# Pre-Eclampsia Watch Dog on the loose.



## gossamer (Feb 28, 2002)

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&#8230;

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&#8230 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


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## umefey (Sep 10, 2004)

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.


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## gossamer (Feb 28, 2002)

This is the myth.

Quote:

3. Preeclampsia only happens once and only in the first pregnancies.
What follows,

Quote:

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


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## danaalex (Mar 19, 2003)

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!


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## ramlita (Mar 26, 2002)

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









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


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## gossamer (Feb 28, 2002)

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


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## mezzaluna (Jun 8, 2004)

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







for you and the memory of Mary Rose.


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## veggiemommy (Nov 21, 2003)

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


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## natashaccat (Apr 4, 2003)

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?


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## shannon0218 (Oct 10, 2003)

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.


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## pamamidwife (May 7, 2003)

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.


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## gossamer (Feb 28, 2002)

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


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## veggiemommy (Nov 21, 2003)

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


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## gossamer (Feb 28, 2002)

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


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## crazy_eights (Nov 22, 2001)

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.


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## natashaccat (Apr 4, 2003)

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?


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## OnTheFence (Feb 15, 2003)

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!


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## gossamer (Feb 28, 2002)

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


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## Quirky (Jun 18, 2002)

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.


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## Stone Fence (Mar 10, 2004)

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


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## gossamer (Feb 28, 2002)

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









Gossamer


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## elyice (Apr 7, 2003)

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


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## laralou (Nov 27, 2001)

Stuck!


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## AmyB (Nov 21, 2001)

Quote:


Originally Posted by *pamamidwife*
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


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## gossamer (Feb 28, 2002)

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


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## crazy_eights (Nov 22, 2001)

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.


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## mwherbs (Oct 24, 2004)

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...p/hbp_preg.htm

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

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


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## cwaddick (Oct 16, 2002)

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


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## acrathbun (Apr 27, 2004)

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


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## gossamer (Feb 28, 2002)

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


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## OnTheFence (Feb 15, 2003)

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.


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## gossamer (Feb 28, 2002)

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


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## OnTheFence (Feb 15, 2003)

Quote:


Originally Posted by *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


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.


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## gossamer (Feb 28, 2002)

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


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## OnTheFence (Feb 15, 2003)

Quote:


Originally Posted by *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

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.


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## shannon0218 (Oct 10, 2003)

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???


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## crazy_eights (Nov 22, 2001)

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


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## acrathbun (Apr 27, 2004)

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.


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## crazy_eights (Nov 22, 2001)

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


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## gossamer (Feb 28, 2002)

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


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## shannon0218 (Oct 10, 2003)

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.


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## crazy_eights (Nov 22, 2001)

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


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## shannon0218 (Oct 10, 2003)

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"


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## gossamer (Feb 28, 2002)

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


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## gossamer (Feb 28, 2002)

Shannon, how are you doing?
Gossamer


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## shannon0218 (Oct 10, 2003)

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


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## gossamer (Feb 28, 2002)

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


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## gossamer (Feb 28, 2002)

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


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## shannon0218 (Oct 10, 2003)

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.


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## gossamer (Feb 28, 2002)

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


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## gossamer (Feb 28, 2002)

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


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## shannon0218 (Oct 10, 2003)

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!!!


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## shannon0218 (Oct 10, 2003)

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!


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## mwherbs (Oct 24, 2004)

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?


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## shannon0218 (Oct 10, 2003)

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????


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## mwherbs (Oct 24, 2004)

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


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## shannon0218 (Oct 10, 2003)

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.


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## shannon0218 (Oct 10, 2003)

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!


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## LoveChild421 (Sep 10, 2004)

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.


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## shannon0218 (Oct 10, 2003)

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.


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## LoveChild421 (Sep 10, 2004)

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!


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## Sarasein (Jun 15, 2004)

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.


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## shannon0218 (Oct 10, 2003)

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.


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## Sarasein (Jun 15, 2004)

Quote:


Originally Posted by *shannon0218*
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.


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## LoveChild421 (Sep 10, 2004)

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!


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## gossamer (Feb 28, 2002)

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


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## shannon0218 (Oct 10, 2003)

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)


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## gossamer (Feb 28, 2002)

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


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## LoveChild421 (Sep 10, 2004)

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.


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## gossamer (Feb 28, 2002)

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


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## shannon0218 (Oct 10, 2003)

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!!!


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## gossamer (Feb 28, 2002)

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


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## LoveChild421 (Sep 10, 2004)

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!


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## KaDeDiD (Jan 26, 2005)

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







..... Son was 5 pounds and healthy


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## mtm (Dec 4, 2003)

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?


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## gossamer (Feb 28, 2002)

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


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## mtm (Dec 4, 2003)

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


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## gossamer (Feb 28, 2002)

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


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## shannon0218 (Oct 10, 2003)

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.


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## mtm (Dec 4, 2003)

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.


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## shannon0218 (Oct 10, 2003)

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.


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## mtm (Dec 4, 2003)

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.


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## gossamer (Feb 28, 2002)

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


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## sarajane (Oct 20, 2004)

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


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## gossamer (Feb 28, 2002)

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


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## crazy_eights (Nov 22, 2001)

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.


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## Serenityone (Feb 16, 2005)

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


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## crazy_eights (Nov 22, 2001)

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.


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## shannon0218 (Oct 10, 2003)

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.


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## gossamer (Feb 28, 2002)

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


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## Houdini (Jul 14, 2004)

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?


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## gossamer (Feb 28, 2002)

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


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## Houdini (Jul 14, 2004)

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.


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## gossamer (Feb 28, 2002)

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


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## Houdini (Jul 14, 2004)

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.


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## gossamer (Feb 28, 2002)

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


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## crazy_eights (Nov 22, 2001)

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.


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## Houdini (Jul 14, 2004)

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).


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## emmasmommy (Feb 26, 2004)

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.


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## sarajane (Oct 20, 2004)

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.


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## mtm (Dec 4, 2003)

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.


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## gossamer (Feb 28, 2002)

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


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## mwherbs (Oct 24, 2004)

Quote:


Originally Posted by *sarajane*
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-


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## ramlita (Mar 26, 2002)

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.


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## mtm (Dec 4, 2003)

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







.


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## gossamer (Feb 28, 2002)

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


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## gossamer (Feb 28, 2002)

Quote:

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.


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## shannon0218 (Oct 10, 2003)

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.


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## ramlita (Mar 26, 2002)

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!


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## Wabash (Feb 27, 2005)

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.


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## gossamer (Feb 28, 2002)

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


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## weebitty2 (Jun 16, 2004)

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!

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


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## shannon0218 (Oct 10, 2003)

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








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.


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## gossamer (Feb 28, 2002)

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


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## shannon0218 (Oct 10, 2003)

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.


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## kimisaur (Aug 13, 2003)

Quote:


Originally Posted by *Wabash*
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


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## gossamer (Feb 28, 2002)

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


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## kimisaur (Aug 13, 2003)

Quote:


Originally Posted by *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

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


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## flyingspaghettimama (Dec 18, 2001)

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).


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## shannon0218 (Oct 10, 2003)

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.


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## SaraMama (Sep 19, 2004)

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!!!







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!


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## jillene (Apr 8, 2005)

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


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## shannon0218 (Oct 10, 2003)

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 *definitely*would 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)


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## Quirky (Jun 18, 2002)

Jillene,







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.


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## gossamer (Feb 28, 2002)

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


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## acrathbun (Apr 27, 2004)

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.


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## jillene (Apr 8, 2005)

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.

Gossamer - I did not have any DNA testing done for clotthing factors. No aspirin therapy or heparin shots. I did have a moderate hemorrhage between the uterus and the placenta in the beginning (around 8 weeks), but it's since cleared up. Not sure if that's related at all. Other than the developments of the past couple of weeks everything has been going perfectly. The baby is even measuring more like he's due 5/26, which makes me feel slightly better because my first ds was always measuring at least a week behind the due date.

Thanks for your prayers! I will definitely keep you all updated!


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## shannon0218 (Oct 10, 2003)

Jillene, I know it's a huge pain, especially with a toddler, but I would strongly urge you to go to emerg and be seen earlier than tuesday, as you saw the last time, symptoms can escalate extremely quickly--in some of Gossamer's earlier posts you'll see she says eclampsia is latin for lightening (I think, I think!)
At least they can run blood work to have a base line and perhaps they will put you on bp meds--or I'll warn you now, they may put you on bedrest, but it's well worth it.
My guess is that if they find anything on the blood work, they can then call your OB and ask her what she wants to do--and I'm quite sure that miraculously there will be a way for her to see you early next week.
Please take care and please let us know what happens. Just so you know, I was on heparin injections, baby aspirin and blood pressure meds for my pregnancy adn they managed to hold me off to 37 weeks (although the span between 36 & 37 were spent in hospital) anyway, she was just fine at birth, not a single issue.


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## Quirky (Jun 18, 2002)

I definitely would not wait until Tuesday. At 31 weeks the baby should still have plenty of room to move around and not be so high up and so stuck in a position that would cause you pain like that. Please call the doctor and tell them you need to be seen now or else go to the ER. Again, much much better safe than sorry - Tuesday is too long to wait.


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## gossamer (Feb 28, 2002)

That pain you are describing sounds like liver pain. YOu can't breathe because your liver is enlarged and your lungs cannot expand. Your liver is in danger of rupturing and with your nosebleeds I would be cautious of low platelets. If you have no platelets and your liver bursts you could very easily and quickly bleed to death internally. My vote is for going to the er immediately. The life of your child is worth a trip to the er. Pre-e can also result in placental abruption and if you are not in the hospital being seen, it can almost certainly mean death to your unborn. Again, my vote is the ER IMMEDIATELY!
Gossamer


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## shannon0218 (Oct 10, 2003)

How are you this morning Jillene??


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## jillene (Apr 8, 2005)

I'm feeling okay. I went and bought a blood pressure cuff last night and it's been back down to normal all night. It's been staying around 116/70. That's a relief at least. I ordered some protein test strips online since I couldn't find any at my local pharmmacies. They kept trying to give me ketostix, but ketosis is more of a diabetes thing than a proteinuria thing. All the presence of ketones will tell you is if you're burning fat cells. Not quite the info I need. So I ordered some URS-3 strips online. Those do protein, glucose and pH.

I do have some liver pain but it's nowhere near as bad as it was when I had Aidan. I don't think they ever checked my enzyme or platelet levels. If they did, they never mentioned it to me. On Tuesday I'll ask Dr. Debbs to check those when he orders the bloodwork for the 24 hour urine.

I know a couple of you want me to run to the ER now but instinctively, I don't feel that level of urgency yet. I prayed about it a lot last night and I feel comfortable with waiting until Tuesday so that's what I'm going to do.

On a side note, for the past week, I've had pain in my cervix like the way it felt when they did the cervadil and had me on pitocin the first time around. Like it's ripening already. Honestly, I don't want to do the preemie thing again, but if I'm going through pre-e again and it's going to happen anyway, I'd much rather go through it naturally. If my body is readying itself for an early labor, it gives me further confidence that it knows what it's doing and that it will recognize that it has to deliver the baby to save itself. I'd started dilating at around week 34-35 during the first pregnancy and I wouldn't be surprised if I had had him a couple of weeks early if the doctor hadn't felt the need to do an immediate induction (again, it was because of rapid rise in protein levels. My bp was normal that entire pregnancy).

I also bought an infant car seat last night. That was the one necessary thing we didn't have yet. I was putting it off because I've had this impending sense of urgency to get everything ready the past couple of weeks. I didn't really want to accept what my body apparently already knows, that I'll be going early again. Not sure if that makes any sense. I was just really hoping for a full term, normal, healthy, vaginal birth this time around. So buying the carseat last night was me admitting to myself that it's not likely to happen that way.

Jillene


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## shannon0218 (Oct 10, 2003)

Jillene, I cannot possibly stress to you enough just how important and urgent this is. You are having symptoms of advanced pre-e and you are having MANY of the symptoms--sometimes it's too late when only one symptom shows up. Your bp does not have to be up to be dangerous, your liver pain does not have to be horrible to be serious. The problem with pre-e is that the later it is caught, the less can be done about it, caught early it can very often be controlled and managed until the baby is further along--but first both the mother and the doctors have to take it seriously! Your concern is having another baby in the NICU, your best way to prevent that is to be proactive about things and not let ANYTHING get out of hand. I can guarentee you and so will my doctor that had I NOT been diligent about my condition--which by the way NEVER got serious, that Molly would have been born well before 37 weeks. You are having liver pain, nosebleeds headaches, facial and upper extremity swelling and have a documented incidence of high blood pressure, in my opinion, you are FAR more urgent RIGHT NOW than I ever was. I'm sure you're feeling like we're trying to scare you, but my God, this is something you simply can't rest easy about--if you go in and they run blood work and it all comes back fine--then great, relax and just monitor it, but the fact is, until that blood work is done--you have NO IDEA how serious you are. Please read Gossamers story of Mary Rose and ask yourself if you can handle that outcome. Please read the story about when my mother had me--she went home from work (in the blood lab at a hospital) with a bit of a headache and 10 hrs later doctors were telling my father that neither she or I would survive.

So yeah, I am trying to scare you here--with the symptoms you describe, you should be scared--and if you mentioned them all to that midwife--frankly, she should be shot! Please do not take this lightly--the outcome of waiting and seeing could very well be the death of you and/or your baby. What is your fear of going in and just making sure everything is alright?? Are you worried they'll put you on bedrest??


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## jillene (Apr 8, 2005)

I'm not worried about bedrest. I've pretty much put myself on limited activity (as much as possible with an almost 2 year old) and I'm drinking lots of water and keeping my feet up. The swelling has gone down a lot. My face doesn't looks so fat and I have ankle bones again. The baby is **** moving all over the place like crazy. I'm convinced he's going to be an acrobat.
Part of why I don't want to go in right this second is that I'll feel more stressed sitting in the ER all day surrounded by sick people than I will if I'm resting comfortably at home. We don't have anyone to watch my son and he's not feeling well. He's had a fever the past couple of days and horrible diarrhea. I don't really want to be exposing him to more germs when his immune system is already working overtime. And I definitely wouldn't want to go by myself, I'd want dh there with me for moral support. The only symptom I'm really feeling righ this second is a mild headache but that could easily be dehydration (just woke up about an hour ago).
I do understand how serious it is. I'm not taking it lightly or being dismissive of it. I did tell the midwife about everything, and I agree that she should be shot. I don't think she was taking it seriously at all. That's part of the reason I'd like to wait until Tuesday. I trust Dr. Debbs to take good care of me. I will call my OB though, and explain to her everything that happened yesterday and that I don't think the midwife is being cautious enough and ask her for lab paperwork. If I can get her to do that without having to go to the ER and deal with a bunch of strangers who don't know my history and who are just as likely to think I'm overreacting as the midwife did, then I'll certainly go in for the labwork. I think part of my problem is that my mother is a complainer. Everyday there's something horribly wrong with her and I'm always wary of coming off that way or of crying "wolf" I guess. I try not to complain unless I really think it's critical because I don't want to be ignored in the future if it is serious. Not that this isn't serious. I just don't want to go through crazy amounts of drama and stress myself out and make it worse than it already is.

Jillene


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## shannon0218 (Oct 10, 2003)

Can you not go into labor and delivery directly?? I mean at least one OB has to be on call--what if you were having contractions?? Personally, I'd call labor and delivery and tell them you're having cervical pressure and pain and you're concerned something is wrong and you'd like to come in. I know at my hospital at least, once you're past 12 weeks, any problems you go directly to labor and delivery-if I arrived at the hospital and said I had a headache they would send me directly from the ER to be assessed at L&D.
I understand your fears of looking like you're overreacting but Jillene, in my OB's words, there is no such thing as overreacting to fears of pre-e. I don't think there's any such thing as over-reacting to any pregnancy concern and any good OB or OB nurse is going to feel the same way. I remember rushing into L&D because by 11 am I hadn't felt any movement, of course as soon as I arrived she was kicking and rolling, they did an NST anyway and I felt embarassed and said sheepishly to the nurse--"so she was just screwing with me?" the nurse laughed and said--"get used to it, she'll be screwing with you for the next 30 yrs or so. Then she said--"you can never be too safe, there's nothing so tragic as a late loss"


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## jillene (Apr 8, 2005)

I wish. At our hospital you have to go to the ER first, even when in labor, and they evaluate you and decide whether or not you should be admitted to maternity. Then you get sent up to the floor maternity is on and get to wait again and go through another evaluation with the nurse and then she decides whether or not you need to see the OB.
Currently from my doctor's office, the stupid midwife is on call. I just found out when I called there and asked to leave a message for Dr. Bredin. So that's not going to help, although she did say if I start feeling worse to call and they'd see me sooner. But their office hours are M-F 9-4:30 so the soonest they'd see me in the office is Monday. Maybe she'd call ahead so I could go straight to L&D? I'll have to ask about that when I call back. I'll do that after I've eaten breakfast and readied myself for battle.

Jillene


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *jillene*
I wish. At our hospital you have to go to the ER first, even when in labor, and they evaluate you and decide whether or not you should be admitted to maternity. Then you get sent up to the floor maternity is on and get to wait again and go through another evaluation with the nurse and then she decides whether or not you need to see the OB.
Currently from my doctor's office, the stupid midwife is on call. I just found out when I called there and asked to leave a message for Dr. Bredin. So that's not going to help, although she did say if I start feeling worse to call and they'd see me sooner. But their office hours are M-F 9-4:30 so the soonest they'd see me in the office is Monday. Maybe she'd call ahead so I could go straight to L&D? I'll have to ask about that when I call back. I'll do that after I've eaten breakfast and readied myself for battle.

Jillene

L&D nurse checking in here. Go to L&D or however it works at your hospital NOW. You need to be evaluated sooner rather than later. If you called me while I was managing the phones in L&D I would tell you to come in for an eval. and we would notify your OB.


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## shannon0218 (Oct 10, 2003)

Jillene, any news yet? How are you doing?


