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#1 of 38 Old 02-16-2011, 06:22 AM - Thread Starter
 
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I thought I'd start a thread to see if there were any other high(er) risk mamas here, and have a thread where we can share our experiences. (Please, if you haven't gone through a high risk pregnancy, don't crash this thread to advise us against testing or procedures.)

 

I have chronic hypertension (baseline 165/105) and a history of superimposed preeclampsia. My daughter was delivered by emergency CS at 37 weeks--I was too sick for induction. Not too terrible but I do get extra monitoring and I'm staying on beta blockers. My MFM said that since my Toprol is controlling my BP there's no reason to switch to labetalol. Plus, this baby is the result of fertility treatment, so I'm being extra careful.


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#2 of 38 Old 02-16-2011, 06:44 AM
 
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I'm high risk.  Type one diabetic.  Not controlled as tightly as I would have liked at conception, but things have been pretty darned controlled since.  This is my first, so I'm pretty on edge, but trying not to stress too  much and enjoy it.  I'm very happy and excited, but very nervous too.  It is a lot of work, constantly adjusting everything.  I'm up several times a night testing my blood glucose because it seems to go high at night then crash. 


Thanks for starting this thread.  Even with different medical issues, it is so nice to hear success stories of mamas who have faced medical issues and gotten through it!


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#3 of 38 Old 02-16-2011, 07:01 AM
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Like livacreature, I am type 1 diabetic.

 

This is my second pregnancy. My first was a healthy pregnancy, no complications, but birth was a trainwreck -- c/s after a long and complicated induced labour. I also found the 'something terrible could happen AT ANY MOMENT' attitude during pregnancy totally exhausting, not to mention the enormous amount of time I spent in appointments, making sure that everything still looked a-ok.

 

I'm finding it a lot easier the second time round so far. I test a ton, adjust my basals and ratios, and while it's definitely a lot of work, I knew what to expect so it isn't quite the shock it was the first time. I'm also in a different place in my life, and less naive about how the health system works. For my first, I was still a fairly new grad student and just getting started in medical research. Now I'm done my phd and my area of research gives me more insight into medical risk than I had the first time, which I expect will make for slightly easier conversations with health care providers.

 

livacreature, that (nighttime high followed by a crash) happens to me if I eat anytime in the two-three hours before bed. I just don't do that when pregnant and it makes life a lot easier. A little big of cheese, eggs, nuts, veg, etc. work fine (you know the drill), but nothing that requires a bolus, make sure overnight basals are tuned well, and voila, no problems and no sleep disturbance.


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#4 of 38 Old 02-16-2011, 04:23 PM
 
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I have pcos & thus am insulin resistant - but that seems to be getting worse & worse despite my best efforts. I had gestational diabetes with ds & fully expect to again.

 

I've actually been testing my bs the last couple days to get a baseline to bring to my ob next week. I'm really hoping to avoid the awful glucose challenge tests. Unfortunately I am finding my fasting is consistently high. The rest of the day things seem to be ok but I can't seem to get that fasting down. Frustrating. That was what I struggled with last time too.

 

The most annoying part was definitely all the extra appointments & the stress of that (the endo that I saw last time would talk c-sec every. single. time. I saw him leaving me stressed & in tears - grrrr.).

 

I'm in a different country this time so it'll be interesting to see the difference.


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#5 of 38 Old 02-16-2011, 05:01 PM - Thread Starter
 
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I also have PCOS with IR--my sugars were okay last time, but it's been 4 years, and I'm nervous they won't be now.


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#6 of 38 Old 02-20-2011, 06:22 PM
 
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I had GD with my second, and expect to again this time. I was lucky because I was able to achieve excellent control with diet and exercise. I certainly hope that is the case again, but its 2 1/2 years later... (however, I am also starting out 30lbs less, which ought to help some). I was also lucky that my HBMW was totally supporting me throughout b/c those mainstream folks (and I was seeing midwives!) were super stressful.

 

Planning a HB this time too, and I am going to talk upfront with MWs before we hire one about how they will help me manage my diet and blood sugar and their approach to GD moms. I probably won't do a GTT, just start monitoring (like Lifeguard). I'm across the country now so I can't have the same MW, which is too bad, b/c she was so incredible- knew a ton about mainstream and alternative health, was GREAT with diet too. I have my old forms for logging food, exercise, sleep and BG, so I can still use those.

