagnosed with HELLP.
Gossamer

[Houdini]

They didn't say it was HELLP. They said it was thrombocytopenia, which basically means low platelets. I had blood draw done quite frequently to monitor my platelets.

[gossamer]

When you are not pregnant it may be called thrombocytopenia,but while pregnant and with other symptoms of pre-eclampsia, I would think HELLP. Did they ever do any blood tests to test your liver enzymes and RBC count?
Gossamer

[crazy_eights]

Actually, unexplained lowered platelets in pregnancy (without being part of HELLP syndrome) is not that uncommon in pregnancy. I had it in one pregnancy (hovered around 100,000, so not too low) and took care of a woman that had a platelet count of 35,000 her entire pregnancy. The hemoncologist that took care of her left an article in her chart for those caring for her to puruse that said that approx. 7% of pregnant women have lowered platelets in pregnancy for no explainable reason.

[Houdini]

They drew CBC's (I think) so RBC would have been on there. I am not sure about liver enzymes unless they are on CBC.
Do you know if there is a connection between low platelets at birth and pre-disposition to problems with pregnancy. I wondered if her platelets were low due to my platelets being low when she was born (they were 54,000).

[emmasmommy]

I have read through this thread a couple of times and want to thank gossamer and everyone for the great information here.

I just found out yesterday that I am pregnant with #2, and I had pre-e with my first. I consider myself VERY lucky that my midwife took everything so seriously right from the start. My bp started going up at 24 wks and I immediately began with weekly appointments. At 28 wks I was told to stop working (though not on bedrest yet). At about 32 wks, protein started showing up in my urine. At 33 weeks my care was moved to the high risk unit at the hospital, and at 35 weeks I was hosptitalized. My dd was born by c-section (they tried for two days to get me dialated with the gel stuff (don't know what it's called) but I didn't dialate at all) at 37 weeks weighing only 5.5lbs but very healthy. While in the hospital they put me on bp meds, did NST tests twice a day, and drew blood every two days to look for changes. My urine was also checked every morning. Before I was in the hospital, my midwife loaned me a home bp monitor and gave me a bunch of test strips and I had to test at home myself and check my bp 3 times a day and phone with any drastic changes. A funny thing with my c-section was that it was on a Sunday. They decided on Saturday that they were going to do it on Monday, but there was a doctor from another hospital that was only working at this hospital over the weekend and he wanted to do the section because he was doing research on pre-e and wanted a sample from my placenta and from my uterine wall. I happily agreed, with the hope that it will help others in the future. The only thing I didn't like was that the anethesiologist (sp?) came in to my room at 3am to discuss the spinal with me. I was barely awake, and don't remember much of what he said.

[sarajane]

I haven't looked at this thread in awhile. Has anyone brought up flax seed oil yet? My mid-wife had me on that as soon as I started seeing her. She says it helps to prevent this. Apparently there has been research on it. It is good for you either way though that is for sure. Pregnant or not, that I do know for sure.

[mtm]

Gossamer and Shannon, my bp spiked today (by 25 points yikes) and I've a wicked headache so my doc is putting me in l and d and going to watch me/likely induce me. I hit 37 weeks yesterday. Just wanted to say thanks again, you made me take this seriously.

[gossamer]

mtm,
I am sorry your bp has spiked, but I am so glad your dr is taking it seriously. 37 weeks is not bad at all. I will keep you in my prayers.

Amandalynn,
I haven't heard from you in a couple of days. Is everything ok?
Gossamer

[mwherbs]

Has anyone heard of a high pulse being a sign of a problem? My pressure is low and my pulse is high....? Wierd.

could be from the low pressure, or could be anemia talk to your care provider. very low likelihood it is pre-eclampsia-

[ramlita]

Just wanted to make sure everyone knew about the book,

What Every Pregnant Woman Should Know

and the site:

http://www.blueribbonbaby.org/

I am impressed with their work done on the subject, and think they make a lot of sense.
Both of my midwives have strongly recommended this style of diet,
without insisting that it needs be followed to the absolute letter.

