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Discussion Starter · #1 ·
I gave birth 4.5 months ago and am still completely baffled by what happened.<br><br>
My antenatal care was basically a shambles, I had no choices at all. I had to have an OB-led, hospital birth as I did not meet criteria for midwife-led/home birth (<a href="http://www.bcf.nhs.uk/what_we_do/maternity/midwifery_led_acceptance_criteria.pdf" target="_blank">http://www.bcf.nhs.uk/what_we_do/mat...e_criteria.pdf</a>) if you'd like to hoot. I didn't want a HB but a birth centre one did appeal.) I saw someone different every appointment.<br><br>
At 22 weeks (first midwife appointment before being booted up to consultant) I had 1+ protein and 140/95 BP. All subsequent dips were normal and my BP didn't go up--it fluctuated up and down, remaining slightly elevated, the whole time. I never had any swelling or other symptoms.<br><br>
At 38+2 I experienced some mild contractions and I went to the hospital (where the antenatal clinic was) so they could have a look and tell me if I was going to go into full labour soon or what. Really, it was just reassurance I wanted. I showed uterine activity on the CTG and when they finally got a urine sample I was 4+. They insisted I stay in for monitoring.<br><br>
Over the next 2 days, they did the full urine collection plus periodic dips (all 3+ or higher) and BP checks--steady and slightly elevated. I felt absolutely fine. On Friday afternoon, my CTG trace started being abnormal--heart rate elevated. The SHO (junior resident) on duty said I was looking at an induction. Then (after a failed membrane sweep) she said she'd spoken to the on-duty consultant (attending) and I was being booked in for emergency CS. I never got to speak to anyone. I still have no idea who decided I needed a section or why, or who did my section other than the fact that it was the surgeon on duty.<br><br>
No one ever explained anything and I have no idea who I'd ask. Can anyone shed any light on this? Part of me suspects that they wanted to do an emergency CS on a Friday night rather than risk an over-the-weekend induction (especially since my hospital has a very bad track record of having to close its doors to new admits) but I have no evidence. My whole pregnancy I got treated as if I were making trouble for asking questions (I'd get the brush off when I asked for the result of a BP reading, and the only way I knew any of my blood test results was by reading my file when the doctor was out of the room). this was my first, I plan more, and it would really be good to know more.
 

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That is confusing! 140/95 isn't terribly high, but what were your pressures normally? If it's a big enough jump, it can be pre-e even with what would normally be considered "borderline" BP. What kind of bloodwork were they doing? In your situation, I'd request a copy of all of your hospital medical records and take them to a more accomodating doctor to get things explained if you don't understand them. Things can go bad really quickly with pre-e, even if you're feeling ok, so it might have been necessary to have the baby that early, but it might not have been. Hard to say without all the records.
 

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Discussion Starter · #3 ·
I might be able to get the records, I assume the hospital would have to release them if I asked, but I don't know who I'd ask to look at them. You can't just go see an OB here (we have private obstetrics but hardly anyone does it, private insurance won't cover).<br><br>
My BP was about 130/85 all through pregnancy, it fluttered a bit but there was no trend. The day after that 140/95 I went back in and got 118/78 (I'm still convinced that was a fluke: I haven't measured under 120/80 since I was 18.) I used to be a steady 120/80 but antidepressants pushed it up slightly. Again, i got very consistent readings pre-preg, always slightly above normal. I had one fluke high one at 36 weeks (160/105), but I'm 99% sure it was stress (got called when I was in the loo!) as they re-took it 10 minutes later and I was fine.<br><br>
I don't remember all the bloods; I do remember my albumin was low both on the set at booking-in and the one at admission, but all tests were fine early 3rd trimester. I think albumin was the only one that got flagged as out of reference. I don't know the protein result for my 24h collection but I know it was way too high.<br><br>
That's why it's so confusing: blood work said pre-E, but no other symptoms!
 

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Albumin is almost always low in pregnancy and alkaline phosphate is almost always high. You'd want to look at your 24 urine protein, ALT/AST (liver enzymes), LDH (which should not be elevated during pregnancy but will be elevated after a c-section i.e. surgery elevates it), and your blood count to see if your platelets were dropping. A diagnosis of pre-e is made when a person has proteinuria (which you seemingly did have) and a sustained bp of 140/90 or higher.
 