 

There was a GD support thread at the time, which was so incredibly helpful for me. Finding other mamas going through the same things just made a huge difference in my emotions and stress. I didn't feel alone and isolated about it... And- Lifeguard- I think we might have missed eachother on that GD thread b/c you were a little ahead of me, but I remember you from it! (It was really, really long, took me several weeks to read the whole thing by the time I joined).


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#7 of 38 Old 02-20-2011, 06:28 PM
 
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I am considered high-risk because I have Leiden Factor V, which is a genetic mustation that causes overactive blood-clotting.  With my first I took blood thinners, with my second, I didn't and both turned out fine.  My mom and grandma both have the genetic mutation as well, and had lots of healthy babies- they didn't know about it back then.  So I don't really consider it to be a high risk, but the docs do. 

 

If anyone else out there has it, all I can say is don't worry too much- my family has had lots of healthy babies and we all carry it!

 


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#8 of 38 Old 02-20-2011, 07:13 PM
 
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I had a high risk pregnancy after 7 miscarriages between 12-14wks. The whole pregnancy was very difficult I have CIDP which my body attacks my nerves. I had to be in a wheelchair for 4mo of my pregnancy. I was in the hospital weekly for IVIG infusions. I had GD and preeclampsia. I was induced at 35 wks due to extremely high BP. I never dilated so after 36hrs I had a c-section.  After the C-section I needed a blood transfusion then my uterus wasn't clearing the lochia so they wanted to do a D&C on be, but because my son was in the NICU I wouldn't consent because it would be another 24 hrs before I would be able to see him and I was hysterical about not being able to see him. So instead of a D&C the doctors removed the lochia manually which was the worst part of the whole event but allowed me to see my son sooner. My son had several problems that kept him in the NICU for 4wks. The NICU is a very frustrating place because ever thing is about measurable increments up or down multiple times each day, they had a lactation consultant who tried to encourage breastfeeding but the doctors discouraged it for so many reasons in the end to get my son home I had to agree to put my son on formula otherwise they were going to send him to a step down hospital. The doctors make it seem like they are all powerful because if you don't agree with what one of the doctors told me was that I would be going against medical advice and there would be serious consequences for that, to threaten me.

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#9 of 38 Old 02-21-2011, 04:48 AM
 
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Ugh, I had a horrible blood sugar day yesterday.  I had my highest reading since finding out I was pregnant (376) due to an issue with my infusion set.  Then I plummeted to 35 and blacked out for the first time in eleven years of diabetes.  It took 32 ounces of OJ, 16 ounces of milk, 1 fistful of glucose tabs, and 2 peanut butter waffles to even get me to break 70.  DH was worried, so was up every two hours testing me to make sure I didn't bottom out again.  I'm trying not to stress over ever abnormal reading, but yesterday sucked!


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#10 of 38 Old 02-21-2011, 05:43 AM - Thread Starter
 
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Oh no!

 

I have to do a GTT today. :( My OB wants to rule out preexisting Type 2. It is theoretically possible that I have it and it was masked by taking metformin and Byetta, although my last A1C was 6.0.

 

Plus, my BP was 140/85 on Friday, which made me a little nervous--last month it was 115/70. Anything below 140/90 is okay in pregnancy so it's not concerning in that respect, but your BP is supposed to go down in the first trimester, not up... and this happened in my 1st pregnancy too. I actually thought it was a bit low because I've been getting dizzy, but I guess that's something else. I've got an appointment with the internist tomorrow, anyway.


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#11 of 38 Old 02-21-2011, 06:01 AM
 
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I hope it goes okay for you, Alexis! 


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#12 of 38 Old 02-21-2011, 10:27 AM
 
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emmaegbert - that gd thread was crazy long but it was also kind of helpful. Maybe someone will need to start a new one!

 

thamilton - that sounds very stressful. I hope this time around goes much smoother for you.

 

livacreature - what a terrible day.

 

Alexis - good luck. I don't really get why it's so important to diagnose type II that may be masked. I mean, even if you do have it, it's well controlled so what's the difficulty? I am worried my doc will feel much the same way.

 

I see the doc this week so we'll see what he wants to do from here.