[mtm]

I went in for my 37 week appt last Friday and my blood pressure skyrocketed as had my weight gain so they scheduled my induction for that night. First they tried a foley catheter which got me to 4, next day they started pitocin. Pitocin is the devil. At 6 cms I asked for an epidural, no luck, all the anaestheologists were in surgery and there was an emergency c awaiting them. He walked in just after Noah was born. Thank god I do fast labours.

Noah Riley was born on Feb 19, 7 pounds, 8 oz. He looks like a little old man, just like his older ds did. He was born with considerable breathing difficulties and rushed to the NICU where we spent several tense days ruling out immature lungs and pneumothorax (hole in the lungs). Turned out to be a bad case of pneumonia so it was a week of antibiotics, the c-pac to help him breathe and a feeding tube among other machines. He's home now though and that's all that matters. Thanks again to all of you on this thread for your support :love .

[gossamer]

mtm, I am so thrilled for you. I am glad Noah turned out big and healthy. That is everyone's ultimate goal, to have a healthy baby at the end. Success stories like yours absolutely thrill me. They give me hope that maybe some day Mary Rose will have a little brother or sister who gets to come home from the hospital. Thankyou for sharing your story.
GOssamer

[gossamer]

Just wanted to make sure everyone knew about the book,What Every Pregnant Woman Should Knowand the site:

http://www.blueribbonbaby.org/

I am impressed with their work done on the subject, and think they make a lot of sense.
Both of my midwives have strongly recommended this style of diet,
without insisting that it needs be followed to the absolute letter.


Of course a healthy diet is always the best course of action, but world wide there is a stable occurence of pre-eclampsia regardless of diet. Healthy unprocessed foods are always better than highly processed sugary foods, and I do not doubt that poor diet exacerbate a tendancy to pre-eclampsia, in the same way that poor diet could exacerbate a tendancy to gestational diabetes.

Naturally I advocate a healthy diet, but I don't want people to get the idea that a specific diet protects you from pre-eclampsia. Just because you are eating a specific diet does not mean you should not keep an eye out for warning signs and symptoms of pre-eclampsia. No-one is immune at any time.

[shannon0218]

Mtn!! Congrats on Noah, I was wondering what was going on with you :)
Gossamer, you are so right about diet and perceptions, I was back in hospital for complications from my c-section and a tragedy happened while I was still waiting in emerg that I found out more about later (my OB was on call and it upset her) This woman was under midwife care and in spite of a prior diagnosis of pre-e her midwife told her the blue-ribbon baby diet would solve all--was not even doing bp checks or anything. Ultimately this woman passed out at home, seizured and was rushed in unconcious by her husband. Our hospital air lifted her to a hospital with a nicu and she died in the chopper, baby was born by c-section immediately upon arriving at the hospital and he passed away 4 hours later. The woman was at 37 weeks and had last seen her midwife at 34 weeks and a bp had not even been done then--after all, she was following this diet to the letter so no worries.
When my ob talked to the husband while they were waiting for the chopper he mentioned she'd been having headaches for 6 weeks and swelling for 2. This was definitely 2 deaths that should never have happened.

[ramlita]

:guilty That is terrible!
There is no excuse for not providing such basic prenatal care!

I would never suggest that there is one simple, infallible answer-
for this or anything else!
I am shocked that a professional health care provider would do so.

I also want to clarify that in bringing attention to the work of the Brewers, I am not at all suggesting that pre-e only happens to women who don't eat well- that is clearly not the case. It's just that their work seems to be very successful in decreasing the incidence of pre-e/MTLP, and merits consideration,
to be taken with a grain of salt- and a heap of responsible prenatal care!

[Wabash]

I am new to this site, but wanted to add my two cents in since this is a topic very near and dear to my heart. I am currently 23 weeks pregnant with my 4th child. I lost my 3rd child, Jordan Edward, 2 years ago to severe pre-eclampsia and HELLP syndrome. He weighed 13 oz. at birth. He was born during my 26th week of pregnancy via emergency c-section. He fought valiantly for 9 days in the NICU before he died. When I was pregnant with my first child, Sarah, who is now 13, I had the same thing. I had her via emergency c-section too when she was 35 weeks along. She was fine at birth, albeit a bit on the small side weighing in at 4lbs 14 oz. When I was pregnant with my second kid, I didn't experience any signs of pre-eclampsia at all.

