# Post-Partum Preeclampsia (updated)



## spruce (Dec 11, 2004)

Hi, all. I had my baby girl on 11/11 (her due date, of all things). She's healthy and beautiful, but I ended up with a roaring case of postpartum preeclampsia. Since the headache prevented me doing much reading before ending up in hospital, I don't have a lot of info. I wondered if this has happened to anyone else here?

I took the baby to the hospital with me, and they put me in the womens' center (the labor/delivery/recovery area) so that wasn't TOO bad, but all in all it was a harrowing thing to go through, especially with four more kids at home, the holidays about to jump on me, etc.

I'm still dealing with the b/p issues, which may go on for quite a while, and something of a headache although not nearly what it was.

If anyone else has been through this, I'd love to hear your stories. I am too achey and tired to do a lot of surfing.

Thanks,

Love, Penelope


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## TurboClaudia (Nov 18, 2003)

i know another mama here who also recently recovered from postpartum pre-eclampsia. i will pm her with this thread so she can share her thoughts.

peace and healing vibes to you, mama...

~claudia


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## EStreetMama (Sep 5, 2003)

Congratulations on the birth of your healthy daughter!!!!

Sorry to hear about your pre-eclampsia...I had it too!! I actually had HELLP syndrome (pre-e plus drop in platelets), and the symptoms never appeared until 3 days post-partum.

My blood pressure was only slightly high once or twice during pregnancy, and I never had any protein in my urine. We never ran a prenatal liver panel. Did you? I am 40 y.o. BTW.

We had a beautiful home birth--bp's were normal. I had a postpartum hemorrhage of about 8 cups of blood. I was treated with pitocin and methergine. I fainted twice and we had to get 911 to start an IV because I was dehydrated and I'm always difficult to poke.

A few days after birth I started getting this incredible stomach ache. It lasted only for 3 hours so I didn't think too much about it although I was complaining to DH and my midwife about it. I thought for sure that it was gallstones.

Then I started getting a HORRIBLE headache. I wasn't doing anything about
it because my baby was severely jaundiced and was admitted for bili lights. We were going back and fourth between the hospital every 3 hours to nurse and I was just barely functioning at all. They didn't have room for us to sleep at the hospital. I kept imagining one of those steel cables they use along the highway going through the back of my skull.

Finally I drove myself to the ER in the early am. My DH stayed home with the baby (MISTAKE). The ER doc was clueless about what was happening. He was insistant on doing a full GYN exam which I adamantly refused. I called my midwife and she said there was no need. THen he did a head CT and a liver ultrasound. Then he was insisting on a spinal tap which I also refused. They still hadn't given me anything for my headache and they wouldn't give me any water to drink in case I needed surgery. Finally, they called OB and asked them for a consult. They knew what it was immediately and had me admitted.

I was in the hospital for 3 days. I wasn't able to take care of my baby so my DH stayed home with him. My mom flew out to help. The baby was already supplementing because of the jaundice and I was managing to pump, but in hindsight I should have the baby at the hospital because my milk never really came in well. DH brought the baby in for lots of visits, but nursing wasn't going well and it just went downhill from there.

Anyway, that's my long story. It was AWFUL!!! I felt awful, the ER experience was scary, I missed my baby more than I can say, and I feel that it was the demise of our breastfeeding. Ugggghhhhh.......

Otherwise, my bp is at the high range of normal, but my doc says it's fine. I am still pumping but my baby won't take the breast. He is very healthy and happy though!!

I have been worried about some sort of lasting damage to my body, but the doctors say that my liver panel is normal now and that everything is fine. They said it was really rare to have the symptoms only show up in the post-partum period. Did you have the horrible stomach (liver) pain or just the headache? Did your milk come in ok?

That's my long story!!! How are you feeling now? I found that the headache got better with more sleep. See if you can get some help with the kids so you can catch an extra bit of sleep (easier said than done, I know.)

Tell more of your story when you have a chance. I know that you have your hands full and that it may take awhile. Don't worry...I will be interested in hearing about it even if it takes you many months to get a chance to write.

Take very good care of yourself!!! Again, I'm so glad that you had your baby safely and that you and your daughter are ok!!! I hope more people learn to recognize postpartum pre-eclampsia quickly.