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## jillene (Apr 8, 2005)

I saw Dr. Debbs today. BP was 120/84 and urine was still trace protein, which isn't horrible. I start the 24 hour urine collection in the morning and turn that into the lab on Thursday morning and have the blood work done then. He said he should have results for me on Monday or Tuesday at the latest. So that's good. He is concerned and said I'm doing the right thing by having bought a blood pressure cuff and ordering the protein strips. If it ever reads higher than a 1, he wants me to go straight to L&D. If I get a headache that won't go away or gets worse after taking two extra strength tylenol, he wants me to go straight to L&D. The baby is measuring phenomenally well and everything still looks good and healthy in there. If the labs come back alright, he wants to see me in 4 weeks (when I'm 36 weeks, which is when I had Aidan). If the labs look bad, he'll want to see me sooner. He told me to go ahead and keep the appointment with the midwife on Friday. I told him I found protein strips for $10 online for a container of 100 strips and he said that was a really good deal.  I'm such a good little internet shopper. Froogle is my friend. lol

I feel relieved that the protein hasn't gone up in the past few days. My lower number in my bp keeps staying up there but it's not in the danger level yet. It's weird because Sunday night it was 109/80. I think it's weird for the numbers to be that close. But if he's not worried, I'm not going to worry too much. He told me I can go to my last prenatal yoga class tomorrow (though I'm not sure how I'm going to work that yet with the urine collection issue) but otherwise he wants me to keep my feet up and rest all the time. Which will be interesting with a sick 2 year old to take care of.

So that's what's going on with everything for the moment. My symptoms haven't gotten any worse. My swelling has actually gotten better. It's still bad in the morning but by midafternoon I can put my rings on again. I have to take them off before bed or I wake up with my fingers hurting from the circulation getting cut off from the swelling and I have to run my hands under cold water with lots of soap to get the rings off so I can go back to sleep. Not fun at 3 am.


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## jillene (Apr 8, 2005)

Just wanted to give you guys an update.

Monica the midwife called Wednesday night.

She got my lab results and spoke with Dr. Debbs. She told me I should be on bed rest as much as possible and that my protein was a little high and I should watch my blood pressure and if it goes up at all or I have any severe swelling or headaches or blurriness or... the usual list for preeclampsia symptoms then I should call them and go into the hospital. Yup, thanks. I already know the drill. Then she told me that my insurance covers blood pressure monitoring for me but I told her I already went out and bought a cuff. I did manage to refrain from telling her the reason was that I didn't trust her to follow through properly so I took matters into my own hands. Heh. I also told her about the protein strips and that I'm keeping an eye on that as well since that was the big problem last time, not my blood pressure. Though I'm still doing daily blood pressure checks as well, just in case.

So that's what's going on lately. Swelling has been mild for the most part (spurts of yicky swelling but it goes back down within a few hours). The baby is still very active and my blood pressure has been staying down (was 119/77 last night) and my urine has been good. I've been getting negative readings with my protein strips, so I'm not sure if the protein that was there from the 24 hour went away and it was a temporary spillage or what. Maybe my strips are just bad. No blurriness, mild headaches on and off but they go away when I take Tylenol. So I'm not worrying about it too much for the moment. If my symptoms spike up again I'll probably freak out again but for now I'm content to be calm and stay pregnant and let this little guy cook a while longer.


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## gossamer (Feb 28, 2002)

It sounds like you are doing well and being well monitored. Did you get any blood work done to check your liver enzymes? That is the next thing I would advocate for if you didn't. I hope the little guy is doing well.
Gossamer


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## emmasmommy (Feb 26, 2004)

I was hoping I could avoid this thread this time around, but I don't think I will be so lucky. I'm only 13 weeks today and my blood pressure was 134/90 on Wednesday. My doctor is concerned because of my having pre-e with my first, but he thinks it's too early for pre-e to set in. Is it? I'm starting to really worry that I am going to have a very premature baby, and I don't want that of course. My doctor hasn't discussed meds yet, but I'm sure it will come up at some point if it doesn't go down on it's own. Is there anything I can do that will help it go down naturally. I am trying to eat better and up my protein intake (but I can't and won't follow the Brewer diet - I think it's far too restrictive and I can't live like that for 6 months without a guarantee that it will work anyway). I am also going for walks every night after supper, though those are not very strenuous as they are at the pace of my 2.5 year old. I slept really bad last night because I started thinking about all this when I woke up to pee at 3am.


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## jillene (Apr 8, 2005)

I don't know if they checked my liver enzymes or not, though the midwife did mention the upper right quadrant pain as being something to head into the hospital for. They did check my platelet levels and they were normal.


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## jillene (Apr 8, 2005)

I think trying to stay as little stressed as possible, practice deep breathing and relaxation techniques, and just taking care of yourself in general will help a lot with the blood pressure. Do you knit or crochet or paint or anything like that? It helps me to relax and gets my bp to go down, I've noticed. Are you nervous/anxious at all when you go in for doctor's appointments? It may have just been high from that. When did you develop preeclampsia the first time?


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## emmasmommy (Feb 26, 2004)

I don't really know for sure, but my bp was elevated at 24 weeks last time, but since I had no checks from 8 weeks until then (that's how pre-natal care in Sweden works, they do almost nothing in early pregnancy, I had an u/s at 18 weeks, but other than that, nothing) I don't really know when it started going up. I do want to get a home monitor and will ask my doctor if he will prescribe one so my insurance plan will pay for it. I have had a lot of stress the last couple weeks with work and a sick kid and then a sick husband, but that has all died down, so hopefully now that my life is a bit calmer, it will go down.

ETA - I'm glad I am back in Canada this time where there are more checks early on in pregnancy.


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *emmasmommy*
I was hoping I could avoid this thread this time around, but I don't think I will be so lucky. I'm only 13 weeks today and my blood pressure was 134/90 on Wednesday. My doctor is concerned because of my having pre-e with my first, but he thinks it's too early for pre-e to set in. Is it?

Some women get 'gestational hypertension' which is not pre-e. At only 13 weeks, I'd suspect that was the case and yes, it's too early for pre-e. However, it *might* make you more suceptible to pre-e later ('hypertension with superimposed pre-e').


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## emmasmommy (Feb 26, 2004)

Thanks Mom2six. That actually makes sense. My blood pressure was high long before I started showing other symptoms of pre-e (33 weeks, but I made to 37 before baby was born thankfully).


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## jillene (Apr 8, 2005)

Just wanted to give you guys an update on how things are going with us. I had an OB appointment on Friday and my proteing was at 1+ so she ordered another 24 hour urine. I turned that in this morning. I go back on Friday for the results of that and for the vaginal exam. Oh joy. I've been having a lot of pain in my cervix and crazy braxton-hicks. She said if I went into labor she wouldn't stop it since it's looking like they'll have to take him early anyway. At least I could have the benefits of a vaginal birth that way rather than scheduling a repeat cesarean. So now I'm just hoping I actually go into labor before it gets bad enough that they have to deliver him. My blood pressure has been good and I haven't had too many problems. Last Tuesday I started seeing spots, and I told her about that. I think a lot of what happens next will depend on how the 24 hour urine comes out. My protein goes up and down though. Some days it'll be negative, others it'll spike up to .3 and the next day it'll be back down to trace or negative. So I'm trying not to worry about Friday's spike to 1.0 since Saturday it was only trace and today it's .3. I didn't test it yesterday since I was doing the 24 hour collection. I wasn't sure if that would contaminate a sample.
So that's the news from here. Just wanted to let you know what's going on so you don't worry.


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## gossamer (Feb 28, 2002)

Jillene,
It sounds like you are doing a good job of keeping an eye on it. That's great.
Gossamer


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## jillene (Apr 8, 2005)

I'm trying to. I've been monitoring it closely. I don't want to miss anything important but I don't want to rush to the hospital and have him too early because I'm overreacting either. I'm trying to find a happy medium that keeps me pregnant as long as possible and both of us healthy.

How are you feeling?


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## cherubess (Oct 14, 2004)

This thread is so valuable.

When my pregnancy was confirmed and some weeks thereafter, my GP talked about how I could possibly be a high risk candidate for pre-e (pre-existing high BP and on meds prior to pregnancy). He made me aware that pre-e wasn't a good thing however I didn't realise how dangerous it was until I found MDC and this thread.

Armed with the knowledge of the consequences of pre-e and the symptoms it scared me into action.

Early on I adjusted my diet, made sure I exercised, rested when my body said I needed to and generally looked after myself. I am being looked after by a high risk OBGYN who has also since referred me to a physician/internist because of my pre-existing high BP.

I am now 28 weeks pregnant and both my OBGYN and Physician are pleased with my progress so far.

I am now on maternity leave (I left early based on medical advice).

However I am not silly enough to think that things won't change so I have on my fridge the warning signs of pre-e. I am doing all that I can to prevent it (if it is possible) but also being aware that if I get some symptoms to get it checked straightaway.

I want to say THANK YOU to all you ladies and Gossamer for making me aware of how dangerous pre-e can be.


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## kir (Apr 29, 2005)

Wow, this thread is amazing, and there is nothing like hearing other people's stories to make the threat of Pre-E more real. It's definitely something i'll have in the back of my mind.

I have a question about baby aspirin. When i found out i was preg. a friend gave me a few of her prenatal vitamins and some baby aspirins to take til i saw a midwife; these were from her own doc, since she's trying right now. then the midwife said don't worry about the aspirin. now that i know i'm preg with twins, is aspirin a good idea, since there is at least some reason to believe i could be in a pre-e risk group?

k


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## gossamer (Feb 28, 2002)

I am so happy to hear from you ladies that my little thread has brought around so much awareness. My goal is to just make sure that Mary Rose did not die in vain and hopefully her story can help prevent similar tragedies.

Ange, please be sure to keep us updated. We will want to see pictures of your little one when he is born.

Kir, I would only take a baby aspirin on advice of your midwife or physician because taking aspirin during pregnancy has been linked to miscarriage. It become a point where you have to weigh the risk reward ratio. FOr me, it was worth the risk of miscarriage because my pre-e was so severe.
Gossamer


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## shannon0218 (Oct 10, 2003)

Kir, as someone who was on aspirin my entire pregnancy, honestly, don't take it unless directed to do so. I was on aspirin and heparin injections and the risks of heparin injections is actually significantly lower than the aspirin!
Aspirin can be used to prevent miscarriage in women prone where implantation issues are suspected because of clotting, but if you don't have any clotting issues, it can indeed cause miscarriage.


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## taradt (Jun 10, 2003)

i have also been asprin my last two pregnancies. though this was after discussing the risks and what else i was taking.

tara


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## kir (Apr 29, 2005)

ok thanks. this makes sense.


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## jillene (Apr 8, 2005)

My protein has been at 1+ the past two OB appointments (today and last week). But my bp this week was only 118/68. Last week it was pretty low too. I get to do a 24 hour urine every week now. My protein is going up but slowly so they're not delivering yet. If I don't go into labor naturally by June 2 (my due date is June 7) and I don't suddenly spike in my protein spillage, she's going to do a repeat cesarean then because she doesn't want me going long with that much protein spillage. It's at about 450 mg right now. When I had Aidan it was at 2500mg (got that high suddenly. One week urine was negative the next it was the greenest it could be and the 24 hour came back at over 2500 so they induced and did the cesarean within a couple of days of getting the lab results back). She said if I get up to 1000mg they're going to have to just deliver the baby, which means repeat cesarean since it's not safe enough to induce.
There's a more detailed update in my pregnancy journal (link in signature). But that's where we're at now. Just monitoring my protein and bp and hoping nothing goes wrong and that I go into labor before June 2. I really want to avoid another cesarean if possible.


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## jillene (Apr 8, 2005)

My urine has still been at ++ today. I've been dumping the last couple of drops from the cup for the 24 hour collection onto the test strips to keep checking it. It's been at ++ all day. In addition to that, I've been drinking a ton but my output is pitiful. There's not much urine in the jug at all and it's a very dark orange, almost brown color. Not good at all. Don't be surprised if I have the baby by the end of the week.

I'm going to call Dr. Bredin in the morning and see what she wants me to do. My bp is alright, no swelling (for the first time in weeks), mild headache, no spots, no liver pain. Baby is moving (currently I'm having a contraction) regularly and responds to stimulus. I'm just spilling protein like crazy again. Lovely. I'll be 36 weeks on Tuesday.


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## SaraMama (Sep 19, 2004)

I'll be praying for you and baby. Just try to think positively. I had Aaron at 34 weeks and Colton at 37 weeks. They were both born healthy, with no health problems at all... didn't even need oxygen!

If you are getting Pre-e it will be much better for you (and the baby) for him to be outside rather than inside!


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## jillene (Apr 8, 2005)

I had DS at 36 weeks because of the same problem, crazy protein spillage and he ended up in a NICU over an hour away for 16 days. I didn't get to see him until he was 4 days old or hold him until he was a week old. It was not a fun time, it was very scary and bittersweet. Not something I want to repeat, that's for sure. Though I know I'm lucky because he was able to come home and so many babies don't. It was definitely hard on me though and I don't know if I can handle going through all of that again plus reliving those memories and feeling like I'm torn between my 2 yo at home who still needs his mom and my newborn in the hospital who also needs his mom. I don't know how I would handle that. I think that's my biggest fear about the whole NICU thing.

I'm really hoping I'm right about my due date (I think it should be 5/26) because then I'm closer to 38 weeks and have a lot less to worry about.


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## shannon0218 (Oct 10, 2003)

Jillene, can you give them a call now?? The protein wouldn't worry me so much if it weren't for the poor urine output, your kidney's could be starting to shut down on you.
If it's not possible to get in now, at least measure the amount of fluid you take in and measure what amount is coming out.
I know it is horribly inconvenient to head to the hospital in the middle of the night, but as you know, pre-e can go from moderate to tragic in a matter of hours.


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## gossamer (Feb 28, 2002)

Dear Jillene,
I think you should go to the ER now. The "coca cola" pee is another sypmtom of pre-e. It is a sign that your kidneys are shutting down. I would hate to have you wait too long and wind up with dialysis or a kidney transplant. My prayers are with you and your baby. I know that the NICU is no fun, but it is better than a funeral home. Please keep updated.
Gossamer


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## jillene (Apr 8, 2005)

I turned in the 24 hour and had the bloodwork done yesterday morning and talked to the OB last night. My urine looks normal again and output is normal again, though it's still fluctuating between 1+ and 2+. She wants to wait until she gets the blood results back today. She said if I went into the hospital last night, all they would do is watch my bp (which I'm doing at home), watch my protein (which I'm doing at home), count fetal movement (doing at home) and take blood again but they still wouldn't have results until today so I may as well stay home where I'm more comfortable. I have a huge checklist of things to go into the hospital for. It wasn't really cola colored, more like iced tea. Nowhere near as dark as cola. That would have freaked me out a ton. My OB seems confused that my bp isn't really going up. It never did the first time either though. I'm starting to wonder if it's even toxemia/pre-e and not just kidney problems related to the genetic condition I have. Maybe my kidneys just can't handle this much strain? Not that it's any less serious, but I would think it would require different action than waiting for my bp to get too high or even relying on my bp as an indicator that things have gotten bad enough that delivery is required. I might call the perinatologist and see what he thinks of that theory and what he would recommend. Not that I don't trust my OB, she's great, but it would be good to have another opinion from someone more familiar with me and my genetic condition.

Anyway, I should have a better idea of what's going on today.


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## gossamer (Feb 28, 2002)

I am so glad you are keeping such a close eye on this. High blood pressure can be the last symptom to appear. So don't be fooled by your blood pressure. It can still be pre-eclampsia. Did you have kidney problems prior to pregnancy?
Gossamer


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## jillene (Apr 8, 2005)

Not serious kidney problems but I do get a kidney infection about once a year or so, and they can get pretty bad. I have to have my protein checked yearly just to be sure I don't start spilling any. I have a condition called Nail Patella Syndrome that you can read more about at http://www.nailpatella.org if you're interested. I'm definitely more prone to kidney problems. So it could just be that my kidneys can't handle the extra strain of pregnancy for this long and that's why I start having problems. I'm sure that it still doesn't create a good environment for the baby but I would think that my protein levels would be more important than my bp levels if this is the case.


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## crazy_eights (Nov 22, 2001)

If your only symptom is proteinuria and you have a kidney issue, that could very well be your problem. A consult with a nephrologist might be in order.


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## jillene (Apr 8, 2005)

I do get swelling and my bp has been pushing up towards high but not really hitting the 140/90 mark my OB seems to be waiting for. The highest it's gotten is 137/88. But my nromal bp is around 110/60 or slightly over that. When pregnant (earlier in pregnancy) it's been around 116/64. So still pretty low compared to what it's been doing. I also get headaches and have seen spots and such. So I'm not completely symptomless.


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## jillene (Apr 8, 2005)

Ryan Cooper VanNostrand was born 5/11/05 weighing 6 lbs 6 oz and measuring 19" long. 4 weeks early due to pre-e. You can find my birth story in my pregnancy journal in my signature. We're both home and doing well!


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## shannon0218 (Oct 10, 2003)

Oh Jillene, I was just wondering about last night! I'm so happy he was born and you're both doing well. Good for you for watching your symptoms so diligently. Did he have to go to NICU at all or was everything perfect?


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## gossamer (Feb 28, 2002)

Congratulations on bringing home a big beautiful baby. I am sorry he was born early but I am glad you and he are safe and sound. Congratulations again.
Gossamer


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## cherubess (Oct 14, 2004)

hi Jillene,

Congratulations to you.

I'm glad to read that all turned out well in the end.


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## MrsMoe (May 17, 2005)

I have preclampsia with my first born.

I want to state I didn't have any of the risk factors other than a first time pregnancy. I was not overwieght other than an extreme amount of water retention late in the game. It didn't show until the 3rd trimester.

