Pre-Eclampsia Watch Dog on the loose. - Page 15 - Mothering Forums

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#421 of 601 Old 06-10-2006, 01:22 AM
 
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Could you please find me some examples of studies that showed an increased morbidity?

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

I would be interested in that information.
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#422 of 601 Old 06-10-2006, 12:35 PM
 
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Originally Posted by maxmama
I would ask why the bedrest, period. Ask for some studies that show it actually does anything for preeclampsia, because there's any number of studies showing significant morbidity associated with bedrest. My perinates are nationally known PE researchers, and don't do bedrest at all in their clinical practice.
Very interesting. I haven't seen any of those studies, can you point me in the right direction so that I can read them?

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

I'm not going to do anything to put me or baby at risk. But if outright bedrest is also a risk I'd like to discuss that with her too.
Thanks,
Jen
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#423 of 601 Old 06-10-2006, 01:39 PM
 
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The morbidities weren't PE related; they're nonspecific to bedrest in general. They include loss of muscle mass, loss of cardiovascular function, increased risk of DVT and pulmonary embolus and depression. One interesting one is an increased risk of colic in newborns (see Bellieni, et al.).

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

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

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

References:

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


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


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

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

Goldenberg RL, Cliver SP, Bronstein J, Cutter GR, Andrews WW, Mennemeyer ST. Bed rest in pregnancy. Obstetrics and Gynecology. 1994 Jul;84(1):131-6.

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#424 of 601 Old 06-11-2006, 10:56 AM
 
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Thanks maxmama!!!
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#425 of 601 Old 06-11-2006, 07:55 PM
 
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New update!

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

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

eta: Had my u/s today. She said he's about 3.5 lbs (give or take a lb either way, lol). He was also heads up which explains the bump between my ribs but he's got time to flip.
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#426 of 601 Old 06-22-2006, 01:57 PM
 
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Well, I did a 3rd 24 hr urine and it was 348. I know it's still not great but much better than the first. My bp is still within normal limits. I'm seeing the ob every Friday from now on. So now we just wait to see where we go from here.
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#427 of 601 Old 06-22-2006, 02:20 PM
 
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Oh Jen, the waiting game is SO hard isn't it.
I know I and I know Gossemer as well felt so much better when we passed 28 weeks. No it's not a great time to be born but more babies make it then than not.
Out of curiosity, have you been tested for clotting problems?? There is a significant increase in the thought that clotting issues (both genetic and aquired) play a major role in pre-e. Since you've had pre-e before, it may be worth checking out.
Some of the tests are less reliabe in pregnancy but maybe they could at least get a general idea of whether you're over clotting or not. Any history of stroke or DVT's in your family???
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#428 of 601 Old 06-23-2006, 12:32 AM
 
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Oh Jen, the waiting game is SO hard isn't it.
I know I and I know Gossemer as well felt so much better when we passed 28 weeks. No it's not a great time to be born but more babies make it then than not.
Out of curiosity, have you been tested for clotting problems?? There is a significant increase in the thought that clotting issues (both genetic and aquired) play a major role in pre-e. Since you've had pre-e before, it may be worth checking out.
Some of the tests are less reliabe in pregnancy but maybe they could at least get a general idea of whether you're over clotting or not. Any history of stroke or DVT's in your family???
I am happy to be at 32 wks. My dd was born at 35 so I will feel even better then.

I never had any clotting issues testing. In fact, I knew nothing about it before I found this thread after I was already pg. As far as I know, there is no family history in my family at least back to my grandparents. I'll ask my dr tomorrow.
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#429 of 601 Old 07-02-2006, 12:32 AM
 
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I know this is a rather old thread but I wanted to bump to ask a question. Has anyone dealt with significant kidney disease (prior to pregnancy) and pre-e/pih? Specifically, a disease that would rule out a high protein diet?
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#430 of 601 Old 07-02-2006, 03:25 AM
 
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I don't have personal experience w/ kidney disease, but I did want to say that I'm pretty sure the high protein diets don't prevent Pre-e, etc. There's a lot of hype, but no real data. Someone please correct me if I'm wrong.
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#431 of 601 Old 07-02-2006, 02:10 PM
 
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Quote:
Originally Posted by acrathbun
I don't have personal experience w/ kidney disease, but I did want to say that I'm pretty sure the high protein diets don't prevent Pre-e, etc. There's a lot of hype, but no real data. Someone please correct me if I'm wrong.
That's true. The data supporting the Brewer diet, etc., all are from small studies done many years ago, and despite numerous studies, have never been successfully replicated.