Surviving sleep deprivation one day at a time with dd (Oct '11) & ds (Oct '08).

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#13 of 38 Old 02-21-2011, 10:37 AM
 
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Quote:
Originally Posted by TeacherMomma View Post

I am considered high-risk because I have Leiden Factor V, which is a genetic mustation that causes overactive blood-clotting. 

 



I also have Factor V Leiden. I was only recently diagnosed when I went to talk to an OB about TTC. It explains most of the issues I had with my first birth (emergency c-section, IUGR, no amniotic fluid). I'm going to start taking the blood thinners (Lovenox) very soon. Injections every day- a little nervous about that, but I want to have a healthier baby/birth this time if I can help it.

 

I want to be treated high-risk this time so I don't mind the label. I'm focusing on a VBAC but am being open-minded about the path to get there.


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#14 of 38 Old 02-21-2011, 10:38 AM
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Best of luck, Alexis. Hoping for no type 2 for you.

 

livacreature, ugh. I hate the swings, even when they aren't quite that dramatic. That must have been really scary for your DH. For what it's worth, I find that I need to really stay on top of set changes during pregnancy. They just seem to go bad much more quickly. I have never been able to get a good explanation as to why that might be, but it's definitely true for me, and I know other women experience it as well. I am normally pretty laissez-faire when it comes to set changes ('hey, it's day seven and you're still working -- awesome, let's keep going, then!') but when pregnant I put reminders on my calendar to change 3x a week.


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#15 of 38 Old 02-21-2011, 11:03 AM - Thread Starter
 
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Quote:
Originally Posted by lifeguard View Post

 

Alexis - good luck. I don't really get why it's so important to diagnose type II that may be masked. I mean, even if you do have it, it's well controlled so what's the difficulty? I am worried my doc will feel much the same way.

 

The issue is that it would've been masked and controlled when I wasn't pregnant... but it wouldn't be now, because I'm off my meds. Management of T2 is different for pregnant and not-pregnant, too--docs differ in their approach to oral meds, but i would still need to control my diet more carefully, monitor my sugars, and might wind up on insulin.

 

Hopefully, I'll be okay. I think I am, and I won't mind the baseline. The glucola is disgusting, though!


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#16 of 38 Old 02-21-2011, 03:52 PM
 
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I am high-risk as well and like you AlexisT my issue is hypertension.  I developed severe preeclampsia at 38 weeks with DD#1 and my blood pressure never returned to normal post-pregnancy.  Throughout my pregnancy with DD#2, my blood pressure was fairly well controlled until 37 weeks, when I was induced after failing the 24-hour urine test and some really wacky BP readings. 

 

So far my BP has been pretty good.  I'm taking labetalol.  Hoping for the best!


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#17 of 38 Old 02-21-2011, 06:05 PM
 
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Hi ladies,

 

I have Lupus (SLE) and just found out today that I also have APS, or *antiphospholipid antibody syndrome (defined at bottom). I am totally stressed out about this added hurdle in my pregnancy. I am reading so many scary things about it, and wonder just how common things like still-births and mental health problems actually are?

 

Anyone else with an autoimmune disorder or knowledge of this? My rheumatologist suggested low molecular weight heparin at my last appointment, but I wanted to wait. I really hate all this. Grrr.

 

 

 

 

*Antiphospholipid Antibody Syndrome or APS is an autoimmune disorder in which the body recognizes certain normal components of blood and/or cell membranes as foreign substances and produces antibodies against them. Patients with these antibodies may experience blood clots, including heart attacks and strokes, and miscarriages. APS may occur in people with systemic lupus erythematosus, other autoimmune diseases, or in otherwise healthy individuals.

APS is also known as APLS, APLA, Hughes Syndrome or "Sticky Blood."

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#18 of 38 Old 02-21-2011, 08:11 PM
 
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Alexis - that makes sense. I'm not off of the metformin & am pushing to stay on it for the whole pregnancy. I realize I may have to switch to insulin later but if I can avoid it this time that would be terrific.


Surviving sleep deprivation one day at a time with dd (Oct '11) & ds (Oct '08).