My doctor was a moron and iddn't give me any treatment for the condition. I labored for over 16 hours (hard labor - over 24 total) and my blood pressure was 210/117. When your blood pressure is that high and you are having a nasty back labor, let me tell you, it's not fun. I am still shocked the Dr. didn't take her by C section, then again, I think the entire delivery I saw him twice, and the pushing stage he wasn't there but to catch the baby and sew me up.

I do have a prolapsed mitral valve and I have (after havign my daughter) had some issues with high blood pressure, in fact due to high blood pressure I can not take birth control. Before my daughter was bron I never had any issue with high blood pressure.

I am pregnant again with my 2nd, I truly hope I do NOT go through the preclampsia nightmere again.







:


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## cherubess (Oct 14, 2004)

MrsMoe







: that all goes well for you


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## tuppence (Feb 18, 2005)

Hey! I've read through this thread and decided that you guys would be the best folks to talk to about this. My providers think I have early pre-e, based on hand swelling, elevated BP and slight protein in my urine. My BP started out abt 110/60 and now ranges in the 130s-140s/70s-80s with one spike up to 152/97. It seems that it might have been getting higher every few weeks. My bloodwork is fine though and I don't have headaches or blurred vision.

After the last spike on Weds, my midwife sent me to the hospital for induction--I had three doses of cervadil in 36 hrs, none of which accomplished anything. My vitals were good enough that they let me go home for the weekend on bedrest, as long as I promised to check my bp regularly, but I have to go back on Sun evening for another induction attempt and this time they're going to try a very small dose of cytotec (25mg).

I know that cytotec has had some very scary side effects and I've read a lot of articles about it--it does seem like the worst cases were with higher doses or in women with previous c-sections, but still, I'm trying to decide if it's worth the risk. I don't want anything to happen to me or the baby because of the pre-e, and I don't want an emergency c-section, but is that cytotec riskier than that? I just don't know. The OB who will be doing it has a lot of experience with the drug and seems pretty confident about the result, but don't they always...


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## jillene (Apr 8, 2005)

Shannon, thanks! We did not have any NICU time, though he spent his first night in the intermediate nursery because he was doing that wheezy, moaning thing every breath he took. The peds said it was likely just extra fluid in his lungs because he was a cesarean baby and didn't have labor to squeeze any of it out. He was breathing well on his own by morning and didn't need oxygen or anything, so that's good. That was my biggest worry. My first was in the NICU over an hour away from where I delivered him (at a children's hospital) and that whole ordeal was just so emotionally draining. I couldn't imagine going through that with a two year old at home who needed me too. That would have broken my heart, so I'm glad Ryan is healthy and that everything went smoothly, given the circumstances.

Charlotte, I would try to avoid the cytotec. I've heard some pretty nasty stuff about it and I don't think it's something I would allow. Have they tried pitocin at all? Pitocin is the devil as far as comfort goes but I think as far as safety goes, cytotec is worse. Good luck with whatever you decide. I hope everything works out alright!


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## gossamer (Feb 28, 2002)

Charlotte,
I would see if they would be willing to monitor you in the hopital. It sounds like your body is not ready to labor yet. I am not usually one to advocate waiting, but if they monitor you in the hopital they can do constant bp checks, lab work to check your liver enzymes and keep an eye on your urine out put, all of which could tell them if you are headed down a rocky road. I owuld try to avoid the Cytotec, i have heard horror stories about it. Please keep us informed of what's going on.
Gossamer


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## gossamer (Feb 28, 2002)

MRsmoe,
Are you on any supplements like baby aspirin or vitamin C? Have they checked you for any genetic clotting disorders? Are you seeing a different Dr. this time, a perinatologist? Please keep us informed about how your pregnancy is going.
Gossamer


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *gossamer*
MRsmoe,
Are you on any supplements like baby aspirin or vitamin C? Have they checked you for any genetic clotting disorders? Are you seeing a different Dr. this time, a perinatologist? Please keep us informed about how your pregnancy is going.
Gossamer


I have yet to even go to the Dr.







: I don't have OHIP yet (going through immigration process) so since we are paying out-of-pocket I have been pushing it off. Last 2 days my blood-pressure has been high, I have acid reflux, and my face is on fire from being all swollen. Over the several days, since blood pressure went up, I have put on some sudden weight, I am positive it is from water retention. I also had a headache that lasted 2 days straight, and I have had headaches off and on since. So, I have a bad feeling this will be a repeat of the last pregnancy.

I don't know if I have any clotting disorder. I bruise real easy, have very heavy periods, and chronic nosebleeds, but I'm not a "bleeder" or anything (like when I get cut I don't bleed like crazy.) I am taking pre-natals a friend gave me and I take half an aspirin at night before bed (I heard it was good for you if you are at risk.) I also eat well and snack on fruits.

I am going to go to an OBGYN who was highly reccomended, and is a professor at McMaster University. I have plans next Saturday to go to a walk-in clinic and get a referral (you have to get a refferal in Canada.) To be hoenst with you, I don't even know what a perinatologist is...


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## shannon0218 (Oct 10, 2003)

Mrs Moe, you need to go to an ER now. I can tell you with certainty you are VERY unlikely to get a referral to a professer at Mac by going to a walk in clinic for a first visit, it's just not the way it works.
Where are you?? I'm assuming you are somewhere close if you are looking at McMaster, let me know, I can give you my OB's name--she could get you in at Mac as she's still affiliated with that hospital--but you still won't likely get to pick your doc, you'll get whichever peri can see you first.


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *elyice*

My Mika, My best friend in the world, soul sister and lifelong running mate is gone.


Quote:


Originally Posted by *gossamer*
"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. This is the miracle of life. " -Maureen Hawkins Mary Rose 07/29/03 11/18/05

I don't even know what to say... Went back and read every post in this thread, so sorry for your losses. It brought tears to my eyes.


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *shannon0218*
Mrs Moe, you need to go to an ER now. I can tell you with certainty you are VERY unlikely to get a referral to a professer at Mac by going to a walk in clinic for a first visit, it's just not the way it works.
Where are you?? I'm assuming you are somewhere close if you are looking at McMaster, let me know, I can give you my OB's name--she could get you in at Mac as she's still affiliated with that hospital--but you still won't likely get to pick your doc, you'll get whichever peri can see you first.

I can't pick my doctor? You are kidding right? If they want to be that way, I will jsut go over the border into Buffalo, cause that's stupid. I called Dr. Ramanna's office already, they said it wouldn't be a problem soon as I got a referral? I had told them a friend referred me etc.

ER??? Na, I just have to take it easy... right? I mean, why go to the ER? With my daughter at the end I had those severe "gas" pains and whatnot (my doctor was so so so stupid.) but I was way way worse with Emma's pregnancy than I am now.


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## acrathbun (Apr 27, 2004)

Quote:

ER??? Na, I just have to take it easy...
I hope you are right. Pre-e has a way of sneaking up on you. You think you are fine....and then you just *aren't*

Good luck at the dr's this week.


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## MrsMoe (May 17, 2005)

thanks

PS - When I called the Dr's office to make an appointment, and she told me to get a referral, she told me just to go to a clinic to get one because I would never be able to get to a Dr. She also said she looked forward to meeting me, and we went over all of the fees etc.

Edited to add - going to go to the clinic for a referral tomorrow instead of Saturday.







Thanks guys!


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## shannon0218 (Oct 10, 2003)

I'm glad you're going tomorrow to see someone







When you read some of the stories here of what can happen when it does go wrong, you'll see why I'd say better safe than sorry


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## SaraMama (Sep 19, 2004)

MrsMoe, I'm so glad to read that you are going to the doctor sooner than Saturday.

I, for one, didn't even know I was sick at all (I had Severe Pre-e and HELLP Syndrome) when I went in for one of my monthly OB appointments. I had to be rushed to the hospital where I was induced immeaditely. They later told me that if I hadn't seen my doctor that day I'd probably not have survived another 24 hrs! That is sooo scary to me since I had NO idea at all! I remember having a little 'heartburn' and swelling, but I thought that was normal during pregnancy...

I'll be praying for you and your baby.


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *SaraMama*
MrsMoe, I'm so glad to read that you are going to the doctor sooner than Saturday.

I, for one, didn't even know I was sick at all (I had Severe Pre-e and HELLP Syndrome) when I went in for one of my monthly OB appointments. I had to be rushed to the hospital where I was induced immeaditely. They later told me that if I hadn't seen my doctor that day I'd probably not have survived another 24 hrs! That is sooo scary to me since I had NO idea at all! I remember having a little 'heartburn' and swelling, but I thought that was normal during pregnancy...

I'll be praying for you and your baby.










wow, so lucky you had a good doctor!!!!!!!!


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## Oonah (Jul 28, 2004)

A very important first post from a long time lurker.

I have a 17mo old....I was never diagnosed with pre-e with that pregnancy, but I did have PIH starting around 34 weeks. After 6 weeks of bed rest and weekly NST's I delivered a healthy full term baby boy.

Here I am pg with #2....20 weeks. Today at my appt my bp was high 148/88. My regular pressure holds steady at 130s/80s (never really went back to "normal" after pg #1). Protein in my urine today (+2). I've been having some headaches...not too terrible, they don't last long. They drew blood today and I got the gear for a 24 hour urine sample and my OB has asked me to stop working and start bedrest.

I am very frightened. I am only 20 weeks!! I am intimidated by this long road of worry and anxiety that lies ahead of me. I feel depression coming on fast, this road ahead seems so long and it just seems to me now that things are only going to get worse....this can't possibly turn out good.

I have been on the phone all evening with my dear friend who is also my doula. She has given me incredible support and encouragement. The fear is overwhelming and I know it's not helping ANYTHING at this point.

I would love to hear any advice anyone has to offer on any part of my story.

c


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## shannon0218 (Oct 10, 2003)

Please don't panic but do be diligent. At 16 weeks my bp flew up, and I did have protein in my urine, but my blood work was still normal. I was told to take things very easy, I was put on blood pressure meds and my baby girl was born at 37.5 weeks very, very healthy







I was in hospital for 10 days before she was born as it got harder to control but we all made it. Your doctor sounds wonderfully proactive and believe me, that is more than half the battle.
Do some research, hang out here, take warm baths with epson salts and buy yourself a bp monitor but please dont' panic yourself as that will not help your pressure at all.

We're here for you sweetie and there's no reason to think you will loose this baby provided you and your doctor are diligent.


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## acrathbun (Apr 27, 2004)

Hi there,

I'm not sure if my post will be helpful or not, but here goes!

I started w/ pre-e symptoms at 24-26 weeks w/ my last pregnancy. Thomas was delivered at 31 weeks. That has been pretty consistent for me w/ my pre-e pregnancies.

W/ my first I started having symptoms at 25 weeks and Spencer we delivered at 32 weeks.

For me, and I know that it can be so different for everyone, I have about 7 weeks from onset of symptoms to baby delivered.

I hope that you will be able to make it until at least 32+ weeks.

Thinking of you.


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## gossamer (Feb 28, 2002)

simply me,
There is no reason to panic until you get your blood results back. If everything is ok as far as liver enzymes etc... then you do need to be diligent about taking any meds they recommend and taking bedrest seriously. Luckily Shannon was able to hang onto Molly until she baked long enough to be able to come home. But it is because Shannon was vigilent about following the Dr.'s orders and did not take anything lightly. Pre-e is serious and I hear so many women say, oh it's such a hassle to go to the ER or make another appointment or call my doctor or find another Dr. I always remind them that is it nowhere near the hassle of planning your child's funeral or picking out a casket to bury your baby in or trying to decide what they will wear the first and only time you ever get to dress them. That is a hassle. So be diligent and vigilent and most importantly, trust your gut. If you think something is not right, say so and say it until someone listens. I will be praying for you.
Gossamer


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *simplyme*
A very important first post from a long time lurker.

I have a 17mo old....I was never diagnosed with pre-e with that pregnancy, but I did have PIH starting around 34 weeks. After 6 weeks of bed rest and weekly NST's I delivered a healthy full term baby boy.

Here I am pg with #2....20 weeks. Today at my appt my bp was high 148/88. My regular pressure holds steady at 130s/80s (never really went back to "normal" after pg #1). Protein in my urine today (+2). I've been having some headaches...not too terrible, they don't last long. They drew blood today and I got the gear for a 24 hour urine sample and my OB has asked me to stop working and start bedrest.

I am very frightened. I am only 20 weeks!! I am intimidated by this long road of worry and anxiety that lies ahead of me. I feel depression coming on fast, this road ahead seems so long and it just seems to me now that things are only going to get worse....this can't possibly turn out good.

I have been on the phone all evening with my dear friend who is also my doula. She has given me incredible support and encouragement. The fear is overwhelming and I know it's not helping ANYTHING at this point.

I would love to hear any advice anyone has to offer on any part of my story.

c

I know preeclampsia is scary, but I am glad you caught it early. I am also glad that your doctor has ordered bedrest, be glad he isn't an ignorant fool and advised you to work anyhow (like my doctor did and other doctors of other mommies on this forum)- but- what about medications? Any meds to lower your blood pressure? Or is your BP lowering on it's own? Are you taking your BP daily? You can buy a little home machine at the local drugstore.

Make sure you AVOID caffine! And drink lots of fluids. That will help with swelling and blood pressure.

Now, some things to make you feel mroe at ease. One thing I notice is that your blood pressure is normally 130, which is on the highest end of normal. While your BP isn't perfect currently, it could be far worse. And the diastolic is under 90, which is decent. While it isnt' ideal of course, your BP isn't extreme. Now if your BP was normally 110/65 then I would think, WHOA HUGE JUMP! At least it hasn't climbed TOO far, if you know what I mean.

Please keep in mind, stress in any form will increase your blood pressure. Try to relax. Order a movie. Have your man buy you some bon-bons and a Star magazine. Try everything to stay relaxed.


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## greenmansions (Feb 16, 2005)

Question on Pre-E: I just found out I am pg w/ #2. I have not been to my OB yet, but am wondering how likely I might be to get PE with this pg. I got it at the very end of my 1st pregnancy after 4 days of labor w/ 5-10 minute apart contractions pretty much the whole time (point is, it was very stressful and painful) and I was 40 at the time. I developed PE after 2 hours of pushing on day 4 - high bp, high creatinine etc. So I had an emergency c-section. I weighed more after the baby was born than I did right before from all the swelling, lasix for 3 weeks, etc but my bp went back to normal and has been very good since.

Anyway, do you think the PE came on due to the circumstances of my labor and therefore I might be less likely to get it again with this pg? I am very concerned about the possibility of getting it earlier this time 'round and we have no support system since we moved here, away from family and closest friends. Bedrest would be a nightmare because of that.

Thanks for any thoughts...


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## MrsMoe (May 17, 2005)

Preeclampsia in the pushing stage of labor? Did you have protien in your urine or any other symptoms besides high blood pressure and high creatinine in your blood or was it Pregnancy Induced Hypertension (very high blood pressure?)


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## shannon0218 (Oct 10, 2003)

greenmansions, perhaps you could look into hypnobabies, if your symptoms only started after days of labor, hypnosis has been known to A) speed labor along and of course B) keep mom calm and relatively pain free so she can rest properly between contractions.
Just a thought.

Mrs. Moe, I did ask my OB what she thought of the OB you're going to and she said he's very thorough and it's a good fit for you if you've had complications in the past--she said the only thing bad she's heard about him is he treats everyone like they are high risk--so I guess he's got a bit of that "pregnancy is a disease" attitude, but basically she said he's very likely to be diligent with your case.


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## gossamer (Feb 28, 2002)

greenmansions,
A substantial number of women get pre-eclampsia after giving birth. Most women who die form pre-e die within 24 hours after giving birth. I wouldn't say that labor brought on the pre-e and the number one risk factor for getting pre-e is having had pre-e. I would caution you to take it easy, know the signs and symptoms and make sure your Dr. knows about your history. The good news is that you contracted pre-e so late in the game. The later and more milder it is, the less chance you have of getting it again. Did that thouroughly confuse you? If you have further questions, www.preeclampsia.org is a great resource for pre-eclampsia.
Gossamer


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## greenmansions (Feb 16, 2005)

Thanks all for the info. I will check out that link for the pe organization.

Mrs moe all i remember was that the creatinine was a measure of kidney function, I think it was measured in urine not blood, tho I'm not positive about that I guess

Gossamer, I am very sorry for your loss and very much appreciate that you are taking the time to help all of us.

I am lucky that my baby is very good and my DS is into keeping everything "low stress" for me during pregnancy - he believes that results in a calm baby, and it worked with the first one. This time round the pe is another reason to keep a low stress lifestyle.

One thing I want to see when I go to my OB (who I really like) is whether she will push me to have a c-section off the bat this time, or let me try a v-bac. I am also not sure which I prefer at this point. But the pe was not fun, and if a c-section at the due date would help avoid it, assuming I don't get pe earlier on, I would consider it. (pe and lasix cost me bfing my son - no milk for 3 weeks- and then pumped & bottle for nearly 9 mos. til no supply left - I'd give up a vaginal birth to be able to bf the next one.)

I apologize if I post this twice, I'm not sure if I submitted it before I went out this morning or not...


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *shannon0218*

Mrs. Moe, I did ask my OB what she thought of the OB you're going to and she said he's very thorough and it's a good fit for you if you've had complications in the past--she said the only thing bad she's heard about him is he treats everyone like they are high risk--so I guess he's got a bit of that "pregnancy is a disease" attitude, but basically she said he's very likely to be diligent with your case.


*Wow, thanks!* That was SO cool of you!









While like you, I am not a fan of treating everyone high risk, in fact I had truly wanted a midwife and a home birth.







But given my medical circumstances and history, I am technically high-risk anyhow, and at this point I would rather have a Dr. be careful vs reckless like my previous Dr.

Again, thank you!

Quote:


Originally Posted by *greenmansions*
Thanks all for the info. I will check out that link for the pe organization.

Mrs moe all i remember was that the creatinine was a measure of kidney function, I think it was measured in urine not blood, tho I'm not positive about that I guess

Gossamer, I am very sorry for your loss and very much appreciate that you are taking the time to help all of us.