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#432 of 601 Old 07-02-2006, 02:34 PM
 
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Hi all,

Just an update. I'm now 34 wks. At my appt on Friday my bp was the lowest it's been yet. Yay!! My protien is holding steady in the mid 300s. Things are looking good. I even lost weight this week, odd since I felt like I had gained a ton, lol. Anyway, just wanted to keep you all posted and let you know we are still laying low and doing fine.
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#433 of 601 Old 07-02-2006, 02:47 PM
 
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Oh Jen, that's so great!!!
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#434 of 601 Old 07-08-2006, 01:53 AM
 
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Is there anything I can do to help my poor friend?

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

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

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

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

I feel so helpless. She is my very best friend, and our relationship is like no other that I have. I would be lost without her, as would her family and countless other friends. Is there anything that I can do beside pray? Why didn't her Dr. take the signs more seriously? Is there hope?

Wife to my DH Mama to my two girls  hearts.gif'03 and love.gif '06 and my sweet babyboy.gif 3-'10 I am blessed.
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#435 of 601 Old 07-08-2006, 02:03 AM
 
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I'm sorry about your friend, I'm not sure what you can do now, other than when she's better to encourage her to ask some serious questions and demand some hard answers.
I almost died after a d&c, my ob/gyn was awesome but I went into DIC and the internists at this hospital SUCKED. They sent me home in a full out addison's crisis that was textbook, they told me I was depressed and to go see my ob. My heartrate was in the high 170's. I did see my OB and she called the internist, I heard her on the phone saying "NO, she is not fine, I've seen her through 3 miscarriages and she is NOT fine. What do you mean you won't see her again??" She insisited I go to a different hospital where I was in a rescussitation room shortly after arriving. She strongly encouraged me to fight the hospital. She printed out the forms for me to make a complaint to the college. She got me the phone #'s and "titles" of every person at her own hospital that she thought needed to know about this. It's helping to validate things for me. Ultimately, what I want is for that ass of a doctor to look at my daughter and then explain to me why he sent me home to die (had my ob not seen me that Friday afternoon, they figure I'd have been dead no later than early evening--they actually can't believe I lived long enough to see her) I know that will never happen and I still have dreams about going into emerg when I see his car in the parking lot (small hospital and I've seen him around town...I know what he drives) and confronting him. I may still, I'm not giving up on that idea.
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#436 of 601 Old 07-13-2006, 07:34 PM
 
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I just got the results form my triple quad screen and it showed elevated hormone levels.. genetic counselor seems to think that it is more related to hypertension/possible placental problems/risk for preterm labor.. anyone with this expereince? HELP
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#437 of 601 Old 07-14-2006, 05:27 AM - Thread Starter
 
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Sarah,
What hormones are elevated? I am not sure I understand correctly? My triple screen cam back high for Mary Rose on the Spina Bifida end and I was told that I was at higher risk for IUGR and pre-term labor. IF your levels came back high, I would strongly suggest keeping on your doctor about monitoring your urine via 24 hour test, your blood pressure and your liver enzymes. ALso possibly frequent ultrasounds to measure your babies growth.
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#438 of 601 Old 07-14-2006, 02:39 PM
 
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I had learned in my Bradley birth classes of a doctor who had virtually no incidence of preeclampsia with his patients, and he told them to get at least 100 grams of protein a day. I stayed at home and got this amount with my second one since I kept a nutrition chart, and I had BP that was 90/60 and no birth complications. With my first, I was working full time and not keeping tabs on my nutrition and showing BP of 140/80 and protein in the urine, but it dissipated by my next doctor visit. Most people don't get enough nutrition, so I think this may actually point to the cause. I do think stress is a major factor---if the body and mind have to deal with too many stressors in the environment, I think it feels forced to reject the pregnancy as an auto-immunological response, with devastating effects on the mother and baby. We can look at pregnant animals, too---for example, livebearing fish will abort their brood if moved by hand too close to their 'delivery' date, and a mother bird will abandon her eggs if she can scent another animal on them. I don't think humans realize that the pregnancy needs to be nurtured, and that a smaller dose of everyday life combined with rest and relaxation would probably reduce the incidence of this horrible disease----just my theory, gals.
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#439 of 601 Old 07-14-2006, 02:56 PM
 
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Originally Posted by sarah9774
I just got the results form my triple quad screen and it showed elevated hormone levels.. genetic counselor seems to think that it is more related to hypertension/possible placental problems/risk for preterm labor.. anyone with this expereince? HELP
Hi, I had an increased chance of Spina Bifida with dd too. Luckily u/s showed no signs of it and I declined the amnio. I did end up with high bp, slightly elevated protein (still under 300), and gave birth 5 wks early. Baby was fine though. Nobody seemed to know if the AFP results had anything to do with all that happened later.