I am terrified of going through that again, but have a wonderful, caring OB who has put me on a regimen of heparin shots, baby asprin and mega doses of calcium to avoid another micro-preemie. She is confident that I can make it till my 32nd week (early May). I am aiming for week 36, myself! Since I am coming into the same time in the pregnancy where things started going downhill with Jordan, I am getting pretty anxiety-ridden. My bp is really low though, which is great. I go in to see my OB every week until the end of the pregnancy. They check my bp, protein in my urine, and the baby's heartbeat every time. I am also taking cranberry concentrate so I don't get any UTI's or bladder infections. I had both with Sarah and Jordan and I believe that it started my health cycling downward.

My symptoms both times included an excruciating pain in my abdomen that wouldn't go away, I also couldn't keep any food down. The nausea and vomiting were horrible. With Sarah, I had the symptoms for a week. I called my dr. and was told that I had the flu and to rest. I had also stopped going to the bathroom for several days since my kidneys had already shut down and my liver was shutting down. I hadn't noticed it at the time, I was just too sick. When I finally got in to see the dr. and they took my bp, they had me rush to the hospital. With Sarah, my bp was 130/110. With Jordan, it got in the 155/130 range.

Medical experts have no idea how to prevent HELLP/pre-eclampsia. Unfortunately it is a human-only problem so they can't replicate it in any other species of animal. So us pregnant women who get it are the guinea pigs. It's scary to know that even if I do everything so perfectly, I might still be dealing with a micro-preemie in a couple weeks.

Gossamer, I am so sorry for your loss.

[gossamer]

Dear Wabash,
I am so sorry for your loss. I am praying for your pregnancy that you do stay pregnant to 36 weeks. Please keep us updated as your pregnancy progresses.
Gossamer

[weebitty2]

My little update for y'all :)

My bp spiked EXTREMELY high all of a sudden late last month - like .. almost doubled from my normal in under 5 hours - so off I got sent for induction.

Induction consisted of AROM :) She was just ready to come out! We've been home since early this week, and she's doing beautifully .. and so am I - even if we ARE a bit tired. :)

Take a peek! (http://photobucket.com/albums/v247/heidiproulx/Melissa/?action=view&current=100_0652.jpg)

She's a good size for a 37 weeker (I made it 37 weeks to the day!) and an absolute stunner. She was born with a TON of red hair, but it's fading to light blonde now, although her eyes are still blue :) :love

[shannon0218]

Well Heidi, I have to agree, she's is a stunner :) What did she end up weighing?? Molly was also born right at 37 weeks--her hair was blond and is turning redder every day!

Wabash, I'm so very sorry for your loss :hug
How are the heparin shots going for you? I know they're a pain but I believe they are the only reason I have my little Molly here with me. Please know we're here for you during this very stressful time as you move closer and beyond Jordan's gestational age. Your story is an important one as especially with your first, your pressure didn't seem horribly high (especially your systolic) and it goes to show what Gossamer has said about it being how high the pressure is compared to YOUR NORMAL pressure.
I hope you feel comfortable with us and sharing your story, Jordan's story may just be that "example" that saves another babes life.
Btw, Gossamer, we have decided what we will be doing with Molly's placenta and I will be sure to send you a pic. We've saved it and in the spring we will be planting a Mary Rose for Molly--and in memory of your little girl. Her story will forever be a part of Molly's life. :hug

[gossamer]

Weebitty,
Your daughter is absolutely gorgeous!!!!!!!!!!! I am so thrilled you were able to stay pregnant as long as you did. COngratulations.

Shannon, you post about the Mary Rose bush has touched my heart in more ways than you can imagine. All I can say right now is thank you.
Gossamer

[shannon0218]

I'm glad Gossamer, I hoped it was not too forward, but as you know we already have one Mary Rose bush (the poor thing was horribly neglected this year because of Molly's pregnancy) and we wanted to do something meaningful with her placenta and your Mary was thought of daily during those 9 mos.