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Get the records, and maybe a nurse or your regular doctor will be able to help you sort it out. Just because it's not their specialty doesn't mean they won't be able to translate some of the knowledge for you, which you can then research on your own. It's hard to say without having numbers and lab values in front of me. I'm sorry that your birth wasn't what you expected, and that it is still bothering you. I hope you get the answers you're looking for.
 

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Discussion Starter · #6 ·
It wasn't so much that it wasn't what I expected--I didn't have visions of the perfect birth. I really felt like I couldn't know without having been through it. It's that no one ever bothered to stop and explain anything to me. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"><br><br>
Anyway, I've written a letter to the hospital asking for my antenatal and birth records. (Told them I'm moving overseas. It's only a white lie, we are going to... just not now <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/wink1.gif" style="border:0px solid;" title="wink1"> )
 

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The thing with pre-eclamsia when you have pre-exsisting issues, is that you can get really sick, really quickly.
 

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I was planning a homebirth but at 37 weeks transferred care to a CNM with hospital privileges due to bp readings of 140ish/90ish. No protein in my 24 hr urine.<br><br>
My BPs were always borderline and at one point the midwife who was originally supposed to do my homebirth started to question whether we had made the right decision (she told me this afterwards), feeling bad that she had us transfer care if I could have had a homebirth.<br><br>
Once I got into labor, my bp shot up (180/100 something, I think). I started showing protein in my urine. This all happened within a few hours. As in normal BP in the morning, sky high in the afternoon.<br><br>
I absolutely needed to deliver in the hospital. The weird thing was that since I had never been in labor before, I had no idea that what was going on was abnormal. I was really shocked when they started talking about pre-e after I arrived at the hospital, because I thought that I didn't really have a problem (I sound like an alcoholic...). I kept wondering when they were going to take the fetal monitor off, because the CNM had told me that she just needed a quick strip when I arrived. It didn't occur to me that I might be one of those rare cases where fetal monitoring was actually necessary. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/dizzy.gif" style="border:0px solid;" title="Dizzy">: As much as I cried about not having a homebirth, I am so glad that we transferred care. It kept my baby and I safe.
 

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You really needed to have liver enzymes, platelet counts, h & h, 24 hour urine to determine whether it was pre-eclampsia. Blood pressure doesn't tell the whole story, people can become pre-eclampic with lower pressures. Did they do those tests? If not, there's no way to tell what really happened.<br><br>
As far as the BP, there were things you could have tried. Epsom salts, other magnesium, hawthorn berry tincture, increasing vit. c, high protein shakes and increased fluid, full body immersion in tub, soaking in epsom salt. all these might have helped the BP stabilize enough to have a homebirth.<br><br>
Even as a HB midwife, I would have done those tests before making decisions as to care. Were you urinating? epigastric pain? Kidney pain? What were your reflexes like? Did they even check them?<br><br>
The hospital must by law release all records to you, but they can charge you for them. don't try to read them by yourself, it will worry you if you don't understand all the jargon (heck, sometimes it worries me and I do understand it<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol"> ). If you can have records transferred to another providers office, they won't charge you, I have had records sent here for review (second opinion, y'know?<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink"> ) Good luck! I wouldn't rule you out at all for a homebirth next baby, but I would want records and I would do bloodwork and I would definitely watch your diet through the pregnancy.
 

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Discussion Starter · #10 ·
I wasn't legal for a homebirth here. My trust's policy is that only women meeting the midwife-led criteria can have a HB. They won't accept consultant led patients, which I was (PCOS, hypothyroid, overweight--all automatic consultant led conditions). From day 1, it was full on hospital birth or nothing.<br><br>
I remember them testing my reflexes, and I think I remember them not being entirely pleased. I felt fine the whole time I was in hospital.
 

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how you feel/felt is not really an indication of what your health was like at the time of delivery. i felt just fine with my son too, but then they tested my blood and my platelets were plummeting and my liver was going up. it sounds like you had hyperreflexia (a big sign of pre-eclampsia). the official criteria for diagnosing pre-eclampsia is two readings of 140/90 and 300g of protein in the urine. other worrisome signs are the hyperreflexia and edema, but it could be just pitting edema. also sometimes the blood tests can indicate that things are getting worse. that would be my guess as to why they rushed you in for a c-section. like everyone else said, getting your med. records should give you all the answers. they were terrible about explaining things to me at the hospital too. sometimes they forget that we are people not just charts.
 
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