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

Jennifer
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#440 of 601 Old 07-14-2006, 03:54 PM - Thread Starter
 
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Originally Posted by bradleybirth2mom
I had learned in my Bradley birth classes of a doctor who had virtually no incidence of preeclampsia with his patients, and he told them to get at least 100 grams of protein a day. I stayed at home and got this amount with my second one since I kept a nutrition chart, and I had BP that was 90/60 and no birth complications. With my first, I was working full time and not keeping tabs on my nutrition and showing BP of 140/80 and protein in the urine, but it dissipated by my next doctor visit. Most people don't get enough nutrition, so I think this may actually point to the cause.
Of course good nutrition is always important during pregnancy, but more and more they are discovering that pre-eclampsia is a disease of placenta with many different causes, including genetic blood clotting disorders and possibly even an autoimmune disorder. Please take your symptoms and your doctor seriously, regardless of the cause, pre-eclampsia kills mothers and babies and is the number one reason for premature birth.
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Before you were conceived, I wanted you. Before you were born I loved you. Before you were a minute old, I would have died for you. That is the miracle of life. ~Maureen Hawkins~
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#441 of 601 Old 07-14-2006, 06:21 PM
 
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Gossamer-

here are my results..

AFP .55

Estriol .48

HCG 3.5

Inhibin 3.4



the counselor I spoke with today said that with the US that I get due to being high risk already have not shown any abnormal signs. I did the quad screening and US at week 15 and they were normal. That is why she said that I will possibly have problems in the third trim with hypertension/ pre-e/ plecental problems or preterm labor.. I think that I feel a little better about this I am keeping an eye on my bp and will talk to the Dr about 24 hr urine and liver enzymes.. I am trying not to stress too much as it does not help..
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#442 of 601 Old 07-14-2006, 10:56 PM
 
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Quote:
Originally Posted by bradleybirth2mom
I had learned in my Bradley birth classes of a doctor who had virtually no incidence of preeclampsia with his patients, and he told them to get at least 100 grams of protein a day. I stayed at home and got this amount with my second one since I kept a nutrition chart, and I had BP that was 90/60 and no birth complications. With my first, I was working full time and not keeping tabs on my nutrition and showing BP of 140/80 and protein in the urine, but it dissipated by my next doctor visit. Most people don't get enough nutrition, so I think this may actually point to the cause. I do think stress is a major factor---if the body and mind have to deal with too many stressors in the environment, I think it feels forced to reject the pregnancy as an auto-immunological response, with devastating effects on the mother and baby. We can look at pregnant animals, too---for example, livebearing fish will abort their brood if moved by hand too close to their 'delivery' date, and a mother bird will abandon her eggs if she can scent another animal on them. I don't think humans realize that the pregnancy needs to be nurtured, and that a smaller dose of everyday life combined with rest and relaxation would probably reduce the incidence of this horrible disease----just my theory, gals.
I guessing you're referring to the Brewer diet. Diet has not been supported as either a cause of or treatment for preeclampsia, and it's been studied extensively. Brewer's results haven't been repeatable in larger studies.

The perinate I see has been doing interesting work in vascular function and insulin resistance as risk factors for preeclampsia, but they freely admit they don't have a cause or a cure for pre-e -- as I think most reputable researchers agree.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#443 of 601 Old 07-14-2006, 11:03 PM
 
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Originally Posted by maxmama
I guessing you're referring to the Brewer diet. Diet has not been supported as either a cause of or treatment for preeclampsia, and it's been studied extensively. Brewer's results haven't been repeatable in larger studies.

The perinate I see has been doing interesting work in vascular function and insulin resistance as risk factors for preeclampsia, but they freely admit they don't have a cause or a cure for pre-e -- as I think most reputable researchers agree.
Nevertheless, some of us do feel that the high-protein diet was very helpful to us personally. I do feel my increased protein, nutrition, and low-stress lifestyle was helpful in avoiding pree and HELLP second time around, and helping me to have a healthy homebirth.