--Adrienne


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## ldsapmom (Apr 8, 2002)

I had a doula client in September who had mild pre-e before baby, but after baby's birth (day 5) she had to be readmitted due to pre-e -- it was the worst it had EVER been. They would not readmit baby, and she was partnerless, so my family had a sweet little houseguest for about 4 days







. After about a month and a half of high blood pressure, her OB finally referred her to a cardiologist and they are still trying to find the right combo of meds for her







. This is her first baby and she is 43 (a huge factor can be age!).

Just wanted to let you know it can still take some time, so hang in there!


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## MrsMoe (May 17, 2005)

I delt with severe pre-e during pregnancy (not post) and I know how nasty you can feel when your BP is through the roof.


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## spruce (Dec 11, 2004)

Thank you, everyone who responded. Adrienne, I really appreciate your sharing your story.

I had moderately high bp at the end of my pregnancy---for me. My bp is usually around 98/56, very low. I am really active but took the end of this pregnancy seriously easy by changing to non-response status at the station. I still chop and haul wood, carry a toddler, etc., but I did feel less athletic...So when my blood pressure started to go up to 120/80, the midwives weren't concerned, but I was. They said it was probably normal end-of-pregnancy hypertension. I had one little pee stick that was trace positive for protein, but I ignored it. I wasn't very good about regular visits as I felt pretty confident in my ability to grow my baby without stressing about numbers and charts.

I also have a history of severe migraines, and they flourish during pregnancy, so I joked with them that that I wouldn't know pre-eclampsia if it walked up and bit me on the nose. How right I was! The DEM I was seeing agrees that I had pre-e, but that it was BETTER that we didn't catch it beforehand...I had the homebirth of my dreams and the baby was 7 days old before we tried to go tot he hospital for treatment. Aside from the fog of pain after she was born, I am so glad I stayed home.

The day she was born was very normal. My bp was up (for me) to 130 systolic, but the midwives again said they see rises like that in labor. Nobody was worried and I was obviously handling labor really well. Iris was born at 8:40 am and the midwives left around noon, I think. She was my smallest baby, at 6lbs, 8 oz, and was born on her due date, which is very very early for me.

That night I was up playing with my 2yo and cuddling the baby at around 2am. I started out ok, but within a few minutes I was miserable, bloated so much it was scary, I had a headache that wouldn't quit and I was HOT. My husband came upstairs when he heard me crying and helped me downstairs to cool off (we have a wood stove and it was very hot upstairs) and rest a little. The swelling was really alarming. For the first time ever, I had to take my ring off (two days later, I couldn't get it off that night).

Our head DEM came the next day for the 24hour visit and we asked about the swelling. My bp was still in the 120s and she said the swelling might just be my body adjusting its fluid balance. With such a low normal blood pressure, there was really no thought about pre-e or anything. (For which I'm grateful now).

When Iris was six days old I was in so much pain and my blood pressure was SO HIGH we were worried. My husband was taking it for me constantly at home and it was alarmingly high. After our one-week visit with the DEMS for Iris that day, we went to see our CNM who agreed to fit me in. I apparently looked awful as her office staff ran back to get her to tell her to send me to the ER. I am glad she didn't, the ER would have been a fiasco. My bp there was 168/124. Very scary. She wanted to put me in the womens' center that day but the doctor she worked with said I should go home and try to rest through it. (Grrr, I can't stand that doctor, but to see my CNM I had to see him).

The next day we tried to sign in to the hospital but when we got there we were informed that I had to have someone with me 24 hours if I wanted to keep Iris with me. Nobody had told us this earlier and we had no one lined up, either to stay with me or to take the other kids so Brad could stay with me. It was very upsetting and I ended up going home more worried and stressed than when I got to the hospital. I had thought I'd finally get some relief.

The NEXT day, Iris was 8 days old. It was a Saturday. I hadn't slept all nigiht. I was taking ice-cold showers to combat the headache and the swelling. I was crying. I couldn't figure out which part of my head to hold onto for the pain. It was unbearable, and I like to think I have a pretty good tolerance to pain. I told Brad to call the CNM and get the orders reinstated for the hospital, we'd drag all the kids with us if we had to. At 1:40 that day we were checking in.