[kimisaur]

I am terrified of going through that again, but have a wonderful, caring OB who has put me on a regimen of heparin shots, baby asprin and mega doses of calcium to avoid another micro-preemie. She is confident that I can make it till my 32nd week (early May). I am aiming for week 36, myself!

I'm so sorry about the loss of your child.

I wanted to tell you that I had severe pre-e at 27 weeks with my third, but thankfully they were paying attention. After 13 weeks in the NICU, all has ended well for us. This pregnancy, I also am on daily heparin shots, baby aspirin, and being closely monitored. I'm thrilled to report that today I am 39 weeks! In my case, I think the treatments really have made a difference, and I hope they will for you too.

-Kimberly

[gossamer]

Kimberly,
That is amazing news. YOu must be so thrilled. I am glad your first little one came home and now you are expecting to bring #2 home. Do you have a family history of pre-eclampsia?
Gossamer

[kimisaur]

Kimberly,
That is amazing news. YOu must be so thrilled. I am glad your first little one came home and now you are expecting to bring #2 home. Do you have a family history of pre-eclampsia?
Gossamer

Oh, this is #4! :-) And yes, I've had pre-e with two of my previous three babies. I'm a bit flumoxed, since I was so expecting this baby to be early as well, and I've been wondering where she is for the past two weeks. :LOL

But yes, I am so thrilled. Heck, I was thrilled when I hit 28 weeks!! Bringing home a term child will just be so wonderful. :)

-Kimberly

[flyingspaghettimama]

Hi all,

I'm *just* pregnant and am hoping that I don't have the problems I had the first time with preeclampsia, HELLP, baby born at 34 weeks, NICU for a week, and sustained HBP for a week afterwards. My midwife did recommend an adequate amount of protein and healthy diet; multivitamins, and I am exercising 4-5 times a week for 20 min- 90 min (viniyasa yoga) Although this week I got the vomiting flu from my kid, so not so often! She said to keep that up and that it would hopefully make the difference. I would like to have a homebirth. I am also not letting myself eat everything in sight, which definitely happened the first time, and I'm at a better start weight to begin with. I'm lucky though, my 5 year old is now very tall for her age, sweet, and is reading the Cat in the Hat all by herself.

I did read about the Spanish study regarding the baby aspirin therapy at night - does anyone anyone know, is that supposed to be started right away or in response to specific signs during the pregnancy?

I know ultimately though, that I'll do the best I can throughout but that I (nor anyone else) knows what causes it, so there's only so much I can do other than recognize the symptoms (took the doctors a LOOOONG time to recognize last time).

[shannon0218]

Welcome and congrats, I too hope you don't experience the same problems as last time!
On the baby aspirin, the thinking is that pre-e is a disease of the placenta so the baby aspirin is supposed to help the placenta so yes, ideally you start it ASAP while the placenta is forming. Generally they will stop the baby aspirin at 34 weeks or sometimes even earlier.
I think recognizing the symptoms is more than half the battle to be honest, so many women downplay the warning signs as they are common complaints of pregnancy but when they are happening to a worse degree or more than one of them is occuring at the same time it's up to us to know our bodies and insist that something isn't right.

[SaraMama]

I just found this thread and am sooo glad that this info is here for pregnant mamas to read.

I was diagnosed with HELLP syndrome during my first pregnancy, at 23 weeks. I had no idea what was going on with me. I felt a little "weird" but didn't have headaches, epigastric pain, nose bleeds... I just happened to have my regular monthly OB appointment that day. They immediately knew I had pre-eclampsia because my BP was something like 180/125 and my reflexes were hyper-sensitive. After a blood test showing that my liver enzymes were also very high I was admitted to the hospital and placed under the care of specialists.

They immediately induced labor and after 48 hrs of labor I delivered my son, stillborn. He weighed only 13.8 ounces and was 11 1/2 inches long.

I had no family history of pre-e or any pregnancy complications really. My doctors later determined that I have an auto-immune disease called Antiphospholipid Syndrome, a blood-clotting disorder.