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#19 of 38 Old 02-22-2011, 02:24 PM
 
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I went for my viability ultrasound today because this bub wasn't exactly meticulously planned and they said everything looked great.  I'm measuring 6 w 1d which is a week behind what they initially calculated, but I already knew I ovulated later than that and the heartbeat sounded good.  So relieved!  joy.gif

 

On the frustrating side my pump kept saying it wasn't primed today.  Finally it stopped.  Not sure what the deal was.

 

I imagine switching to insulin during pregnancy would be intimidating with all the changes your body is going through anyway!  

 

FOF: I've never known of someone with APS.  How did they screen for it?


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#20 of 38 Old 02-22-2011, 05:02 PM
 
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LivaCreature: They can actually screen for the antibody. They usually do two to three screening 6-12 weeks apart to determine APS.

 

My OB made me feel much better today about everything. I start heparin injections tonight. Fun.

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#21 of 38 Old 02-22-2011, 10:40 PM
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livacreature, great to hear!

 

famofour, I have a couple of autoimmune disorders that are related to each other (type 1 diabetes and Hashimoto's), but nothing related to Lupus or APS. That sounds really difficult. A new diagnosis is always daunting; I can only imagine how much more so during pregnancy. I'm so glad your OB was able to be of comfort.

 

I got bloodwork back today and everything is looking good, though my iron remains stubbornly low and my thyroid numbers are inching off target. A1c was 6.5, down from the 7.1 it was shortly before conception, so that's pretty good news. The time period of the test would have covered a good chunk of time before pregnancy, too, including the holidays, and since my numbers have been excellent ever since I found out, I am confident that I am doing well. I am aiming to have the A1c under 6 by next blood draw. I kept it sub-6 throughout my pregnancy last time, and it definitely made everyone panic a lot less.


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#22 of 38 Old 02-23-2011, 12:06 AM
 
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As someone with recurrent miscarriages, APS was certainly on the table as a possibility.  However, after all our testing, we don't have a reason. 

 

With anti-coagulents, and really careful prenatal care, especially in the third trimester, APS affected pregnancies have great outcomes.  It's going to be an intensive ride, but it will likely work out just fine.  I would liken it to a more complicated twin pregnancy.  Lots of verifying, occasionally suggesting a premature birth, but mostly fine. 

 

 

I'm in a weird place, personally, because I'm a homebirth midwife, and I'm planning a homebirth, but I've got a few things going on, medically.  I have kidney issues that put me at higher risk of pre-eclampsia, and I have "unusual" immune labs, although no diagnosed condition.  This is my fifth pregnancy, and the only one to progress past 7 weeks.  I've had 4 ultrasounds so far, and two more scheduled before 13 weeks.  It's certainly not the care I imagined when pregnant for the first time.  But I'm very grateful for it. 

But I miss optimism. 


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#23 of 38 Old 02-23-2011, 07:15 PM
 
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Jane: Wow, a homebirth midwife with a high-risk pregnancy, that must be hard. I totally know what you mean about "missing optimism", it much easier said than done to be positive.

 

The word "intensive" makes my stomach sink, but I remain hopeful that despite any intensity, I will still have a lovely, calm birth which bears a lovely, calm child. 

 

LivaCreature: I really wish that this APS would've been caught sooner, so that I could be more prepared for the injections and the complete despair I felt after finding out. But, I am pregnant with a baby and I am happy for that and grateful. Whatever I time I get with this little once, is time well spent and appreciated.

It sounds like you're doing so well! My professor in college has Hashimotos (diagnosed when she was 25, in the early 80s) and went on to have five children and not a single miscarriage. All over pregnancies were high-risk, but undamaging.

 

I started my Fragmin (Heparin) today. I hope I get used to injecting a needle inside of myself. 

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#24 of 38 Old 02-23-2011, 11:33 PM
 
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Thanks for the thread -- I'm a high-risk pregnant mama.  Because of a luteal phase deficiency, I struggle with my progesterone level in the first trimester.  I'm always well supplemented, but my levels sometimes crash around 8-9 weeks causing a loss.  After a couple of my losses, my MFM suspected a clotting disorder like Factor Leiden V, but test results came back fine.  He keeps me on a baby aspirin throughout every pregnancy because he said I could be reacting to the high doses of progesterone (clotting is a side effect) or I may have some issue for which there is not a test (totally my luck!).  To closely monitor my hormone levels, my doctor orders blood work for me every Monday and Thursday for the entire first trimester.  Draw #4 is tomorrow -- only 12 more to go after that!