It took until 4:30 for anyone to give me any meds. I was given Mag Sulfate and 5 mg Morphine via IV. The morphine seemed to take the edge off my headache but it was not working at all within half an hour. That was upsetting. EVentually they started giving me 5IV and 5mg IM (in my hip) every two hours. The nurses bitched and moaned about how much morphine I was getting, but nobody had any better ideas and nobody told me morphine can cause headache.







I was so miserable for two and half days, until the morphine was switched to percocet and Imitrex in the hopes of sending me home the next day. I actually had one night nurse who refused to give me the ordered meds and I didn't know how to argue...I was in so much pain that just THINKING hurt too much. I couldn't concentrate on arguing long enough to make sense, it just hurt. My girlfriend who was with me didn't feel like she should interfere but she was very angry...and my dh was FURIOUS the next day when he heard. Thankfully she was only one nurse...I think we were the floor's gossip that day. The nurses were pretty condescending and acted like I was a naughty kid who did this to herself. Sigh.

They collected a 24 hour urine and it was very positive for protein. Another confirmation of the pre-e.

The doctor kept concentrating on silly things, like my vision and whether I detached a retina when my bp was skyhigh. He wanted to give me non-bf friendly medication and asked if I'd be willing to pump and dump (and feed Iris formula). No way. SO he made fun of me and berated me in front of the nurses, a med student, and my girlfriend because breastfeeding was, "More important than my eyesight." Yep. Dang right.

All through this ordeal, they kept concentrating on EVERYTHING but my blood pressure. I really felt like figuring out the bp issues would help the other stuff...but they didn't seem to care about that except that I was hooked up to enough mag sulfate to stop an earthquake, much less a seizure.

My CNM had pretty much abandoned me to this hopeless doctor because my issues were out of her scope of practice. I felt pretty alone and like I had to just shut up and be a good little patient. The doctor didn't want to talk to ME, so he'd talk to the nurses and they wouldn't tell me anything. Finally Brad called him at work to get some answers, and the next thing we knew the nurses were in talking to us...I guess the doctor was pretty mad at being bothered at work because the nurses didn't want to pass on information that the doctor should have just given to us in the first place.

All through this, I hardly got to see my other children at all. It was horrible and I had a meltdown on Monday morning. I just wanted to go home and I couldn't quit crying, nothing they were doing helped, my head was still pounding and my blood pressure got stuck at 140/88 and wouldn't move for anything. It was terrible.

The next day they unhooked me and sent me home...no bp meds, just some headache stuff and orders to come in in a week. My blood pressure was still in the 140's over 88...

And here it is 5 days after discharge and my bp last night before bed was 142/110. That's outrageous. I don't know what else I'm supposed to do. I'll be going back to the CNM some time this week, but it seems pretty pointless.

I'm just tired and achey and the headache comes and goes. They gave me Imitrex for it but that' s not an approved bf med, either. I've used it once since coming home because the pain was so bad (yesterday), but it worries me.

Thanks for listening to my longwinded story. I'm glad to be home with my kids and what's left of my dh's baby vacation (he goes back to work tomorrow), but I'm worried about the future. If my bp doesn't regulate, can I safely fight fires? Can I stress myself out on the ambulance? 140/88 before a physical agility test would get me put on non-response status...not to mention what will it read AFTER a strenuous test? And what does it mean about my overall health? I'm still at risk for a stroke or seizure, and will be IIRC, until my bp goes down to something like normal.

love, penelope


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## Icequeen_in_ak (Mar 6, 2004)

Penelope, I'm very sorry that you have gone through this.

You are in my thoughts for a great recovery and continued bliss in your baby moon.


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## spruce (Dec 11, 2004)

Thank you karen.

Does anyone know what I should ask my CNM tomorrow? About what kind of tests they might have run? I got a few ideas from Adrienne's post but I would really like to go in prepared to gather information about where I was at during my hospital stay...and what I can expect. I do remember someone telling me my platelets were really low and my hematocrit and hemoglobin are down, too, and I think the doctor mentioned that pre-eclampsia is the cause of one of those, but I can't remember which...

The positive 24-hour urine was at least an indicator that we are on the right track.