Since then, I've had second and third pregnancies that ended in healthy baby boys!!! :D I had HELLP syndrome again with my second. He was delivered at 34 weeks after my being on bedrest since my 29th week. We were both in the hospital for 8 days after delivery (he was in the NICU). I only had pre-eclampsia with my third. He was born at 37 weeks perfectly healthy and I didn't have to be on bedrest at all!

I was on aspirin therapy and daily Lovenox/heparin injections with my second and third pregnancies. I was also watched VERY closely, I went every other week from the start of my pregnancies, then every week, then twice a week with ultra-sounds at every appointment. Once I was in my third trimester I was doing non-stress tests every week also.

I feel that I owe my life and the lives of my boys to my excellent doctors. They were awesome during everything.

A couple weeks after my third pregnancy I had a blood clot in my leg (DVT). A week later it traveled to my lung (pulmonary embolism). I was at increased risk for this due to my Antiphospholipid Syndrome. They tried treating the DVT with the same Lovenox/heparin therapy that was used during my pregnancies, but I'd developed an allergy to it due to being on the medication for such long periods of time. So, I had to be admitted to the hospital for 9 days (this was when my third ds was only 4 weeks old) on intravenious treatment to thin my blood. I couldn't breastfeed him, so he was on formula and I was pumping and dumping to keep up my supply. It was a very stressful time for both of us because we were separated for that length of time.

Anyway, I'm now on Coumadin for the rest of my life. At 26 years old, that is scary, but better than the alternative!

I hope that all pregnant mamas at MDC read this thread. It helps so much just to be in tune with your body so you know when something is not right.

Thanks for letting me share my story!
:D

[jillene]

I'm new to the MDC boards but unfortunately I'm not new to Pre-e. My first was born at 36 weeks due to a sudden onset of pre-e. I went from feeling perfectly fine one week to a week later spilling protein (+3 on the strips, and 2.5g at the 24 hour urine collection), having headaches and seeing spots. So they delivered right away. My OB at the time lied to me to perform a cesarean after only 6 hours of induction (which was progressing well, though slowly) so that he could begin his weekend. My son was taken to the Children's Hospital of Philadelphia (we live about an hour away in Southern NJ) and put on a ventillator. We were able to bring him home after 16 days.

This time around I'm seeing a perinatologist, Dr. Debbs, and a different OB, Dr. Bredin. They've both been great so far. I was really hoping for a VBAC this time around but it's starting to look like that may not be in the cards. I had an OB appointment today with a CNM, Monica. This was my first time meeting her. Dr. Bredin wanted me to meet the other staff though she's the only one who can do my delivery because I'm high risk and where I'm delivering. Today my bp was 130/83 (normally 112/60) and there were trace amounts of protein in my urine. I've been swelling the past couple of weeks in my face and feet, and I've been having headaches and nausea. I've also been having nosebleeds pretty often, which didn't happen the first time. The CNM is being pretty relaxed about it and wants me back in a week instead of 2 to check my protein levels again. Dr. Debbs told me he wanted to see me if I started showing any signs of pre-e again. So I called his office and scheduled an appointment for Tuesday. I don't feel that the CNM was taking it seriously enough at all given my history. I'm 31 weeks 3 days along right now. I'm so scared that I'm going to have to go through all of that again and having a preemie 75 miles away with an almost 2 year old at home who needs me as well. I'm dreading having to schedule a repeat cesarean. We just moved into a 3rd floor apartment with no handicapped access (dumb, I know). I have no idea how I'll get up here after a cesarean. I had enough trouble shuffling around after Aidan without adding 30 stairs to the mix. I also dread having to be away from one of the kids at all times. I'm going to feel horrible when I'm at the hospital with Ryan because I know Aidan will be missing me and not understand why mommy is gone all the time but I'll feel just as bad at home when I know my helpless little newborn needs his mommy too. I guess it wouldn't be so bad if the NICU wasn't over an hour away. I don't know how people do it.