I am lucky that my baby is very good and my DS is into keeping everything "low stress" for me during pregnancy - he believes that results in a calm baby, and it worked with the first one. This time round the pe is another reason to keep a low stress lifestyle.

One thing I want to see when I go to my OB (who I really like) is whether she will push me to have a c-section off the bat this time, or let me try a v-bac. I am also not sure which I prefer at this point. But the pe was not fun, and if a c-section at the due date would help avoid it, assuming I don't get pe earlier on, I would consider it. (pe and lasix cost me bfing my son - no milk for 3 weeks- and then pumped & bottle for nearly 9 mos. til no supply left - I'd give up a vaginal birth to be able to bf the next one.)

I apologize if I post this twice, I'm not sure if I submitted it before I went out this morning or not...

Gossamer has really educated herself on the preeclampsia topic as well as personal history with preeclampsia. If you haven't read through the posts here, please do, there is some very good information here as well as personal exp - some with very tragic results.


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## Oonah (Jul 28, 2004)

Thanks for your encouragement.

I am not on bp meds. I do have a home monitor. I had one high reading today 144/84...but the rest have been hovering around 115/75 so I am thrilled. My bloodwork came back normal....I bet that helped lower my bp!!

I am still struggling with the overwhelming thought of being on bedrest for 20 weeks! I am hooked up to do some work from home, that will help a lot I think. I am just trying to focus on the positive. DH is a SAHD so I get to spend the next 20 weeks alone with my DH and my DS....how cool is that. I get to nap and snuggle with DS...read books, color, cuddle. Tons of good quality time together before we have a new baby in the house.

Here's to taking it one day at a time!!!


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## shannon0218 (Oct 10, 2003)

Simply me you're not on any meds yet, so that step is available before bedrest, just try to take it easy when you can and keep an eye on your pressure. I'm so glad your doc is so diligent--some women actually have to fight just to have blood work done!! Having a doctor taking you seriously and you having the knowledge to know when something just doesn't feel right is more than half the battle in my opinion. You'll do great!!!
Enjoy your dh and ds--we're looking at trying again in August or September, my biggest struggle is with the thought of bedrest with a young child already--my thinking is it will be easier before she's super mobile--even if it means I have to have her in front of the TV in bed with me (I hope, I hope, I hope, I hope!!) My luck she'll walk super early or something just as ridiculous :LOL


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## gossamer (Feb 28, 2002)

Just to give you all some idea of what is available as far as care goes. I see an OB, a perinatologist and a cardiologist. I have had an echocardiogram, an EKG, a 24 hour urine, 2 liver panel/platelet counts and 3 ultrasounds so far. I take my bp 3 times a day and fax them once a week to my cardiologist. I see at least one dr. every 2 weeks. SOme times more often. I saw my OB this past monday, I will see my Peri this monday and my cardiologist on tuesday. T his is the routine until I hit 20 weeks. That is when the monitoring will get intense and frequent. And if I make it to 38 weeks I will have a repeat cesarean section because of my previous classical incision.

Is it the intervention free, natural, crunchy granola pregnancy and birth I dreamed of? No, of course not. BUt does it give me a greater chance of bringing home a baby, you betcha. So, this is what a pre-eclampsia prone pregnancy can look like. IF you are not as closely monitored as I am and if you are not being seen as frequently as I am, there is room for manipulation of your meds and environment and monitoring before you get too bad off. Hope I didn't scare you.
Gossamer


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## shannon0218 (Oct 10, 2003)

Yes, while I didn't see a peri regularily and didn't see a cardioligist at all, I was seen weekly by my ob for fetal hb check and bp--I was also doing pressures 3x a day and was to call if I had 2 consecutive readings that were high, or if I had a high reading accompanied by a head ache.


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## Oonah (Jul 28, 2004)

Quote:


Originally Posted by *shannon0218*
Simply me you're not on any meds yet, so that step is available before bedrest

See now THAT's what I've been wondering. If all else is well and my only issue right now is bp....why can't I take meds and hold off on the bedrest?

I asked my OB that question on Wednesday. His response was, you're bp is not high enough to make it worth the risks that come with starting bp meds. I said....women get pg every day while taking bp meds...many of them PLAN their pregnancies AND continue bp meds their entire pregnancy....why would it be so bad for me to start mid way though. His repsonse....your current bp doesn't meet ACOG standards for starting bp meds, let's treat this naturally with bedrest. He added that even if I was on bp meds he would still have me on bedrest.

Now I am all for an OB that wants to treat things naturally, that is why I chose him, however....20 weeks of bedrest is a LONG time and I strongly indicated to him that this was going to be VERY difficult for me.

We're going to talk about this again at my appt on Monday. We should have my 24 hour urine results to add to the equation.

If my only issue is bp, is it reasonable for me to think that medication and no bedrest would be an appropriate treatment plan for right now? I will still continue weekly visits and I can monitor my bp and protein at home.

Clearly I am fighting bedrest....but not at the risk of my health or my baby's health....that's why I am asking, researching, reading etc.


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## shannon0218 (Oct 10, 2003)

I was put on meds the day my bp had 2 readings of 140/95. For me at least, I was sort of already on some sort of bedrest, I was sick until 20 weeks and couldn't eat anything, that really all I did was lay around, so perhaps that was why further rest was not suggested--however, I felt ok for about 8 weeks and I was active and it didn't seem to make a heck of a difference in my bp.
Maybe you could do a day of rest here and there and see what the difference in your bp is.
Bp meds are considered category C which means that no, they really aren't something you want to be on unless you really need them, that said, I was on so many C drugs for her pregnancy and she is fine. Labetalol seems to be the one with the most use in pregnant women--I'm not sure what Gossamer is on.


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## gossamer (Feb 28, 2002)

I take aldomet 250 mg 4 times day and acebutelol 200 mg twice a day. Labatelol gave me the shakes and pro cardia made my cheeks flush.

There is a risk in taking bp meds because that can contribute to IUGR (Intra Uterine Growth-Retardation/Restriction) becasue it artifically lowers your bp so not as much blood is traveling to the uterus. That is one reason I am walking the tightrope I am with my perinatologist vs. my cardiologist. My peri wants my bp's around 130/80, my cardiologist isn't thrilled about these numbers but is willing to compromise by having me fax in my bp's weekly. IUGR is something Mary Rose suffered from and is partly why she did not survive. Although she was 24 1/2 weeks, physically she was more like a 22 week old fetus. Her eyes were fused shut, her skin was still gelatinous and she weighed less than a pound. And there is nothing worse than thinking that you are eating right and doing everything you can for your baby and then come to find out that your own body was starving her. I understand the 20 weeks bedrest is a hassle and no fun and will be a strain, but once that baby is born big and healthy and gets to come home, you will know it was all worth it.
Gossamer


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## MrsMoe (May 17, 2005)

You know, something in my head sorta clicked. It was mentioned here about auto-immune disorders being linked to preeclampsia. I of course think Lupus and so on when I think auto-immune disorder, but I realized today that I do have an auto-immune disorder (be it not as serious as Lupus.) I have a thyroid condition called Hashimoto's Thyroiditis, which is the most common hypo-thyroid disease. Basically, what I deal with is an underactive thyroid resulting in a multi-nodular goiter on my thyroid. http://www.medicinenet.com/hashimoto...is/article.htm

Do any of you moms have issues with your thyroid?


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## greenmansions (Feb 16, 2005)

I also have Hashimoto's - have had it since age 12. Hmmm...


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *greenmansions*
I also have Hashimoto's - have had it since age 12. Hmmm...


I had it at a young age also (my goiter took years to develop and it wa squite large at the age of 21.)

Interesting. I wonder who else here has it or thryoid issues?


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## emmasmommy (Feb 26, 2004)

I posted on this thread a few weeks ago about my bp being already 140/90 at 10 and again at 14 weeks, so I just wanted to post an update here.

I'm now 20.5 weeks, and at 16 weeks and again this week, my blood pressure has been holding at 130/80. Still not super low, but my doctor is happy with this and so I am I. It has gone down on it's own without medication or bedrest, so that must be a good thing.

Now my goal for the remainder of this pregnancy is to stay healthy and go full term and have a successful VBAC. Barring that, I want to make it to at least 35 weeks and be healthy enough, so I can give birth at our local hospital (no NICU, so that's the earliest they will take you) rather than having to go to the bigger hospital an hour away.


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## gossamer (Feb 28, 2002)

Natasha, that is wonderful. I will keep you in my prayers that you make it to at least 35 weeks if not full term. Please keep us updated.
Gossamer


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## kir (Apr 29, 2005)

Since I am carrying twins, and since a close friend who also recently had twins had preeclampsia that resulted in an early delivery of her babies (they are all fine now!).....I'm totally scared of pre-e.

I'm 15 weeks today. I'm wondering....when do you really need to start being aware of symptoms (like pain in your liver, high bp, etc.)?? what is the range of weeks when pre-e starts to show up?

Thanks for any help you can give....
K


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## MrsMoe (May 17, 2005)

On average, symptoms do not arrive until around 20 week,s but can arrive earlier. First symptom to watch for is high BP and swelling in hands and face. If you get high BP or swelling in hands and face, contact your healhtcare provider and they will test for protien in the urine. Stomach pains due to liver is from advanced preexlampsia/HELLP, but even early stage pree can develop rapidly.

You are at risk for preeclampsia if:
you have chronic hypertension (high BP before you got pregnant)
developed high blood pressure or pree during a previous pregnancy, esp if these conditions occurred early in the pregnancy
you are younger than 20/older than 40
pregnant with multiples (such as twins)
you are diabetic, have an auto-immune disorder such as rheumatoid arthritis/lupus/scleroderma., have a bleeding disorder, have kidney disease

Today I went to my OBGYN. He told me to take Calcium suppliments and Fish Oil pills to prevent pree because I am at risk. I also know taking one baby aspirin per day prior to the 16th week (and onward- but this only works if you start aspirin therapy prior to 16 weeks) can also prevent pree.

PS I didn't have protien in my urine (yay!,) and my BP is back to normal 110/70 from 140/95 because I have been taking it easy around the house. If I get active and start to swell, I stop and relax on the couch.

edited cause i can't speeel


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## aliaspice (May 29, 2005)

I also had this condition. It took talking to a doctor instead of a midwife to diagnose me, tho. The midwife kept saying she "wasn't concerned" with my BP/unusual weight gain, edema, etc. It took seeing a doc in the same practice, to look at my ankles, and immediately say, ok...we need to induce. I was scared to death but under her care, I was closely monitored before, during, and 6 weeks after Xander was born. Ladies, listen to your hearts if you know something is wrong but you don't know what. I loved my midwife, but she kept basically telling me not to each so much. And I was eating only about 1500-2000 cals a day...When I walked my feet sloshed...My BP was at one point in the 160's over 90's. Scary. Thank you for this wonderful "sticky", such wonderful research...it's something that is not talked about a lot but a number of my friends have had it, too! The books usually just gloss over it, and a lot of doctors and midwives do too.


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *aliaspice*
I also had this condition. It took talking to a doctor instead of a midwife to diagnose me, tho. The midwife kept saying she "wasn't concerned" with my BP/unusual weight gain, edema, etc. It took seeing a doc in the same practice, to look at my ankles, and immediately say, ok...we need to induce. I was scared to death but under her care, I was closely monitored before, during, and 6 weeks after Xander was born. Ladies, listen to your hearts if you know something is wrong but you don't know what. I loved my midwife, but she kept basically telling me not to each so much. And I was eating only about 1500-2000 cals a day...When I walked my feet sloshed...My BP was at one point in the 160's over 90's. Scary. Thank you for this wonderful "sticky", such wonderful research...it's something that is not talked about a lot but a number of my friends have had it, too! The books usually just gloss over it, and a lot of doctors and midwives do too.

Oh sweetie!







I so understand what you went though!







The doctor that delivered my first treated my pree like it was nothing.

Today I went in to see my Dr. and gave him my medical background. He wanted to know about my first pregnancy, so I told him what I went though with Emma (even with severe abdominal cramping, high amount of protien in my urine, BP pre-labor 180/100 and during labor 210/117) and how my former Dr. did nothing, no tests for liver function or anything else, nothing.. well, when I told my Dr. today, his jaw fell open, literally, and he wanted to know what doctor and what hospital.

High blood pressure and severe edema are always a concern, even if it's not pree - it can progress to that rapidly, but for some screwy reason a lot of medical professionals don't seem to care. Maybe because pree is so common? Sad.


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## gossamer (Feb 28, 2002)

Quote:


Originally Posted by *kir*
Since I am carrying twins, and since a close friend who also recently had twins had preeclampsia that resulted in an early delivery of her babies (they are all fine now!).....I'm totally scared of pre-e.

I'm 15 weeks today. I'm wondering....when do you really need to start being aware of symptoms (like pain in your liver, high bp, etc.)?? what is the range of weeks when pre-e starts to show up?

Thanks for any help you can give....
K

kir,
You should know that carrying twins is a risk factor for pre-eclampsia. It is not diagnosed as pre-eclampsia until 20 weeks gestation but the symptoms can appear before 20 weeks. My bp started rising around 16 weeks and never got under control. Please go to the beginning of the thread and read all of the symptoms of pre-eclampsia. They do not necessarily come in any specific order and although high Blood PRessure is one of the most common signs, it can be the very last symptom to present itself. That is why you should be aware of every sign and symptom of pre-eclampsia. I hope this is helpful and I hope you have a pre-e free pregnancy. Keep us updated and feel free to pm or e-mail me privately if you want to.
Gossamer


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## kir (Apr 29, 2005)

Thanks for the reply, gossamer and others. I'm hyper-alert after seeing what my friend went through! And i'm glad this thread is here to return to.

So far BP has been low (120/70 or lower), and my doctor seems appropriately concerned/aware about what's going on. BUT i don't see her again til 18 weeks, so i want to be aware myself too!

I've upped my protein consumption a lot, and gone on a vitamin regime recommended in Barbara Luke's book about multiples pregnancies. Beyond that, i think i need to just be calm and aware. Not much you can do!

I'll be in touch....

K


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## Goldiemom (Jun 1, 2004)

I have a quick question for you Mommas that have had Pre-e or PIH before. I have had two perfectly normal pg's. This pg has been pretty normal as well, until now. I am at 31.5 wks and I went to the L&D last night because I was having contrax and just didn't feel right. Now I realize that stress will raise a bp, but I haven't had a bp that 164/83 at all this pg. Nothing even remotely close. Today my bp is still very high being 163/80. In two weeks my top bp number jumped 64 points. Can stress cause that high of a jump all by itself? No one seems concerned but me, and I thought that was sort of strange. TIA for any input that you can give me.

Just a side note, I had no protein in my urine and have only had minor swelling in my feet. Nothing in the face that I am aware of. No other signs for Pre-e. I am just trying to find some explaination for the 64 point jump.


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## gossamer (Feb 28, 2002)

Although stress can temporarily raise BP, it cannot maintain it that high. BE sure to let your Dr.'s know and be vigilant.
Gossamer


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## flyingspaghettimama (Dec 18, 2001)

I had bad pre-e first time around, daughter induced at 34 weeks after 4 weeks of bedrest.

Now I'm at 23 weeks, am fit, getting lotsa exercise, low blood pressure (low number in the 60s) no proteinuria as of last visit 3 weeks ago. But in the past week I've noticed the water retention getting not so fun. You remember that "boggy" feeling, girls? Yeah, I've got it. Sloggy feet, puffy hands. It does seem to have something to do with salt intake, like oh say...eating out all weekend while out of town at salty bad food places.







: But to gain 5 lbs over a weekend and then come home and drink a ton of water and some beet juice and lose 4 is really unnerving. And then go through it again if I don't keep drinking lots of water or really watch the salt. I'm not peeing as much anymore either. I'll take off my socks and the indentation is still there hours later. I am not enjoying this and not finding other people with the same issue, and feeling a little weird about it.

Anyone else? At all? I'm sure that my previous experience left me feeling nervous, but I would really appreciate some assistance with this one.


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## shannon0218 (Oct 10, 2003)

Goldie, I agree with Gossamer, that is a high jump, force them to be vigilant, request blood work and NST's and take your bp frequently at home--also take note if it decreases when you lay on your left side--that was the day my doc got really worried, was when it didn't drop when the rolled me to my left side and made me sit perfectly still for 10 minutes.

Loraeillen, you need to be seen and have some blood work done right away--salt will not cause that much retention, especially indents that stay that way for hours, also that sloggy feeling--I know exactly what you're talking about and that is a MAJOR sign--I had high bp's and headaches with small amounts of protein from about 22 weeks, my doc would keep asking me--do you feel slushy--and I really didn't know what she was talking about--but the day it happened, I had no doubt. I had been telling her "well, I don't know, I feel puffy and tired" she would just say, you'll know when you feel that way--and she was right.
Please go in this weekend (as in tomorrow preferably) and get everything checked out.


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## MrsMoe (May 17, 2005)

I hope everything is OK and it all works out


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## gossamer (Feb 28, 2002)

Loraeillen,
What you are describing is pitting edema which is a sign of pre-eclampsia. Is your urine output comperable to your fluid intake? Is your urine very concentrated despite the water you are drinking? Is is orange or brown? I would be sure to let your doctor know asap. THat is what being on call for them is all about. Call afterhours and leave a message to get a call back. It may be nothing, but isn't it better to get checked and be reassured that it's nothing than to let things go on and risk the health of you and your baby?
Gossamer


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## Goldiemom (Jun 1, 2004)

Thanks for the info ladies. I was a bit astonished that no one even commented on my bp except to say that it had to be stress related. I will definately be monitoring it myself and letting my mw know if it continues to stay high. That way she can maybe recommend an ob that can moniter me as well. Take care and I will keep you posted on how things go for me.


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## Mariposa (Nov 12, 2002)

Quote:


Originally Posted by *MrsMoe*
I had it at a young age also (my goiter took years to develop and it wa squite large at the age of 21.)

Interesting. I wonder who else here has it or thryoid issues?









i have hashi's and also had PIH. am pregnant again now and kinda worried. i really don't know what my labs were when i had abby. had very high BPs, some proteinuria and no swelling. going to to to the hospital and ask for my medical records to see for myself exactly what my other labs were. i was only on mag for 12 hours, then sent home on labetalol.