 

I have a history of pre-term labor, so I take weekly 17P Hydroxyprogesterone injections beginning at 16 weeks gestation.  I also have a history of cervical incompetence with two failed transvaginal cerclages.  One failure led to 15 weeks of bedrest with our oldest daughter Gracie, the other failure led to the death of our son Zachary.  After Zachary died, I had a transabdominal cerclage placed, so while my cervix is now essentially irrelevant in a pregnancy, I'm subject to bimonthly monitoring by sonogram to watch for potential risk of rupture.  My first sonogram is Friday to look for the placement of babies in relation to my cerclage.  If all goes as swimmingly as I hope, I'll have an amnio around 37 weeks, and deliver by c-section around 38 weeks sometime in early October.

 

Glad to meet you all!


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#25 of 38 Old 02-24-2011, 05:13 AM
 
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Hi Mamas!

  I am high risk as well due to a rare Factor VII bleeding disorder.  With my Daughter I also had to be induced for preeclampsia (?HELLP) at 35 1/2 weeks.  They gave me a ton of plasma when I delivered and I am hoping to avoid that this time.  Anyone know the incidence of recurrent preeclampsia?


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#26 of 38 Old 02-24-2011, 06:30 AM - Thread Starter
 
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Overall rate is 20% but it varies hugely depending on when you developed it and other risk factors. So, a woman who develops mild preeclampsia at 41 weeks is at less risk than a woman who developed severe PE at 36. Clotting disorders are a risk factor.

 

I passed my GTT, thankfully!


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#27 of 38 Old 02-24-2011, 08:37 AM
 
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AlexisT, great news about your GTT!

 

Steedalyn, I've heard that the rate is about 20% as well -- but I think it's really dependent on your individual risk factors. Your HCP could probably give you the best estimate.  I hope you stay healthy and avoid induction this go round!


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#28 of 38 Old 03-11-2011, 12:09 PM
 
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I had a super-great ob appointment this week.

 

1) I have been told repeatedly by care providers that I would pretty much be an automatic c-section if I ever got pregnant.  The ob I'm seeing said that their type 1 diabetic moms, so long as there are no other complications, are about at 25% for their practice.  She said that they address problems as they are, but in her experience, they can create a lot of problems by doing a one-sized fits all approach for a disease that can be unpredictable.  :-D  Also, the NICU is on the same floor as the maternity wing, so if there are issues, you can visit and bond as soon as possible.

 

2) The lab FINALLY sent over my blood work.  When I was three weeks pregnant (general routine, no prenatal draw) my A1C was 6.9 (much better than my 8 in July!) and my seven week was 6.1!  I'm super excited by this.  Everything else was totally normal.  They did full work ups on some random things per my request (blood cancers are very common in my family, generally striking people in their 20s and 30s, and all of those were good and normal too).

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#29 of 38 Old 05-21-2011, 04:15 PM - Thread Starter
 
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Bumping this thread!

 

How's everyone doing? My BP has been so-so--controlled well, but no drop. Quad was fine (although false-positive AFPs are a bad predictor, and I missed the screening window with DD so I have no history to go on). Color doppler looked good (or at least he said, "everything looks good"). Baby is big. Then again, my severe pre-E baby was 8lbs1oz at 37 weeks, so even when my placenta hates me, it can still suck my blood.

 

OB said I'm looking at NSTs from 32 weeks.

 

I'm starting to hope that I might dodge the bullet this time... but I know that optimism is my downfall. I always get what I don't expect. So if I expect superimposed PE again, I won't get it, right? (Actually, I really don't expect anything remotely like last time because I'm being monitored so much more closely. Realistically, I'm more worried that I'm going to start showing warning signs and they'll decide to deliver me at 37 weeks before it can get bad again.)


DD 01/2007, DS 09/2011

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#30 of 38 Old 05-21-2011, 07:41 PM
 
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Im considered high risk due to my weight and B/P which was running upwards of 190/100s.

 

Im happy to say that thanks to finally getting my ass in gear with taking my meds I have gotten it down to the mid 120s/80!
 

Im really proud of myself but Im worried it will skyrocket again :(

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