Anyway, I just wanted to say I'm glad this thread is here. I didn't realize the stomach/rib pain was also a part of it. I had it pretty severely when I was pregnant with Aidan and for a few weeks after and my OB said it was normal. I would have insisted on further evaluation if I realized it was a sign of liver dysfunction. I have had it again the past couple of weeks but had written it off because of last time. It's something I'll definitely bring up with the perinatologist on Tuesday. I've had swelling/headaches the past couple of weeks and had a feeling things were going wrong again. The elevated bp and protein in my urine have me even more worried. I'm trying to stay calm and relaxed but it's definitely hard. I'm hoping the earlier symptoms this time aroud means it will progress more slowly and we'll still be able to make it close to full term. I'm definitely not ready to have him yet!

Jillene

[shannon0218]

Jillene, when is your appointment with your OB, I think you are very right to be concerned, however, I honestly don't know that I'd wait too long, you have a spike of 23 points in your lower number and that is serious. Are you currently on blood pressure medication?? One thing to consider is if you insist on being taken seriously, it is often possible for them to control things with blood pressure meds for at least a little while to get the baby further along--the problem from my understanding however is that once it's gone too far, it's just too late for attempts at control. I definitelywould not suggest waiting until the appt with your peri on Tuesday. Do you have a home bp monitor?? Trace protein is no big deal, but headaches, facial and upper extremity swelling, nosebleeds and nausea are far too many red flags in my opinion. Couple that with upper quadrant pain (which side is the pain on????) and I really think you need to be getting liver enzymes and a 24 hr urine done NOW, not next week, especially at only 31 weeks.
I'm not trying to scare you (well, yeah, I guess I am trying to scare you, but better scared for no reason than sorry)

[Quirky]

Jillene, :hug I'm no expert but I agree with Shannon - I think Tuesday is too long to wait to get checked. Please call your OB TODAY and insist on being seen. Otherwise go to the ER. Please don't wait. Better safe than sorry.

[gossamer]

Dear Jillene,
I am so sorry to hear about your first experience with pre-e. After Aidan was born did your Dr.s do any dna blood work on you to test for blood clotting factors? Have you been on any aspirin therapy of heparin shots this pregnancy? I am sorry that it looks like pre-e is rearing its ugly head again. PLease keep us posted on your progress. I am glad you called your doctor back and made an early appointment but I think maybe you should see your doctor sooner than that if possible. I would have some words to say about the CNM's lackadaisical attitude. Especially since you have so many sypmtoms. We have a member here, Kimberlylibby, who was on bedrest for a few weeks and managed to stave off pre-e until her daughter was ready. I will keep you in my prayers.

Saramama,
Thank you so much for sharing your story with us. It is always so encouraging to read stories with positive outcomes. I hope you stick around to be an inspiration to the rest of us.
Gossamer

[acrathbun]

Hi Jillene,

You've gotten some great advice so far, I just wanted to say hello and that I've struggled w/ pre-e & HELLP. My boys were born at 31 & 32 weeks...so if you go that early, I'll be thinking of you.

[jillene]

Shannon, I had an appointment today with the midwife and I have an appointment for next Friday to follow up on the protein, again with the midwife. The OB is apparently completely booked all next week (I asked to see her instead of the midwife again). I was told I could try calling each morning to see if she's had a cancellation but otherwise it would be a couple of weeks before I can see the OB. That's why I called the peri directly instead of waiting until after next Friday. The soonest they could get me in is Tuesday.

I am not currently on any type of bp medication or treatment. My bp never spiked the first time and has been normal up until today. I think the reason I'm more concerned with the protein is that I do have a genetic condition that predisposes me to kidney problems (Nail Patella Syndrome - http://www.nailpatella.org) and because that was the only measurable sign they had the first time around - the sudden spilling of large amounts of protein.

The pain is on the right, just under my ribs. There isn't any atm, it comes off and on. I can't lay on my right side though because it hurts too much and makes it really hard to breathe. I'd just figured it was the way the baby is positioned because his butt and feet are on the right. His head is right down in my pelvis.

I do not have a home bp monitor. I was told by my insurance case manager that I can get one and a nurse to show me how to use it for free if the doctor says it's needed. I may just have dh pick one up on the way home from work though. He has to go to WalMart anyway.