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## cherubess (Oct 14, 2004)

hi ladies,

Just to let you know that I gave birth to a healthy baby boy on 14th July (38 weeks gest).

I went in for a normal OBGYN appointment on the 13th and it was confirmed that we were losing control of my BP (I have essential hypertension and am on medication).

It was suggested that we could have some blood tests and have monitoring and see what happened or go into hospital ASAP for monitoring and inducing the baby the next day. DH and I decided that we would induce the following day.

Turns out that it was the right decision as the blood tests came back the next day that I had the beginnings of pre-eclampsia.

I stayed in hospital for 8 days as I had second degree tears and also because my BP was all over the place. It has only just been stabilised and have been allowed home today.









Thanks to this thread for making me aware of pre-e as my DH and I probably would have delayed the birth if we weren't fully aware of it beforehand.


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## shannon0218 (Oct 10, 2003)

Congrats Ange!!!! Enjoy that wee baby! Does he have a name you can share with us?


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## gossamer (Feb 28, 2002)

I am so thrilled that we have brought another precious baby home despite the monster of pre-eclampsia. Congratulations on being so vigilant and willing to be monitored. Congratulations for not letting pre-eclampsia win.
Gossamer


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## emmasmommy (Feb 26, 2004)

Congratulations!!! Your baby boy shares a birthday with my pre-e baby (born at 37 weeks). She just turned 3!!


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## greenmansions (Feb 16, 2005)

I just had my first OB appointment, and will be 11 weeks tomorrow. My bp was 110/60 all other indicators OK too.

I learned that my OB had p-e with both her pregnancies (she just got back from maternity leave last week from baby #2) so she is very clued in on the signs. She said there is not much you can do to prevent it medicinally, that no clinical studies have supported the use of aspirin or magnesium, for example. The clinic/hospital is affiliated with what has been ranked the best med school in the country in recent years, and I really feel like they are top notch in terms of latest thinking.

She also told me that given my age (41) and that I had p-e last time, I have about a 70% chance to get it again this pregnancy. Advanced maternal age plays a big part in that. She also said that since my case was mild and came on very late (during labor) that it was likely, but not certain, that if I got it again it would probably come on late this time too.

So anyway, so far so good. We'll see what happens in the coming months.

Ange congrats on a healthy baby!


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## cherubess (Oct 14, 2004)

sorry ladies, I'm exhausted and brain isn't working too well.

DH and I have named him Zac.


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## bravofrenchie (Oct 15, 2004)

Hi all! I've been here at MDC for a while, but this is the first time I've noticed this sticky.
I was born 2 months early due to my Mom having pre-eclampsia. I'll have to talk to my Mom again to get the details, but as I recall, she just didn't "feel" right that day, so she went to the doctor's. She wasn't uncomfortable or in pain, she just had a "feeling." She was 19. This was August 10, 1983. I was due in late October.

The doctor examined her, and told her, "You need to get to the hospital, NOW." Our small-town hospital wasn't really equipped to take her, so she was life-flighted to Emanuel hospital in Portland, OR, with my Dad and his older sister following in a car. I was born by C-section in the late afternoon, weighing less than 3lbs. I was on a resperator for 3 months.

My aunt says when she walked into the hospital room to talk with my Mom, she walked right back out again and fainted. She says Mom was so swollen, it looked like someone had stuck an air hose under her skin.

I'm now a healthy 21-year old, with no major health problems growing up. The doctors told my Mom I would most likely be small & sickly my whole life, need glasses, battle pneumonia frequently, ect. To date, the sickest I've ever been is a bout with chicken pox when I was 13.


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *bravofrenchie*
Hi all! I've been here at MDC for a while, but this is the first time I've noticed this sticky.
I was born 2 months early due to my Mom having pre-eclampsia. I'll have to talk to my Mom again to get the details, but as I recall, she just didn't "feel" right that day, so she went to the doctor's. She wasn't uncomfortable or in pain, she just had a "feeling." She was 19. This was August 10, 1983. I was due in late October.

The doctor examined her, and told her, "You need to get to the hospital, NOW." Our small-town hospital wasn't really equipped to take her, so she was life-flighted to Emanuel hospital in Portland, OR, with my Dad and his older sister following in a car. I was born by C-section in the late afternoon, weighing less than 3lbs. I was on a resperator for 3 months.

My aunt says when she walked into the hospital room to talk with my Mom, she walked right back out again and fainted. She says Mom was so swollen, it looked like someone had stuck an air hose under her skin.

I'm now a healthy 21-year old, with no major health problems growing up. The doctors told my Mom I would most likely be small & sickly my whole life, need glasses, battle pneumonia frequently, ect. To date, the sickest I've ever been is a bout with chicken pox when I was 13.


Your poor mom. I totally hear the swollen part! Severe edema really does look that way... and it makes you feel just cruddy. She is very fortunate that the doctors took it seriously. It was common place years ago to not udnerstand the dangers of pree or pregnancy edema.

-----

On that note... had an appointment with OBGYN. My due date has been advanced by two weeks so I am now 24 weeks, which is good. My BP is also good but I have protein in my urine which he is concerned about. I have fluid retention as well but he didnt' seem as concered about the fluid retention. He told me to take it easy and make sure I was taking my fish oil and calcium suppliments.

Should I be nervous about the protein?


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *MrsMoe*

On that note... had an appointment with OBGYN. My due date has been advanced by two weeks so I am now 24 weeks, which is good. My BP is also good but I have protein in my urine which he is concerned about. I have fluid retention as well but he didnt' seem as concered about the fluid retention. He told me to take it easy and make sure I was taking my fish oil and calcium suppliments.

Should I be nervous about the protein?

Ew. That was my third symptom, first pregnancy. First, swelling, second, BP, third, protein, fourth, HELLP signs. Do you know what + you're at? +2, etc? According to this website, it says sometimes it's also from bladder infections or other minor infections?
http://www.babycentre.co.uk/expert/542263.html


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## gossamer (Feb 28, 2002)

MrsMoe,
Did you ever have a baseline 24 hour urine test before you got pregnant or early in your pregnancy? Did he do a dipstick in the office or a 24 hour urinalysis? If it was just a dipstick test I would go back and ask him for a 24 hour urinalysis because being a little dehydrated or what you ate before you peed in the office can affect the protein value of a dipstick. If you ahd a 24 hour urine test, was your creatinine level good? That is often a better indication of kidney function than protein count. Keep us updated.
Gossamer
Go


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## MrsMoe (May 17, 2005)

Thanks for the responses. What is +2? It was a dipstick urine test. This morning I ate a bowl of Cheerios and had a few glasses of water. Well, I drink a minimum of 1.5 liters of water a day to reduce edema - but usually around 2.5 liters of water a day- so I really doubt I am dehyrdated... No bladder infection, my pee is totally normal and light or clear and I am also not prone to bladder infections (in my entire life I recall having 2 bladder infections that cleared up with Cranberry juice.)

I will call and ask about the 24 hour test, but we can't afford any more tests or Dr. visits for another few weeks (paying OOP.)


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## flyingspaghettimama (Dec 18, 2001)

Well, I think you can buy the testing kits yourself, which would have more information about how they work, and might give you a little more control over the information. http://froogle.google.com/froogle?q=...ff&oi=froogler

Cos I dunno what it means, but for some reason when it went to +2 they all started worrying more. I *think* the higher the number, the more protein you're spilling and less your kidneys are functioning properly. I could totally be wrong, but this seems to be the explanation I've gotten. My current midwife has me dip my urine myself and compare for color and amount (apparently the standard practice here, to help women monitor themselves).


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## gossamer (Feb 28, 2002)

yes, the greater the number, +2, +3 etc.. the worse shape your kidneys are in as far as dumping protein, but a 24 hour urinalysis is still the best way to determine overall function of the kidneys. My urine gets dipped every visit and I show trace protein every time, but my 24 hour urine comes back with some protein dumping, and the amount I dump has been consistant, and perfect creatinine so my Dr.'s are not worried right now.
Gossamer


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## MrsMoe (May 17, 2005)

Thanks for the link! I will be ure to check that out... very cool I think.

Ok with the urine dip - I saw it - there was:

no protien
trace

~then a blank spot~

then a little greenish blue box <---- I had this one
darker greenish blue box
very dark greenish blue box

My original visit I had no protein at all, the strip spot did not change color at all. Thanks for the advice on the 24 hour test, I feel more comfortable now and if my urine has protein again next time - or if I get the strips at home and it goes up - I will request that 24 hour test.


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## emmasmommy (Feb 26, 2004)

I haven't posted an update on myself for a while since things have been progressing quite well with this pregnancy so far, but now I'm not so sure.

I'm 28.5 weeks and had an appointment yesterday. My BP was 130/86 (up from last time, but it has been higher at other points this pg), there was no protein in my urine, but I am slightly swollen in my hands and face. I hadn't noticed the puffiness in my face until the doctor pointed it out, but had noticed my hands, and my feet have been swelling off and on depending on how hot it is. My Dr commented that he has a feeling I won't make it to term. Of course now I'm worried about this.

Other than the swelling I have no other symptoms. I am a lot more tired than normal and am trying to get as much rest as I can (I am still working, but have 2 weeks vacation starting next week and then will cut my hours by 1/3 when I go back). I am supposed to call the doctor about any abdominal pain or headaches and I go back in 2 weeks. I do very occassionally have pain in my upper abdoman (sp?), but it doesn't last long and isn't very severe. It is more to the centre than to the right. Is this something I should be calling my doctor about?

When I hit this point in my last pregnancy I was told to stop working (my bp was 150/95 at that appt). At my appt yesterday my dr mention resting a few hours each morning/afternoon, and as he left the room, I realized that he must not realize that I am working (it is on my chart, but he is known to be a bit absent-minded at times). So I don't know if I really should be working or not, but at the same time, I do need to be here for a couple more weeks at least part time to tie up loose ends before my one year maternity leave.

There really is no real question or point to my post, I just wanted to tell someone who would understand what's going on, and who better than the ladies in this thread!


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## gossamer (Feb 28, 2002)

Natasha,
The fact that your bp is not so high, you have no protein in your urine or severe headaches is a good thing. If the pain in in hte center of your chest and not on the right I wouldn't worry too much. Does it hurt if you press on it? I would suggest htat you ask your Dr. if he will do a liver panel and platelet count blood test and possibly a 24 hour urine to catch any abnormalities that might be creeping up unannounced. The main reason to go on bedrest it to keep your bp low. If your bp is not scary high,which it doesn't seem to be, I would not worry about it. Are you monitoring your bp at home?
Gossamer


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## emmasmommy (Feb 26, 2004)

Thanks Gossamer. I will keep an eye on the pain. It doesn't hurt when I press on it, and since I tend to be quite gassy at the same time I have the pain, I'm thinking it might just be that.

I haven't been monitoring my blood pressure at home as of yet (it hasn't been high enough with the doctor for me to worry about), but I am thinking of buying a monitor this week sometime so I can monitor it at home.


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## emmasmommy (Feb 26, 2004)

Just wanted to add that I did buy a bp monitor last night, and it gives me a little peace of mind to be able to monitor my blood pressure at home, since I only see the doctor every two weeks.


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## Goldiemom (Jun 1, 2004)

I just wanted to post an update to my situation. On Monday I went to visit my mw and my blood pressure was 147/102 when I was there. So they had me do a NST on the baby and she is just fine according to that. But tomorrow I am to go back and get my pressure taken again and if it is still high I will be scheduled for a 24 hr urine. I so hope that everything is ok. I have never had pre-e or anything before and don't know how common it is to develope symptoms of it in a 3rd pg. I am glad you ladies are here to talk to though.


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## shannon0218 (Oct 10, 2003)

Your midwife let you go home without doing bloodwork with a pressure that high????


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## Goldiemom (Jun 1, 2004)

I had had blood work done a few days before and everything came back normal, so I guess she didn't think I needed to have it done. Her words were this exactly "I guess you must just be having a high blood pressure day." I didn't know that I should have had blood work done. I figured since she consults with obs that she talked with one of them, and they told her not to have bloodwork done. I really don't know though. If it is still high tomorrow I should have them do bloodwork?


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## gossamer (Feb 28, 2002)

Goldiemom,
I am sorry you had a scare over your blood pressure. It sounds like your doctor has a good handle on things and I am so glad your baby did fine during the NST. FOrtunately you are very close to your due date and you can be managed until the baby is due as long as your doctor stays on top of things. You might also want to ask him about a full liverpanel and platelet count blood test. Please keep us informed.
Gossamer


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## Goldiemom (Jun 1, 2004)

Today when I went to have my blood pressure taken it was 150/100. So the nurse called my mw and she sent me over to the hospital to be monitered and have my blood pressure taken several times and see if laying down and resting didn't get it to come down. After 2 1/2 hours it did finally come down to 155/89 and they were happy enough with those numbers to let me go home and do the 24 hr urine here. I am to go back in the morning and have blood drawn and my urine analized, but right now they think it is most likely that I have PIH. Just thought you all would like to know how things went.


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## gossamer (Feb 28, 2002)

Again, I am sorry you are having problems with your bp, but it sounds like your doctors have a handle on it. I am glad they are being vigilant about blood tests and urine tests. PIH can be managed if it doesn't morph into pre-e. Are they talking about putting you on medication for your bp?
Gossamer


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## shannon0218 (Oct 10, 2003)

Goldie, I'm glad too that you are being monitored so closely









And Gossamer, how are you doing??? BP staying under control??


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## gossamer (Feb 28, 2002)

SO far. I have had my Acebutelol increased to 400mg twice a day but the OB, Peri and cardiologist are all happy with the numbers. I had a visit with the peri on monday and baby boy has jumped up to the 59th percentile from the 50th % four weeks ago, so we are not suffering from any IUGR yet. My last 24 hour urine and liver panel came back fine. ANd they estimate baby boy weighs about 2 pounds at 25 weeks. COnsidering that my baby Mary Rose only weighed 15 oz at 24 1/2 weeks, I am feeling very good about this one.
Gossamer


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## shannon0218 (Oct 10, 2003)

Great!!! How many weeks are you now??


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## Goldiemom (Jun 1, 2004)

I imagine I will find out about bp meds after I find out my blood test results and the results from the 24 hr urine. So I would guess that either tomorrow or Tuesday at my mw appt they will discuss with me what my options are.

Gossamer, I am glad that you are being able to keep things under control for the time being. It is great news that your little boy seems to be thriving right now. That must be a huge relief. I will be praying that things continue to go well for you.


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## EStreetMama (Sep 5, 2003)

Hi--I just got home from the hospital after a home birth. I started having pre-e symptoms about 3 days after delivery.

I was in the hospital for 3 days and now I've been home for 2, but I am still not feeling well. I talked to the dr and she is not worried about seizures any longer, and just wants to treat my headache with pain meds. My bp was 120/85 yesterday. I have a medium headache, but no more liver pain. No swelling, no visual changes.

I am still concerned and am wondering if anyone has any info about the course of pre-e in the postpartum period. I am just not convinced that the medical people know how to handle this. They had not seen a case like mine and kept talking about how atypical it was.

I really don't know what else to do to take care of myself--my mother is here and is mostly taking care of the baby. I have gotten some good sleep. We are now bottle feeding with mostly formula and some pumped milk--I am afraid that I am losing my milk, too, but that is a whole other issue.

How long will I feel crappy? Has anyone else had pre-e that started post-partum?

I am so grateful that my baby was out of my body, but still feel nervous about this condition.

Thanks in advance for any ideas, info or experiences!! I love you guys!!!

--Adrienne


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## flyingspaghettimama (Dec 18, 2001)

I had increasing signs of eclampsia post-partum. I think my numbers got up to something like 180/120. They put me in a wheelchair and made me take sleeping pills. I was stressed out and overly tired - my baby was in NICU and I didn't sleep for about four days straight. Funny how that can put your BP all out of whack, eh?

The doctors did not seem so worried, despite the fact that I felt like I had suddenly become the world's biggest caffeine addict. The nurses seemed more concerned that my heart was going to give out first.

The sleeping pills and taking the stress down a notch (or seventeen notches) really helped. Maybe you are feeling stressed about the transition to motherhood or not getting as much sleep as you need? Is there a support group locally you could go to (LLL)?


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## crazy_eights (Nov 22, 2001)

There is a real, documented phenomena of 'postpartum pre-eclampsia/eclampsia'. As an L&D nurse, I've seen it more than a few times - even women that went home and came back after discharge. It might be 'atypical', but it's not that rare.


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## gossamer (Feb 28, 2002)

Mom2six is right. Post partum pre-eclampsia is not rare at all. I suggest you follow up with your OB asap. IF possible keep track of your bp's at home to keep an eye on them. www.preeclampsia.org has lots of good informaiton on post partum pre-e. I am glad your baby is doing well, but now it is time to take care of yourself.
Gossamer


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## crazy_eights (Nov 22, 2001)

Gossamer - I've been thinking about you. How are YOU doing? You must be about 30 weeks now? Breathing a sigh of relief to have passed that 'viability' mark?


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## gossamer (Feb 28, 2002)

Chava,
So far I am doing very well. No signs of pre-eclampsia. I have had some bp issues but have been under the care of a cardiologist who is keeping a good eye on my meds. I fax my bp's to him on a weekly basis. I am also seeing a perinatologist who is keeping a close eye on the growth of the baby. SO far the baby is in the 59th% which is such a relief because Mary Rose suffered so badly from IUGR. I am getting monthly 24 hour urines and liver panels. So I am under a lot of watchful eyes and really excellent care. You are right, it is quite a relief to be past the viability mark. Our perinatologist told us that at 28 weeks we have 90% viability and we are now 28 1/2 weeks. DH and I celebrated 28 weeks. I am almost ready to believe we might bring this baby home. Thank you for your well wishes. Thank you also for your wisdom and contributions to this thread. It is so important to me.
Gossamer


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## gossamer (Feb 28, 2002)

Goldiemom,
How are you doing? How did your urine and bloodwork turnout? Just remember that pre-eclampsia is most common in the third trimester so it is something you need to keep on top of.
Gossamer


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## flyingspaghettimama (Dec 18, 2001)

I think goldiemom had her baby already...I think they were planning on induction, but I don't know how it all turned out.