Did anyone get bp meds after seeing their care provider, whether you had pre-e during or after pregnancy? When the CNM originally sent us home, she gave me Nifedepine (sp?) for blood pressure control, but it didn't help (as witnessed by my bp skyrocketing the next day as well). I was only on it for about 36 hours. I am wondering though if my bp would have gone higher without the Nifedepine...and if I should request to be put on bp meds now that my diastolic seems stuck at such a high number (very often my diastolic number is higher than my systolic ever was before this happened...that's pretty alarming).

Should I be following a highbp diet? Will that make anything like a difference? THe swelling is noticably better but the headache is always there, lurking and ready to pounce. Ugh.

Thanks again...

Love, penelope


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## Jane (May 15, 2002)

I wouldn't worry too much about getting your BP down. Although high blood pressure is concerning, bringing it down artificially with medications won't prevent most complications.

When pre-e stikes post-partum, it's just way more complicated. The course of care is very individualized. You might be better off if a maternal-fetal-medicine specialist or a interested internal medicine doc instead of an OB/GYN. At this point, you need to be monitored for blood clotting disorders and infection, as well as general organ health, especially kidneys and neurological signs.

There are several mileposts. One is 48-72 hours after birth, most cases resolve by then. Another is at 10 days. One more is at 6 weeks. Although you've passed the first two without significant relief, there is a lot to say that you will be on the mend at 6 weeks. Don't stress too much about work tests - you are NOT recovered from birth until at least 6 weeks. I wouldn't ask you to do a sit up test now, either (I am smiling, I hope you are too).

There are a couple of things that are recommended to encourage recovery - nifedipine therapy and a d&c if there might be retained placental tissue. It sounds like you've had pretty good care up until now.

One final thought, it's unlikely that this is "just" high blood pressure, but I'll throw it out. Some women develop the high blood pressure they would have got anyway when they happen to be pregnant. Do you have risk factors? Native American or African American ancestry? Significantly overweight? Family history?

About pre-e, it has no known cause, but here's an overview of what's going on - some chain of events involving the placenta set it off. Fluid leaks out of the blood vessels, causing swelling. Platelets rush in to try to repair the vessels, that lowers the amount of platelets present in the blood. Clots form in the placenta (if present) and in the smaller vessels. Cells in the liver and kidneys begin to die off. Clots, spasming vessels, or cell death are responsible for the headache and liver pain that some women feel. Sometimes neurological symtoms occur, too, due to swelling, spasms, cell death, or clots. Generally, women with pre-e feel AWFUL, and for good reason. Luckily, most women make a full recovery. Pre-e is usually a disease that harms babies, not women.


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## spruce (Dec 11, 2004)

Hi, Apricot. Thanks for your answers and taking the time to reassure me.









I'm caucasian, not overweight, in very good physical health aside from asthma and a history of migraine and allergy. My father was hypertensive but controlled it well with a minimum of medications, my mother developed hypertension at 100lbs overweight after 50 years of age...I don't think those are very significant as far as family history? None of my siblings have high bp as far as I know.

I guess what's worrying me now is the very high diastolic readings...spending a lot of time in emergency medicine situations doesn't do much for letting yourself not be concerned.







I wish I could be more laid-back about it all, but obviously something is very out of whack with my body right now, and the annoying voice in my head won't let me let go of it until I figure it out.

Hopefully the CNM will have more information for me tomorrow and I'll get some idea of where we can go from here. Thanks again.









love, penelope


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## Jane (May 15, 2002)

I was editing while you answered. It's the last paragraph that's new.

As far as your family history, I'd suggest mentioning it to the CNM. With your other symptoms, it's unlikely to be the whole cause, but it might be confounding the issue.


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## polka123 (Nov 27, 2003)

well congrats on the new girl
I had PP PE & was on B/P meds plus something else. It was bad. My feet & calves ached so bad.

(from a long, lost friend)


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## cobluegirl (Nov 20, 2001)

Congrats P!! We miss you.


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## spruce (Dec 11, 2004)

Just a quick update...

I never did stop bleeding bright red blood, and a week ago passed a piece of placental tissue that was like twine...veins or something, my mind is still foggy and my body is recovering, sorry for the lack of placental nouns. When I described it to the DEM during Iris' 4 week visit, she said it was membrane.... IIRC.