I guess, I wouldn't ever discount it completely, and it sure doesn't hurt a person (at least in my case) to eat plenty of protein. I also do not have any preexisting medical conditions (clotting disorders) as other have faced.
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#444 of 601 Old 07-19-2006, 06:53 PM
 
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I went to the Dr. and found out that the test was not accurate. However they will watching me closely, urine, BP and doing blood flow studies as I get further along.. the baby looks good, and I am still on the heparin 2x's a day along with the other vitamins they have me on.. I feel good about this.. thanks for info...
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#445 of 601 Old 07-20-2006, 02:31 AM
 
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Originally Posted by flyingspaghettimama
Nevertheless, some of us do feel that the high-protein diet was very helpful to us personally. I do feel my increased protein, nutrition, and low-stress lifestyle was helpful in avoiding pree and HELLP second time around, and helping me to have a healthy homebirth.

I guess, I wouldn't ever discount it completely, and it sure doesn't hurt a person (at least in my case) to eat plenty of protein. I also do not have any preexisting medical conditions (clotting disorders) as other have faced.
One reason I'm not a fan of the Brewer diet is that there may be an underlying vascular renal issue for some women who develop preeclampsia, and the high levels of protein may not be beneficial and may increase the renal workload.

I don't discount anything completely, but I have to say my skepticism goes way up when the results have not been repeatable in 30 years of research in diet interventions. Also, the recurrence rate for preeclampsia is quite low in second pregnancies (it varies according to onset time), so while I'm glad you had a good outcome, I'm not convinced it was the Brewer diet.

What scares me is that some women may self-treat with Brewer or feel completely protected, and it jsut isn't the case.

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#446 of 601 Old 07-20-2006, 02:36 AM
 
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I agree Maxmama--the thing about the whole brewer diet that scares the crap out of me is stuff like the post saying some doctor had NO incidence of pre-e in his practice because he used this diet. That is not possible and if it's true it's because he treats VERY few women or he just doesn't test for it--hey, I never had a clotting disorder until I tested for it, I was blissfully unaware and it cost me 4 babies.
Anytime someone spouts off that x, y or z diet is the be all and end all cure for a disease that can KILL mama and baby but has ZERO repeatable proof or research, it sets up some poor mama to "believe" in the diet and possibly loose her child or her own life.
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#447 of 601 Old 07-20-2006, 02:37 AM
 
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Oh no, I agree, I don't think it was the Brewer Diet completely either, I think it was probably a combination of factors. However, my MW really recommended BD and exercise as the contributing factors to healthy homebirths for previously pre-e women she's attended. I also saw a high-risk doc who gave HIS advice (you know, the sperm theory) and nutritional suggestions (folic acid).

FWIW, I had onset at 26 weeks the first time around, and made it to 34, but with HELLP.

ETA: I think none of us (patients, docs, midwives) know for sure what causes pree, but whatever works for each of us is great - for some, it may be high-protein diets, for others close management by an OBGYN, others exercise and nutritional management. It's really about what makes one comfortable mentally and gets you (and baby) through physically. I wouldn't discount any approach out of hand. Well, maybe shaking a rainstick at the sky and eating donuts nightly won't work too well.
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#448 of 601 Old 07-20-2006, 02:42 AM
 
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Ahh, see folic acid is a blood thinner, often used to treat clotting disorders...the difference is, you never hear anyone saying "Oh, just take folic acid and that will prevent the pre-e"

I totally get what you're saying and I know many a midwife and OB recomends it but like Maxmama said--they've been trying desparately to reproduce "good" results using brewer diet for 30 yrs and have been totally unsuccessful. Alternatively, "good" results from rest, meds, heparin, finally figuring out what was actually wrong, are able to be repeated with ease.

Brewer made a HECK of a lot of money off his own research that couldnt' be reproduced
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#449 of 601 Old 07-20-2006, 02:48 AM
 
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That OBGYN said that he'd seen a huge reduction in pree since recommending folic acid to women. I was already taking a healthy dose, but he suggested basically megadoses. Also, the baby aspirin.

One of the biggest contributors to my healthy outcome (in my opinion) was exercise. I read a great study that talked about the role of exercise for one year prior in warding off preeclampsia for previously preeclamptic women, and exercise throughout pregnancy. I was running up until my seventh month.

I was basically taking about 10 pills per day throughout the pregnancy, and doing the mega protein (but I'm a vegetarian, so it's normally not something I get a whole lot of either). Very exciting. Gag.
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Yeah, I see a rheumatoligist who specializes in recurrent miscarriage and pregnancies with autoimmune issues--he's considered a bit of a clotting guru and anyone who's had pre-e or unexplained miscarriage is put on mega dose folic acid and baby aspirin--some of us are also put on heparin.
I guess that's the thing for me--he can sit down with me and show me 10 different studies telling me how it works, why it works and what the numbers are.
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