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## emmasmommy (Feb 26, 2004)

Glad to hear things are going so well for you Gossamer.

I am still doing OK. The only problem I have right now is a fair amount of swelling. My blood pressure has been staying under control on it's own (well relatively, it's still borderline high, but hasn't gone up at all yet), and there is no protein in my urine to date. My doctor did a liver panel at around 28 weeks and that was good too (I am 31.5 weeks now). I am going to finish working at the end of next week, though my doctor would prefer I quit now. Since I am taking such a long maternity leave, I need this time to make sure the people who will be sharing and taking over my duties are adequately trained. I am very happy that my doctor is being very pro-active right now. I am seeing him weekly, and he wants me resting as much as possible to keep things from happening before they even start. I am doing better right now than I was at this stage in my previous pregnancy, so I'm glad for that.


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## gossamer (Feb 28, 2002)

Natasha,
I am so glad to hear that everything is going well for now. Isn't it encouraging to be able to compare to the last pregnancy and know that you are farther along than you were last time you got sick? I know I was so relieved when I hit 25 weeks.
Gossamer


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## shannon0218 (Oct 10, 2003)

Hi everyone!! So, I'm joining back in the pregnant ranks








We weren't trying yet, but, well, I guess this babe had other plans--so much less stress just finding out









Is there an increased risk of Pre-e in two close pregnancies (Molly is 7 mos old)


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *shannon0218*
Is there an increased risk of Pre-e in two close pregnancies (Molly is 7 mos old)

Not to my knowledge. But without looking at your prior posts, I seem to remember you have a diagnosed clotting disorder? That is going to make you at risk no matter what your baby spacing is.


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## gossamer (Feb 28, 2002)

Shannon,
Congratulations!!!!!!!!!!! I don't think having 2 pregnancies so close together is an issue, but the fact that you had pre-eclampsia in your previous pregnancy gives you at least a 50% risk of getting it again. I will keep my fingers crossed.
Gossamer


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## shannon0218 (Oct 10, 2003)

Yes I do have a clotting disorder and actually have a dvt right now. I fell a couple weeks ago and hurt my leg, I went in this morning with pain behind my knee-it's not a big clot but I'm on a higher than profalactic dose of heparin right now (with instructions not to fall again--yeahhhh, if only someone had thought to tell me that before :LOL)


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## cherubess (Oct 14, 2004)

My DS was born in July, so when DS gives me a few moments of freedom I have popped into the "life with a babe" forum.

However I wanted to pop back here to see how Gossamer and bub was doing.

I'm am very glad to read in the previous posts that you have hit 28 weeks and that things are going well.









I can't wait to read that you have delivered safely your baby boy.


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## Rach (Nov 11, 2003)

Joining the thread.
I am now past the stage of when I developed pre-e in my first pregnancy.
I had pregnancy induced hypertension and at 34 weeks developed into pre-e. Long story short, I was induced but had a c-section at 35 weeks.

I am 35.5 weeks now, and the last couple of days, I've noticed I swell at random times.
My blood pressure has been normal [about 118/70] everytime it's taken, although last time the lower number was 6 points higher than normal, but I've had it do that before in this pregnancy. I have not been able to take my blood pressure during swelling episodes.
As I said I swell at random times, I do get hot but it doesn't feel like my blood pressure. I do whatever is opposite of what I'm doing at the time to try to make it go down. I drink more water, and eat protein, and just wait it out. It seems to go down at random times too.
I can't think of any reason why I'd suddenly start swelling, often for no reason. I did notice that it happens more at night.
I also notice that during these swelling episodes, I pee very little, but as soon as the swelling is gone, I pee a lot and then go back to normal.
I'll admit, I'm a bit worried about developing pre-e again, so I just want to be safe.


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## emmasmommy (Feb 26, 2004)

I've been having the same sort of random swelling as well. But it is happening more and more regularly for me. Enough to concern my doctor anyway. My bp has been borderline my entire pregnancy, and is starting to creep up little by little right now. I am 32 weeks. I made it to 37 weeks last time, and I'm hoping to make it at least that far this time. It seems hopeful since my bp was much higher at this point in my last pregnancy, and my doctor is being very vigilant now.

I had a scare last week with a severe headache. I went to the doctor and everything was OK. I suffer from migraines normally, so that is what this was this time too. That's what I felt it was, but I wanted to be checked out just in case. I had some bloodwork done, and will find out how that came out tomorrow when I have my regular appointment.


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## gossamer (Feb 28, 2002)

Swelling in and of itself is not indicative of pre-eclampsia. Is your face swelling? Are your hands swelling? I would ask your doctor to do a 24 hour urine to see if your kidneys are functioning. Remember that heat is a contributing factor to swelling in any pregnancy with or without pre-eclampsia.
Gossamer


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## Rach (Nov 11, 2003)

Thanks Gossamer.
My midwife thinks it's just normal pregnancy swelling, perhaps caused by the humidity we've been having lately.
She wants me to keep an eye on it a bit more, and if it's not any better by Thursday to come in for a check up and some labs.
I just figured it'd be better to be safe than sorry.


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## emmasmommy (Feb 26, 2004)

I wish I could have a better update from my appointment this morning, but I don't. My bp shot up to 150/100 this weekend. My dr prescribed a blood pressure medication (not sure what, I haven't been to the drug store to fill it yet, and can't remember right now what the doc said it was called). I have an appointment tomorrow for a biophysical profile/ultrasound and go back to my doc on Thursday to see if the bp meds have started to work yet. Beyond that, I don't know what's going to happen, but I am still hoping to make it to at least 37 weeks (how far I made it last time), but my doctor isn't so sure that I will. Again, I'm very glad that he is very vigilant and aware of everything.


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## shannon0218 (Oct 10, 2003)

Natasha, the bp meds can make a WORLD of difference, get that script filled right away cause they sometimes take a couple days to fully kick in.
Good luck!


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## emmasmommy (Feb 26, 2004)

I filled the prescription after work today (this is my last week, and I'm only very part time cleaning up loose ends before mat leave) and took the first dose after supper tonight. I really hope they help.


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## gossamer (Feb 28, 2002)

I think they should help. Just be very diligent about taking them. WHat is your prescription? How often are you schedulted to take it? Do you have a monitor at home to check your bp with? Keep us updated, we are thinking of you.

Rach, yeah, humidity can be a b***h. I live in Houston and my poor little feet look like marshmellows. As long as your hands and face are not swelling and your blood work comes back normal, I wouldn't worry too too much. Keep us updated. Only 4 more weeks or so before that baby comes home.
Gossamer


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## flyingspaghettimama (Dec 18, 2001)

My own personal milestone...

Today I'm at 31 weeks. Yay. At about 30 weeks in my last pregnancy I started exhibiting serious signs, including headaches, large weight gain and edema, very high BP, protein changes in urine. I was on bedrest by 32 weeks for two weeks until induced at 34 for advanced preeclampsia advanced to HELLP. Well, and the seizures didn't really help my case.

So far, so good this time (knock on wood!). Maybe my homebirth really will happen after all. A girl can dream, right?! I am so paranoid regarding looking for signs that at least I know they won't escape me this time like last...Hang in there, other mamas who are going through this 2nd (or 3rd) time around!


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *gossamer*
I think they should help. Just be very diligent about taking them. WHat is your prescription? How often are you schedulted to take it? Do you have a monitor at home to check your bp with? Keep us updated, we are thinking of you.

Rach, yeah, humidity can be a b***h. I live in Houston and my poor little feet look like marshmellows. As long as your hands and face are not swelling and your blood work comes back normal, I wouldn't worry too too much. Keep us updated. Only 4 more weeks or so before that baby comes home.
Gossamer

What is the significance of hand and facial swelling? I tend to swell in my hands and face FIRST - before my feet or any other part of my body - pregnant or not.


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## gossamer (Feb 28, 2002)

Hand and especially facial swelling is an indication that your kidneys are failing which is a symptom of pre-eclampsia. Of course this is in general. If you typically swell in your hands and face first, 24 hour urinalysis would be a better determination of kidney function.
Gossamer


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## emmasmommy (Feb 26, 2004)

I am taking Labertrol (I don't have it in front of me and can't remember how to spell it) 100mg twice a day.

Has anyone found that the meds made them feel kind of "off" at first? I know one of the side effects can be a headache, and I do have a slight headache today, but mostly I don't really feel all there. It's hard to explain. Anyway, I have an appointment with my doctor again tomorrow, so I will ask him about it.

I had the biophysical profile ultrasound today and all is well with the baby anyway. He/she is already bigger than dd was at birth at 37 weeks, and I'm only at 32 (almost 33) weeks. Baby is currently about 2600g and dd was 2535g at birth. I hope this little one keeps on growing!! The tech also pointed out a bunch of hair on baby's head, which is kind of cool considering dd was almost completely bald until she was almost 2!!


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *gossamer*
Hand and especially facial swelling is an indication that your kidneys are failing which is a symptom of pre-eclampsia. Of course this is in general. If you typically swell in your hands and face first, 24 hour urinalysis would be a better determination of kidney function.
Gossamer

Maybe. Or it could be something more. SPeaking of which, I went to my brand new Primary Doctor today and loved her. She said given the thyroid issue and other medical things, she said it I sounds like I might have an auto-immune disorder (which tyriod in itself is a type auto-immune disorder) and as soon as my OHIP goes into place she was to refer me for some testing. Auto-immune disorders can also effect the kidneys.

Maybe that's why I get pree. *shrug*


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## shannon0218 (Oct 10, 2003)

Natasha, that's a low starting dose of labetalol. Yes it takes your body a few days to get used to the medication--so far your body has been compensating for high bp but my side effects only lasted a few days tops. I had a few increases (I was started on that dose) and just to hopefully make you feel better that there is still lots of wiggle room--when I was hospitalized for my pre-e in an attempt to hold off until 37 weeks, I was put on 400 mg, 4 times a day--now I was told that that particular dose is only safe in hospital, but I hope it makes you feel better that even if the 100 mg twice a day doesn't work, there is plenty of room to move up.
I'll be thinking of you


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## emmasmommy (Feb 26, 2004)

Thanks Shannon, it's good to know I won't be feeling like this forever. It seems to get better for a bit right after I eat something, so I guess I just shouldn't let myself get too hungry! The OB I talked to after the ultrasound also said that was a low dose and could be raised if needed. My doctor is actually a family doctor and says he doesn't have to prescribe bp meds for pregnant women very often, so he is probably just playing it safe to start. I hope I can hold off on being hospitalized for as long as possible though. I was in the hospital with dd from 35-37 weeks, and then for a full week after she was born since it took a while after the birth for my blood pressure to stabalize. I hated it!! Funny thing though, it went right down the first night I was home!! I think the hospital was causing some stress!


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## emmasmommy (Feb 26, 2004)

Update again from my appointment yesterday. My bp was 140/90 which was lower, but not low enough for the doctor so I am now on partial bedrest (supposed to be 80% of the time, so I'm sneaking in a bit of computer time right now). I am swelling more and my weight went up again in only 2 days!! Thankfully between dh and my mom I have lots of help with dd, so I can get all the rest I'm supposed to. My doctor is hoping to make it to 35 weeks (only 2 weeks!!) so baby may be here sooner than we think! I need to call my friend who has all the baby gear we need!! All we have are some clothes and a car seat.


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## acruwe1024 (Sep 12, 2005)

I had my first child three yrs ago. I ended up going to the hospital in the middle of the night because i had severe pain on the left side of my back, a little higher than where your kidneys normally are, and I was vomiting. I wasn't sure what was going on. I was immediately given drugs for the pain, and stayed drugged up for pretty much the rest of the birth. I remember it took them a long time to figure anything out, but eventually pre-eclampsia was thrown out there and I was given anti-seizure drugs and induced. Eventually I ended up having a c-section.

Once everything was over, nobody really told me anything about what went wrong or counselled me about pre-eclampsia. I just figured it had something to do with high bp and that it might have been caused by stress.

I am a little surprised to read all of your posts, because I just got pregnant again, and I would have never known it was even an issue for me to be worried about. I see the symptoms listed in all of the posts, but what exactly is pre-eclampsia?


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## gossamer (Feb 28, 2002)

Pre-eclampsia is believed to be a disease of the placenta. IT causes severe high blood pressure which leads to excessive swelling, kidney damage, liver damage, in some cases low platelets and eventually can lead to brain swelling, seizures and strokes all of which can result in coma, organ failure and or rupture, placental abruption and death of the baby or mother. Pre-eclampsia is the second highest cause of death of pregnant mothers.
Gossamer


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## acruwe1024 (Sep 12, 2005)

so it's the high blood pressure from the pre-e that causes all of the problems?


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## flyingspaghettimama (Dec 18, 2001)

acruwe1024 - you know, you can get copies of your medical records during birth. It might shed more light on exactly what you were suffering from. I did not know I had HELLP until I got my records. It will certainly help your next medical provider.


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## gossamer (Feb 28, 2002)

The best place I have found to get information on pre-eclampsia is www.preeclampsia.org They have lots of information on causes, risks, symptoms etc. I don't want to give you erroneous information, so I would suggest visiting that website.
Gossamer


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## kir (Apr 29, 2005)

Two questions:

1) Can someone explain the difference between HELLP and pre-eclampsia.

2) At my doctor today (i'm 28 weeks with twins) i had an odd high b.p. of 140/90. She sent me to get all that protein-related blood work and liver function stuff done, then when she took my bp again it was 130/70 (every other visit it's been 110/70). Do i really need to be that worried yet? I check my bp at home a lot, and it's usually WAY low. I'm getting stressed out thinking about this, and i think it's affecting my bp more!!

Kiran


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## flyingspaghettimama (Dec 18, 2001)

From my understanding, HELLP is what preeclampsia can progress to, and it's when your organs start to turn the lights out...I think you can have one without the other though. BP is a predictable symptom of pre-e or HELLP and not THE problem? I would not worry just yet, but you could call and ask for the results of your bloodwork from your doc?

http://www.hellpsyndrome.com/Informationsigns.htm


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## taradt (Jun 10, 2003)

Doea anyone know about homocysteine levels and pre eclampsia? I have been reading some studies about a link but I am still new to researching it. I was tested after my last loss and mine seems to be a bit high (we have restested), but since then I have read about it causing both early and late miscarriages and pre-eclampsia (all things I have had) and I am wondering if any of you have come across anything like that?

thanks

tara


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## gossamer (Feb 28, 2002)

HELLP is a nasty branch of Pre-eclampsia. It stands for
H=Hemolysis (Destruction of red blood cells)
EL=Elevated Liver Enzymes or Enlarged Liver (Potential for Liver Rupture)
LP=Low Platelets (Blood is less likesly to clot and mather can bleed out if Liver ruptures or stroke out due to low clotting)

You can have pre-eclampsia and never get HELLP, it is very rare to get HELLP without pre-e. Pre-eclampsia can sometimes be managed with bedrest and BP medicine. HELLP requires immediate delivery of the baby to save the mother's life. It cannot be managed and does not get better. That is why my Mary Rose was delivered at 24 weeks. My platelets had dropped from a normal of 250 to 51 and my liver was in danger of rupturing. They couldn't do an epidural b ecause they were afraid I would bleed into my spinal column and 3 doctor's have told me that if I had waited a week to see the Peri, my baby and I would have died.

I would not stress out about the BP until you get the blood work and urine back. One or two anomolous bp's is not that worrisome as long as everything else is working ok. IT could be what you ate, how much you drank that day, how nervous or upset you are. Keep checking it at home and if you notice a trend of it being high, even after resting or drinking some water, don't hesitate to call your doctor.

Elevated homocysteine levels can be the result of a blood clotting disorder. Have you had DNA tests done to check for these? One way to combat high levels of Homocysteines is extra folic acid. Ask your doctor about this. I have a mutation on the MTHFR gene that inhibits my folic acid production an raises my homocysteine level, so I take 800 mcg of folic acid 4 times a day.

I hope this is helpful to you all.
Gossamer


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## acrathbun (Apr 27, 2004)

With my last pregnancy (Thomas) I developed Pre-E at 26 weeks. At 31 weeks I thought I had the 'flu. My dh encouraged me to check my bp. It was Crazy High. I went into L&D, thinking that my bp monitor was 'off' somehow.

Once they realized I had HELLP, Thomas was born w/in the hour (31weeks, 1day)

I think it's just waaaay more life threatening...but I'm not clear on all the details.


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *gossamer*
Elevated homocysteine levels can be the result of a blood clotting disorder. Have you had DNA tests done to check for these? One way to combat high levels of Homocysteines is extra folic acid. Ask your doctor about this. I have a mutation on the MTHFR gene that inhibits my folic acid production an raises my homocysteine level, so I take 800 mcg of folic acid 4 times a day.

I find this very interesting - I did a 20-week consult with a perinatologist this time, and he said that in his experience, the high doses of folic acid was what helped THE most in his patients with previous experiences of preeclampsia. Perhaps he knew the reason (which you've explained well) but figured I had enough information. I don't believe I have a blood clotting disorder, however. Would you know without testing?


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## crazy_eights (Nov 22, 2001)

There is a disorder called MTHFR which is a type of clotting disorder that can cause both fetal demise and pre-e. It is treated with high doses of folic acid. Perhaps this is what he was refering to. You would only know if you had this disorder if you had testing for the mutation that causes it.


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## kir (Apr 29, 2005)

thanks for the explanation about HELLP

The one thing i actually like about my hospital is that there is a counter for patients to pick up test results, so i can pick up my paperwork separately, and my doc can read the stuff on her computer. so i can get a sense of what is going on, and phone her with questions. i'll do that today!