Four days ago, while sitting at the kitchen table eating dinner w/ my family, I felt *something* emerging...the same feeling as when a placenta is delivering. I was so terrified.

I quietly went to the restroom and passed a piece of placenta (membranes, whatever, it had lots of venous stuff, blood, jelly-like mass, looked like a little gut pile stuck in hard jelly for anyone who has ever butchered an animal) ...and I almost fainted. The piece was the size of both my fists together. I was so incredibly scared. First I had thought (at the table) that my uterus was prolapsing, and then I found this mass of ... STUFF ... had just emerged. I mean, EWWW.

So I told my husband (finally, I was worried he'd be grossed out instead of mutually concerned, I should have known better) very late that night. Long story short, after HIS research while he was on duty at the station, he came home and kind of begged me to call the CNM and set up an ultrasound...he was really scared, too. (This man sees emergencies every day, he's not *scared* by much...I think the idea of raising all the kids alone if something happened to me is what motivates him sometimes.
















Anyway, yesterday (Th) I had an "emergency" mtg w/ the CNM who gave us a referral for an ultrasound. After that, I had my (already scheduled) root canal...then the ultrasound...long day. Tonight (Fri) I came home to a message saying that the u/s was clear but my WBC # is up, which is understandable. I knew I'd passed all the placenta when I *finally* got dark brown blood this morning instead of bright red, arterial-looking bleeding.

So, we're officially on the mend. And the doctor affiliated w/ my midwife could have found out what was causing this by ordering the pelvic u/s they said I was going to have while in hospital FOUR weeks ago.







I'm glad to have skipped a D&C but sad that my poor body has been through four more weeks of really tough stuff.

Thank you everyone for your support and kind words.
love, penelope


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## TurboClaudia (Nov 18, 2003)

spruce, i'm so relieved that you feel like your body is finally working towards healing. how scary about all the tissue/ placenta/ whatever it was passing...

please be gentle with yourslef and take it easy, as much as you can with such an active family!

sending you hugs and healing vibes and lots of strength and peace...

~claudia


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## spruce (Dec 11, 2004)

Thank you so much, Claudia.









I did want to add that, for anyone who EVER goes through PP Pre-E, some things happen at different times. While my milk did come in when my dd was just a couple days old, I didn't go through the norma (for me) engorged and so-forth sensation/sessions until she was 4 weeks old, at which time I think my body was beginning to slough off the retained fragments.

I am losing weight a little more slowly, but not so much that I am concerned about never losing it.









I still feel like I don't quite *know* Iris...like she's a newborn every day and we're working on that. For that reason (and others) she and I sleep together on the couch at night (she sleeps and I read) so that I can have time with her without interruption. I just get to cuddle and look at her, be awake with her when she's awake, etc...I am sure that soon I'll feel more like my baby isn't a newborn, b ut for now I've missed out on most of her first month of life by being in pain/sore/sick/exhausted/ scared/confused...it's very sad.

I did have (and am dealing with) some PPD stuff, which I think is related to feeling helpless, sick, sad, and frustrated. My CBCs were off but not so off as to be life-threatening or anything, but I do think the lack of some vitamins and minerals because of the excessive bleeding and swelling had a lot to do with feeling more crappy than I *ever* have felt. I love the PP period (except the hot flashes) normally, so this has thrown me for a loop. I'm working my issues out at home, talking a LOT with my DH who is a doll and listens so wonderfully...but if I were single and didn't have him as a sounding board and supportive partner, I might be in a bad place. PPD can happen for SO MANY reasons, I'm really learning that it's nothing to trifle with.

I think my body just figured out it's not pregnant any more and things are going to keep changing rapidly...I'm so happy for that. Even if the changes are a trifle off-balancing, at least I'm not dealing with what was going on beforehand.

And I have Iris...and all the other children...what a gift!!

Love, penelope


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## MamaTaraX (Oct 5, 2004)

Wow, I'm sooo glad all of the placenta is finally passed. How scary for you (and your DH!) Ih ope you mend quickly and nicely. Retained placenta is just plain scary







Here's to peace for you andyour family and some good time getting to know your new little girl!

Namaste, Tara


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