Thanks, everyone
kiran


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## massaginmommy (Mar 5, 2005)

I would like to have another baby. I have 3 birth children all boys, was induced with all of them. One adopted daughter. My last boy was born when I was 39 and my bp didn't rise until the 8th month and then I spilled protein only once 2 weeks before my edd and they sent me to the hospital for induction. My BP while in labor was extremely high like 220/170s (seems to be my pattern) no seizures because of mag. But I was very sick after the birth of my last one. I had a severe headache the next day and just didn't feel like myself for a few days. They had me on bp meds in the hospital. When we went home I felt like my heart was racing at times and I had no energy. As for the placenta, with my 2nd and 3rd the placenta was healthy and intact with my first it was not and fell apart upon delivery. There is a 15 year space between my 2nd and 3rd child. BTW my pressures don't go down right after delivery either they take a couple weeks to get back down. I did take bp meds for awhile after my second. Some docs seem to think I normally have high bp while others do not. Right now my pressures seem fine.
Most of my pregnancy I was under the care of midwives who were very thorough. They monitored me and I took my pressures everyday at home. As soon as there was a problem they referred me to their consulting MD. Part of my problem is that each birth has been in a different place with new people involved. We moved around alot. I would like to know what kinds of things I can do to prepare for next time. I am 42 had previous pre-e and PIH also I had a kidney that was backing up as a child so I had a urethra-otomy when I was nine. I am wondering if I can do anything to strengthen my kidneys and liver prior to pregnancy to try to offset the problem? I have never taken meds during pregnancy for high bp because it doesn't go up until the end. I realize I will probably always have to do the tradition birth but would like to do everything I can to be as healthy as possible before getting PG next time.
Sorry this is so long it is hard to summarize and keep it short.


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## gossamer (Feb 28, 2002)

I would have a pre-conception consultation with an OB even if you decide to use a midwife. Get a baseline on your kidney function by doing a 24 hour urine before getting pregnant and a baseline liver panel. Ask the OB about testing you for blood clotting disorders. There is some evidence that an aspirin a day, and vitamin C & E during pregnancy can prevent pre-e as well as folic acid.
It is not uncommon contract post partem pre-e and for a lot of women it takes weeks or months for their high bp to come back down. For some, it never returns to "normal". For more information, visit www.preeclampsia.org. They have a discussion board and information center. You can get really good information there. I hope you found my answer helpful.
Gossamer


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## massaginmommy (Mar 5, 2005)

Thank you gossamer. I will set up an OB appointment asap and ask for all those things.


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## MrsMoe (May 17, 2005)

Also - another preventative is Calcium Citrate and Omega 3&6 per my OBGYN.


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## kir (Apr 29, 2005)

My B.P. has not been terribly high. The highest has been 130/90 (today), and my impression is that that's right on the border of being a concern.

Here's what I'm confused about: BP is monitored as a sign of something like pre-eclampsia or HELLP, right? So if your BP goes up a little, but the underlying causes of pre-e/HELLP are not there (my liver function, bleeding and clotting, etc. are fine), then it's ok for now, right?

But if you DO have pre-e or HELLP, then using relaxation or supplements or whatever to bring down BP isn't really the issue because the REAL problem is that your liver/kidneys are getting messed up? Is this right?

I'm trying to understand this, so I know what kind of treatment to expect from my doctor, and also so I know what I can do on my own. I've been taking all that vitamin C, calcium, etc. etc. for a while. I feel a little helpless about the fact my BP might be climbing a little.

Kiran


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *kir*

But if you DO have pre-e or HELLP, then using relaxation or supplements or whatever to bring down BP isn't really the issue because the REAL problem is that your liver/kidneys are getting messed up? Is this right?

Kiran

Well, once you GET pre-e - it doesn't go away with suppliments - but per my OBGYN - it can be prevented with Calcium, Omega 3&6, Vit C, and a high protein diet. And so far, it's working for me!

He also said for me personally not to be alarmed at BP that is in the 130's in the final stages of pregnancy as BP tends to increase twords the end.

Also - I had to go to the hospital to get checked (early labor symptoms) and the nurse checked my BP and whatnot. My BP was 140/90 and she said not to worry - very normal (she saw I was nervous.) I was 7 months pregnant and this was 2 months ago.

I dunno about you - but my BP is normally in the high 130's. Now if my BP were normally 100/75, then I think 140/85 would be a cause for concern. It's not the BP itself - it's how much the BP goes up vs your normal BP as well as protein in the urine and swelling in face and hands (pointing to kidney issues.) Pre-e is a combo of these symtoms. And HELLP is Pre-e gone NASTY, when your organs start to fail - and trust me, you'd know if you had it.


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## shannon0218 (Oct 10, 2003)

Actually you wouldn't necessarily know you had HELLP. It can come on incredibly fast--as in everything can be completely normal in the morning and by afternoon you can be in very serious trouble. This is what happened to my mom when she was pregnant with me. She'd been at work that morning with a nagging headache--but not bad and her BP was only very slightly elevated. She worked in a hospital and was told to go home and put her feet up. By early that evening my mother was in a coma and my father was being told that neither of us would survive. She had had blood work done the day before that was basically normal.


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## gossamer (Feb 28, 2002)

HIgh blood p ressure is a symptom that can lead to pre-e in the same way high bp can lead to heart disease. If your high bloodpressure is managed appropriately and you don't have a genetic blood clotting disorder, pre-e can possibly be prevented.

Quote:


Originally Posted by *kir*
So if your BP goes up a little, but the underlying causes of pre-e/HELLP are not there (my liver function, bleeding and clotting, etc. are fine), then it's ok for now, right?
Kiran

High blood pressure is the cause of pre-e/HELLP. Liver function, kidney failure, falling platelets etc are symptoms of pre-e not the cause.

One abnormal reading of blood pressure is not cause for immediate concern. But it is a reason to keep an eye out. You want to keep your blood pressure under control. The numbers themselves are not as important as the rise in pressure. If your normal bp is 120/80, then one abnormal reading of 130 over 90 is not that big a deal.

Quote:


Originally Posted by *mrsmoe*
but per my OBGYN - it can be prevented with Calcium, Omega 3&6, Vit C, and a high protein diet.

WHile a healthy diet is the best for every pregnancy, there are several genetic factors that can contribute to pre-eclampsia including blood clotting disorders, autoimmune diseases etc...

Gossamer


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *kir*
But if you DO have pre-e or HELLP, then using relaxation or supplements or whatever to bring down BP isn't really the issue because the REAL problem is that your liver/kidneys are getting messed up? Is this right?
Kiran

BP is like a symptom, not the underlying cause, as Gossamer pointed out - BP is a symptom of heart disease, but you have to treat the underlying issue. (Right? or am I confused?)

It is, as MrsMoe pointed out, easier to prevent than to fix after the fact. But ultimately, who really knows how to prevent it? Many of us are trying lots of tricks, supplements, aspirin, etc, and maybe we should do some sort of poll afterwards (our own MDC completely unscientific anecdotal study) to see how it turns out!


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## gossamer (Feb 28, 2002)

Once you have contracted pre-e it can *possibly* be managed but the only *cure* is delivery of the baby. HELLP is life threatening once contracted and cannot be managed and requires *immediate* delivery of the baby. Once you have contracted pre-e, your blood pressure will not go down. You can have elevated blood pressure during pregnancy without it ever progressing into pre-eclampsia. And remember that high blood pressure is not always the first sign of pre-eclampsia. Again, I suggest www.preeclampsia.org for the best information on pre-e.
Gossamer


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## flyingspaghettimama (Dec 18, 2001)

Ok, you tell me if I'm just being paranoid (because I'm rather used to the label)...

But - previous symptoms of preeclampsia in my last birth, progressed to severe HELLP, induced at 34 weeks. This time at 35 weeks, no symptoms at all (BP very normal to almost low, 112/72 yesterday; no more swelling than any other normal pregnant person; no proteinuria). Is it still possible to become eclamptic suddenly during labor? No signs at all?

I've heard of this happening at a homebirth in my community...I'm having a homebirth. How do they monitor for this issue? Did this MW just drop the ball in ignoring symptoms? My current MW is very laid back, confident (not the same as MW with eclamptic patient), which is cool - but I don't really know what to ask for regarding monitoring for possible problems. BP checks, sure. I guess if I suddenly blow up, that would be weird. But what else? They're not going to be doing panels during a homebirth, nor would I want them to. But I don't want any seizure business either.

Any suggestions? I know many mamas with previous HELLP/Pre-e use the hospital or birth centers, but homebirth has really been my goal in keeping myself really really healthy through these past 8 months. I'm just getting last-minute cold feet! If no suggestions, I'll ask the larger I'm pregnant board?


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## gossamer (Feb 28, 2002)

I am not trying to scare you but the fact of the matter is that most women die of pre-e within the 24 hours after giving birth. It is possible to contract pre-e during labor and after delivery. In fact the workd Eclampsia comes from the greek for lightening becasue it can be so suddenly onset. If you do a hb, I would just make sure your MW knows how to diagnose pre-e in an emergency. Ask her how she plans to monitor you and what would be her red flags for transerring you to a hospital.
Gossamer


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## flyingspaghettimama (Dec 18, 2001)

Yes, I do know her backup hospital, etc...and we live an extremely short distance from the nearest hospital (maybe a 1-minute ambulance ride). Last time, the pre-e onset was steady and predictable, but I didn't know that it could onset so quickly without ANY previous symptoms. I thought the greek word for lightning was for the lightning in your brain during the seizure (ha, just kidding, I have a twisted sense like that). I had a seizure last time, but it was one day before they induced (?!).

The other person I know with a seizure during labor had proteinurea and blood pressure symptoms, some swelling (I dunno, if I was her MW I'd be worried when those two signs popped up). I guess I'm just wondering if there is anything else? Reflexes? I will ask my MW next week. I'd just assumed that the onset would show itself before labor if it were going to show at all...I will have contractions a little on my own at first, so I wanted to know for myself as well.

I've really been the most concerned about it so far - even the perinatologist I met with wasn't so concerned and was supportive of using a midwife - he said to just watch out for symptoms but that I had a low chance of getting it again.


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## flyingspaghettimama (Dec 18, 2001)

Darn my google skills:

"In a prospective study at the author's center, as many as 28% of the women with a diagnosis of eclampsia did not have a diagnosis of preeclampsia prior to seizures."

http://www.emedicine.com/neuro/topic323.htm

Well, I guess we'll have a hearty talk next week.


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## shannon0218 (Oct 10, 2003)

For sure have a good talk and I'd consult with a different peri too because the single biggest risk factor for pre-eclampsia is having had it before, so for him to say your chances are low of getting it again is in my opinion extremely irresponsible.


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## MrsMoe (May 17, 2005)

flyingspaghettimama -

Please be careful and safe and make sure your midwife would take pre-e seriously if your homebirth should happen to go wrong. Hospitals may be nasty places, but your life is precious.


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## flyingspaghettimama (Dec 18, 2001)

Shannon - he was a very good perinatologist, I should have explained... He was more nuanced than I give him credit for here - he said I had a low chance, but higher than someone who'd never had it before, particularly due to the early onset date (27 weeks). He gave some great advice about how to monitor for and hopefully prevent it. He asked lots of questions about my life previous to the first pre-e issue. Apparently, it was his specialty. Pre-e, not my life.









Thank you MrsMoe. I have no doubt that if things get bad, I'm going straight back to the hospital. I have a wonderful family that I need to think of first, before my comfort level in the hospital...I'm even going to write it into my birthplan (also why I was fishing for things to monitor for - I'm putting it into the birthplan so nobody is confused).

That article is scary. Retinal detachment, indeed! Bleh.


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## gossamer (Feb 28, 2002)

Quote:

I guess I'm just wondering if there is anything else? Reflexes?
A symptom of pre-e is hyper reflexology.

Did the peri do any dna tests on you to test for blood clotting disorders? Do you have any autoimmune disorders like Lupus or Rheumatoid arthritis etc.?

The earlier you contract pre-e the greater your chances of getting it again.

On the first page of this thread there is a list of symptoms to look for. I hope the information you have found here helps you make your decision that is best for your family. Feel free to ask if you have any more questions. You can also pm or e-mail me.
Gossamer


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## gossamer (Feb 28, 2002)

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.

Gossamer


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## cherubess (Oct 14, 2004)

Gossamer, how are you and your baby?
Hope you are both doing fabulously.
How many weeks gestation are you now?


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## gossamer (Feb 28, 2002)

Baby and I are just great. I am 34w 3d and no signs of pre-e anywhere in sight. My last 24 hour urine came back better than the one before. My last liver panel came back perfect. My bp's continue to be in the 120/70's to 130/high 70's which does not have anyone concerned becasue bp usually rises in the third trimester. So we are tentatively planning a scheduled C-Section on Nov. 1. 3 weeks from now. I can't believe it. Thank you so much for asking.
Gossamer


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## greenmansions (Feb 16, 2005)

Congratulations Gossamer on your great progress! I'm rooting for you!

Here everything is A-OK so far, in week 23 tho, so still early.


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *gossamer*
Baby and I are just great. I am 34w 3d and no signs of pre-e anywhere in sight. My last 24 hour urine came back better than the one before. My last liver panel came back perfect. My bp's continue to be in the 120/70's to 130/high 70's which does not have anyone concerned becasue bp usually rises in the third trimester. So we are tentatively planning a scheduled C-Section on Nov. 1. 3 weeks from now. I can't believe it. Thank you so much for asking.
Gossamer


Glad to hear it!


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## cherubess (Oct 14, 2004)

Gossamer, that is wonderful news.

Hope the next three weeks are comfortable for you.


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## clavicula (Apr 10, 2005)

i had severe per-ecclampsia. my pregnancy was fabuolus, but 36w4d i had severe headache, edema everywhere and 180/110 Hgmm BP. And of course, proteinuria. it was terrible, i had natural birth, which was awesome by the way (ebrantyl infusion was administered).

dd is 11 wks old now, i still have the proteinuria, so i have to take ACE inhibitors.
my kidneys will never be healthy again.

i think, pre-e IS a big deal. it was my first pregnancy. i am 25, normal-sized, european woman, my BMI is 22, i am healthy (i mean i was).
i just hope i could have more children...

just wanted to share.


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## kir (Apr 29, 2005)

I have some slight hypertension (140/90 was the highest ever), and am taking some meds that control it well. So I really shouldn't be getting TOO scared about pre-e....But I'm now almost 32 weeks, with twins, so i know it's a risky situation for developing pre-e. My doctor says if ANY weird stuff develops in my blood work she'll deliver the twins. Has anyone had experience being on hospital bedrest to postpone delivery? Is this something I should bring up, or is it foolish to wait if pre-eclampsia develops?

Thanks for your thoughts. And please send good wishes that nothing turns up in my tests tomorrow!









Kiran


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## shannon0218 (Oct 10, 2003)

Well, if full out pre-e develops, I'm guessing she won't give you that choice-kwim? It sounds like she's on top of it and that's great. I was on hospital bed rest for 10 days before I delivered. My bp had shot up and I was scared--however, my hospital can't deliver until 36 weeks--I DID NOT want to change hospitals, my hospital and my OB were so awesome. So I was on hospital bedrest to take her to 36.5 weeks. Blood work was done twice a day, NST's were done 3 times a day and a machine was left in my room in case I got worried about her. I was controlled until the night before, my bp shot up, bloodwork was still basically normal, I was told that night that I would be a mom the next day.


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## shannon0218 (Oct 10, 2003)

Oh and mega good vibes coming your way


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## kir (Apr 29, 2005)

Thanks for sharing your experience. I need to take this one day at a time. I never would have thought I'd feel this way, but I'm so eager to give these babies a good start that I think I'd be totally motivated to stay on the kind of bedrest/testing you describe if it would give them another week!

But let's see....I feel fine, but I get nervous every time I give blood for tests.

Kiran


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## gossamer (Feb 28, 2002)

Kir, it sounds like your doctor is ontop of things. Bedrest is usually used to control BP, so if your BP is under control via medication, I am not sure bedrest is a viable option. As much as you want to give your babies every opportunity, sometimes, being in utero is more dangerous than being born. 32 weeks is 98% viable and pre-e is very deadly. So it is a tightrope we walk. Keep an eye on your bp's, take it easy and keep us updated.
Gossamer


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## gossamer (Feb 28, 2002)

I am 36 weeks today. An official take home baby. I saw my Perinatologist on Monday and the baby is doing great. He is still in the 70% and weighs between 5.5 and 6 pounds. I got an 8 out of 8 on my biophysical profile.

Tuesday I went to my cardiologist and my meds were upped a little bit becasue my bp was creeping up again to the 130's over 80's. But my bp responded immediately and is back down to the 120's over 70's. The next time I see him will be in the hospital after the baby is born.

THursday I went to the OB for another biophysical profile. I did not like the ultrasound technician. SHe asked so many questions. "WHen did you last see the peri. WHy are you here today? Why did you start seeing the peri? It has a cute face, boy or girl?" TOtally pissed me off. I told her I saw the peri on monday, the office called and told us to come in for an NST, I started seeing the peri because my last baby died." Then she said he measured in the 39th% percentile because his leg was short and his head was small. SO the whole time I was waiting for the OB I was terrified that he was suffering from IUGR. BUt everything turned out ok. The OB said I scored an 8 out of 8 on the biophysical profile which is the most important thing right now. We are scheduled to deliver via C-Section on Nov 2nd at 7:30 am.

So all in all, very good news and very exciting news.

Tomorrow we go to the infant care and breastfeeding class at the hospital. Things are really moving but I am still in denial. THe baby's room isn't even close to being ready, I haven't done any laundry, I don't have an outfit picked out for him or anything. As I told my grief counselor, denial is still really working for me.

Gossamer


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## MrsMoe (May 17, 2005)

Quote:


Originally Posted by *gossamer*
I am 36 weeks today. An official take home baby. I saw my Perinatologist on Monday and the baby is doing great. He is still in the 70% and weighs between 5.5 and 6 pounds. I got an 8 out of 8 on my biophysical profile.

Tuesday I went to my cardiologist and my meds were upped a little bit becasue my bp was creeping up again to the 130's over 80's. But my bp responded immediately and is back down to the 120's over 70's. The next time I see him will be in the hospital after the baby is born.

THursday I went to the OB for another biophysical profile. I did not like the ultrasound technician. SHe asked so many questions. "WHen did you last see the peri. WHy are you here today? Why did you start seeing the peri? It has a cute face, boy or girl?" TOtally pissed me off. I told her I saw the peri on monday, the office called and told us to come in for an NST, I started seeing the peri because my last baby died." Then she said he measured in the 39th% percentile because his leg was short and his head was small. SO the whole time I was waiting for the OB I was terrified that he was suffering from IUGR. BUt everything turned out ok. The OB said I scored an 8 out of 8 on the biophysical profile which is the most important thing right now. We are scheduled to deliver via C-Section on Nov 2nd at 7:30 am.

So all in all, very good news and very exciting news.

Tomorrow we go to the infant care and breastfeeding class at the hospital. Things are really moving but I am still in denial. THe baby's room isn't even close to being ready, I haven't done any laundry, I don't have an outfit picked out for him or anything. As I told my grief counselor, denial is still really working for me.

Gossamer


such wonderful news!!!


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## kir (Apr 29, 2005)

Quote:


Originally Posted by *gossamer*
Kir, it sounds like your doctor is ontop of things. Bedrest is usually used to control BP, so if your BP is under control via medication, I am not sure bedrest is a viable option. As much as you want to give your babies every opportunity, sometimes, being in utero is more dangerous than being born. 32 weeks is 98% viable and pre-e is very deadly. So it is a tightrope we walk. Keep an eye on your bp's, take it easy and keep us updated.
Gossamer

It's good for me to hear you think my doctor's level of vigilance is reasonable! Sometimes I feel that she's out there looking for problems, and it stresses me out.

Everything has been FINE this past week, which is great! My doc has me going once a week for a full liver profile blood test, and in addition I'm getting a color doppler every 15 days to monitor fetal growth. This is reasonable, right? I think that with my awareness of pre-eclampsia in moms of multiples it's actually most important that i don't get too nervous, and stay as relaxed about this pregnancy as I can for now.

Kiran


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## shannon0218 (Oct 10, 2003)

Gossamer Wooo Hoooo!!!!
Kir, sounds totally reasonable.


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## emmasmommy (Feb 26, 2004)

Gossamer - that's a wonderful update!!

As for me, my little one made her appearance Oct 17 via c-section. My bp kept going up despite the meds and bed rest (though no other pre-e symptoms) so my OB scheduled a c-section for 38.3 weeks. Annika Victoria Louise weighed 8.8lbs and was 20.5in. She is doing great. I am feeling good too, but my bp has been slow to come down (same as last time).


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## cherubess (Oct 14, 2004)

Emmasmommy: Congratulations to you and your new family!

Kir: Staying relaxed is good









Gossamer: Pleased to hear all is well. Looking foward to reading the birth announcement soon.


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## Gunter (May 5, 2005)

This thread is really informative. My BP has been great all through pregnancy at 100/60 at first but 110/70 every time since. Well, last night at my 35.5 week visit, my BP was 125/85 so my MW said I need to keep an eye on it. No swelling, no seeing spots, no headaches though.

Any specific tips on lowering BP or keeping it low? I am vegetarian but have been for years so I am aware of keeping enough protein in my body.

TIA


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## gossamer (Feb 28, 2002)

One abberant reading is not that worrisome, especially this late in your pregnancy. BP tends to rise in the third trimester. Just be aware of the other symptoms, keep an eye on your bp's, maybe asking your mw if she can do more frequent readings. Soaking in epsom salts can be helpful because they contain magnesium. Make sure you are hydrated. I think being aware of the symptoms is the most important thing you can do. Congratulations and I can't wait to hear about your brand new pre-e free baby.
Gossamer


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## clavicula (Apr 10, 2005)

i have a question, please answer me....
i posted my story here, i had severe pre-ecclampsia with pg #1 (delivered naturally though 37w3d)
we are healthy (again).
we would like to TTC#2 next summer or so, and i need advices how to avoid pre-eccl with #2?
more rest? naturopathy? excercising? herbal tea?
any advice or experience?
i am a bit worried, of course, i hope i can avoid pre-eccl. next time somehow!


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## gossamer (Feb 28, 2002)

clavicula,
I am so glad your little one was born safe and sound. I would suggest you ask your OB to do some DNA testing to see if you have any genetic blood clotting disorders or autoimmune diseases like lupus, rheumatoid arthritis etc. IF you are negative for any genetic indicators, talk to your doctor about vitamin C, Vitamin E or Aspirin therapy. I had a pre-conception visit with my OB and we went over all of the possibilities and mapped out our game plan. Just some ideas for you. I wish you well. Also www.preeclampsia.org has some good ideas and questions to ask.
Gossamer


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## cherubess (Oct 14, 2004)

Gossamer,

Not long to go now!

I wanted to wish you a happy, safe, comfortable delivery of your baby boy and to let you know that my thoughts and prayers are with you and your family.

I can't wait to read his birth announcement on MDC.


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## gossamer (Feb 28, 2002)

Thank you so much. Yup, 3 more days and then Wednesday morning bright and early my son will be born. It is so surreal to me. ANd praise God, I have not had any symptoms of pre-e. I have had my meds adjusted a couple of times because my bp kept creeping up, but nothing else. My bp reacted immediately to the med change, my kidneys stayed functional and my liver panel always came back normal. I could not have asked for a healthier pregnancy. Thank you all for your prayers, I know they worked.
Gossamer


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## Gunter (May 5, 2005)

Just wanted to let you all know that my BP was down to 117/80 last I checked on Thursday. Yay! Hope that each of you is well and healthy! I do feel like I have grown so much in just one week.

Gossamer- looking forward to hearing how your birth and baby bonding goes my fellow Nov. mama!!!


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## Satori (Jan 30, 2003)

Gossamer, I hope that you are happily holding your little bundle now and that every thing went well!









Since Gossamer is having a baby right now can someone please tell me about Vit E and Pre-e? I remember reading something about it a few years back.


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## AmyGirl28 (Apr 9, 2005)

Gossamer- I am in your November DDC and I just wanted to wish you the best of luck with your birth. I know it might be awhile before you feel like getting back to the computer. I am soooo happy that you didn't get Pre-E this time and were able to carry this baby to term. I am hoping the same thing for myself. I'm praying for a sucessful VBAC, but I will be happy with a healthy baby either way.


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## aprilushka (Aug 28, 2005)

Can I ask those more familiar with preeclampsia about this situation? I'm on a Russian due date club also and a woman there was just told she had to be hospitalized because she gained a whopping 8.5 kg (18.7 lbs) at 26 weeks, 4kg (8.8 lbs) of which in 3 weeks and her legs are swelling a bit, but no protein in the urine or increase in blood pressure. Okay, maybe 8 pounds in 3 weeks is a bit much, but might be understandable if she had lower weight gain before. I'm pretty sure I gained that much in 4 weeks once last pregnancy. Swelling maybe a little early, but also happens. Her doctor said we're not going to wait until you spill protein, we're going to cure you right now, we're sending you to the hospital to be "cured"-- umm, exactly how are they going to do that at 26 weeks (except by delivery which I don't think they are considering)? Apparently some kind of drug will be given. And would preeclampsia typically be suspected here in this case?

It seemed a little odd and one of those cases where the cure may be worse than the disease which doesn't even seem to necessarily exist in her case.


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## flyingspaghettimama (Dec 18, 2001)

Hmm, that is sort of strange. Some people do gain in fits and spurts. I do not think someone would be induced here for weight gain alone - they would do a screening HELLP panel to see if there was some organ failure first contributing to the water weight gain (if it's water at all). Perhaps her doc did this? You can have HELLP without classic preeclampsia symptoms first (I didn't know this either until recently).


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## aprilushka (Aug 28, 2005)

Quote:


Originally Posted by *flyingspaghettimama*
Hmm, that is sort of strange. Some people do gain in fits and spurts. I do not think someone would be induced here for weight gain alone - they would do a screening HELLP panel to see if there was some organ failure first contributing to the water weight gain (if it's water at all). Perhaps her doc did this? You can have HELLP without classic preeclampsia symptoms first (I didn't know this either until recently).

As far as I know, it's only because she has "pathological weight gain" -- ie, the 4kg in three weeks--and some swelling in her legs. I just can't figure out what the "cure" is, what I'm worried about is they'll start starving her.


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## flyingspaghettimama (Dec 18, 2001)

Er, that's bizarre. The only drug they'll give you for pre-e that I know of in hospital is magnesium sulfate, and that's mainly a stopgap to prevent seizures. Usually the only cure is delivery. Starving a person wouldn't do anything except make them completely insane? Does she have headaches or other unusual symptoms?

I gained the way you described as well - I kept an eye on my _weekly_ gains to make sure there was no sudden water problems; but I would frequently gain 5-8 lbs in a month after not gaining at all for the month previous - and repeat the cycle again.

I hope your friend makes out alright. Hopefully she can ask for the panel screening to rule out HELLP; and that would seem to indicate that she is OK, just gains weight a little funky.


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## aprilushka (Aug 28, 2005)

Thanks, I don't know her she's just in a due date club I'm on in a Russian forum. If it comes up again I'll mention the HELLP screens.


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## gossamer (Feb 28, 2002)

If they are concerned about pre-e, bedrest can be helpful and they could give magnesium for a while to stave off high bp. I am sure that if she is being hospitalized, they would do a full liver panel and probably a 24 hour urine which is more accurate than a simple dip. It can tell if you ar enot only spilling protein, but also how your kidneys are functioning. The only way they would deliver at 26 weeks is if her life is in danger. Please keep us informed.
Gossamer


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## aprilushka (Aug 28, 2005)

The problem is I'm not sure if they do the HELLP screens over there. As far as I know they just get excited over weight gain alone.

I'll see what she posts when she gets out of the hospital.

Thanks for your replies.


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## MontMama (Jun 24, 2004)

Wow, N., thanks for posting all the info. I had no idea that pre-e was such a complex condition.









Makes your new little babe all the more special, doesn't it?


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## spruce (Dec 11, 2004)

Quote:


Originally Posted by *gossamer*

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.


Hi, Gossamer. I had to chime in here and say a huge, "Thank you" for bringing so much information to the table.

I developed pre-e with my FIFTH baby. I'd never had high bp ever, and my pre-eclampsia didn't strike until *postpartum* . It's apparently very rare, but just as deadly. I'm lucky I knew that the signs I was having were definitely pre-eclamptic signs, even though my baby had been born. My bout with pre-e began in earnest within 16 hours of my daughter's birth. She was the smalles of all my babies, and the only one born on her due date (my babies are slooow cookers).

Without the knowledge I already had about pre-e and about normal postpartum recovery, I might have gone longer than I did without help. As it was, I waited (foolishly!) until my daughter was 6 days old to really pursue some relief, and didn't GET that relief until she was 8 days old and my bp was more than 70 points (systolic) higher than my normal pressure. Scary, painful, and a sad way to start out getting to know your baby.

I was lucky, I took her with me to the hospital and she never left my bed, so our nursing and bonding was only interrupted by the pain I was in. She is 20 days old now and my blood pressure is still out of control...but they tell me that will probably get better.

Thank you again, Gossamer, and all the Mamas who have posted such invaluable, life-saving information here.

love, penelope


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## gossamer (Feb 28, 2002)

Dear Spruce,
I am so glad you were able to get help. What most people don't know is that most women who die from pre-e, die within the first 24 hours after giving birth and since the "cure" for pre-e is delivery of your child, it is hard to treat post-partum pre-e. It is stories like yours that keep me so devoted to spreading the information and debunking the myths. Once again my precious Mary Rose has helped a mama and her baby.
Gossamer


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## flyingspaghettimama (Dec 18, 2001)

A disclaimer: I do not have any underlying health issues (blood clotting, heart conditions, etc). I had very severe, early onset (27 weeks) pre-e leading to HELLP syndrome and induction in my first pregnancy and gave birth in a hospital with many _necessary_ interventions. This time, I wanted to do everything I could to avoid preeclampsia...even if it didn't work out in the end, I'd know that I tried. I do not think they really know what underlying condition causes pree, so I covered all my bases. This is what I did:

*One year previous to pregnancy, I exercised consistently 3-5x a week. There was a recent study noting a reduction of repeat preeclampsia in women who had exercised for one year prior to conception.

*I started prenatal vitamins and a very high-protein diet once pregnant. I'm a veggie who eats fish 1-2x a week, so this was sort of a challenge.

*My natural supplements included folic acid, magnesium, and calcium-magnesium; in addition, flax seed oil and oily fish 1-2x a week.

*I started low-dose aspirin therapy at 18 weeks until about 30 weeks.

*I monitored my weight and BP on a weekly basis, watching for fluctuations.

*I met with a high-risk specialist in pree issues at 20 weeks to get advice and go over what I was currently doing (he suggested the folic acid).

*I exercised heavily from conception to seven months (still running); prenatal yoga and walking from 7-10 months.

The irony is that I went overdue to almost 43 weeks and had a 9lb 1oz baby. I had an enormous, very healthy placenta, which my MW said was due to my healthy pregnancy lifestyle. No preeclampsia or even PIH this time though. I had my baby at home in a watertub. It was great! Perhaps it was nothing I did, it was just luck. But self-management helped me to feel some modicum of responsibility and power over something that's essentially a mystery.

Hugs to mamas with preeclampsia and those who've made it through the other side.


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## massaginmommy (Mar 5, 2005)

thank you for sharing your story *flyingspaghettimama* It is wonderful to hear that someone beat the odds.


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## 2 in August (Jan 6, 2006)

Thank you Gossamer for starting this thread and congrats on your new little guy. I just read every single post and have learned soooo much!

I started to develop pre-e when I was pg with my dd who is now 4yo. I was lucky in that my ob and the others in her office watched me very closely. I however, had no idea what all the fuss was about. I was put on bedrest at 32 wks and delivered at exactly 35 wks. My dd was very healthy, although small (5lb 5oz). I had a really scary delivery and ended up with a massive infection but now I have a wonderful dd.

Now that I am pg again and knowing what I do now, I will be much more vigilant about knowing what is happening to me and my baby. I pray that I will avoid it all together this time, but I know I've got the risk so I will keep watch.

Thanks again to everyone who has posted their experiences here.
Jennifer


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## greenmansions (Feb 16, 2005)

I haven't checked in here for awhile... I am now 37 weeks and still no signs of pre-e. My BP has been nice and low, last visit it was 107/70. I switched providers to a midwife in the hopes of increasing my chances for a VBAC, and in the process learned a lot more about my previous bout with pre-e as she reviewed all my records with me. I thought my OB had told me everything there was to know, but she had not. She was out of town the week I had DS though, so maybe she thought I had been told by those who attended me at the time - I felt a good rapport with her, so am just not sure what to think.

Turns out I not only had pre-e come on in the last day of my 4 day labor, but I also had HELLP with platelets down to 36,000 but no hemolysis or elevated liver enzymes at that point as far as we know. Initially, my BP was actually within normal range but my protein was going up and they weren't sure what was going on at first. Then the BP kicked in, and the HELLP. (It's not related, but I also had an infected placenta and cord, and had a rising fever - didn't know about this stuff either.) In an odd way I have found some comfort in knowing all this since before, I was never really sure my cesarean was needed, and I had such a long recovery that now makes more sense.

The midwife ran a whole series of tests like bilirubin, platelets, etc last week and everything came out normal. I did a 24 hour urine last Wed and will get the results at my appointment this week. (Such fun running to the frig with pee in a cup in the middle of the night!) She and her backup OB want to have a baseline for all these parameters, as well as just to make sure I am OK to date.

I'm wondering why my previous OB didn't check any of these things during this pregnancy. They did the usual BP and urine dipstick each visit - not sure if that is good enough or not. Does anyone know what is appropriate?

We'll see what the next few weeks hold, and I hope labor is shorter and easier this time around and that I don't get sick again. But I'm mentally prepared for another c/s if things take a turn for the worst...


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## EStreetMama (Sep 5, 2003)

Remember to be monitored closely for signs of PE during the postpartum period, too!!!


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## Satori (Jan 30, 2003)

Quote:


Originally Posted by *greenmansions*

Turns out I not only had pre-e come on in the last day of my 4 day labor, but I also had HELLP with platelets down to 36,000 but no hemolysis or elevated liver enzymes at that point as far as we know.


Not questioning your mw but does she know what HELLP stands for? If you don't have hemolysis AND elevated liver enzymes w/ low platelets then you don't have HELLP and history of HELLP will risk out of a home birth/mw care and even regular OB care and you get stright to a Peri.

I too was told I had HELLP but after consulting some high risk OB's they agree I did not have HELLP but was on my way to getting it. We now know what caused my "HELLP" so it should not happen again but if you truely had it your mw would be risking every thing (including your lives) by taking you on as a client unless your also seeing a peri and plan a hospital birth as HELLP can develop within hours/days of birth.


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## gossamer (Feb 28, 2002)

Quote:


Originally Posted by *greenmansions*
I'm wondering why my previous OB didn't check any of these things during this pregnancy. They did the usual BP and urine dipstick each visit - not sure if that is good enough or not. Does anyone know what is appropriate?

I am really surprised at your doctor's lack of monitoring. During the course of my pregnancy I had 3 24 hour urine cultures and at least 3 maybe 4 blood draws to check my platelets, liver enzymes etc. A urine dip in the dr's office is not adequate for a woman with a history of pre-e in my opinion. Your hydration level can absolutely affect the results of a dipstick test. I was also monitoring my BP at home 3 times a day, faxing them to my cardiologist once a week and seeing my cardiologist every 4 weeks. Maybe I was over monitored, but after having lost a child, I was not taking any chances.
Gossamer


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *Satori*
Not questioning your mw but does she know what HELLP stands for? If you don't have hemolysis AND elevated liver enzymes w/ low platelets then you don't have HELLP and history of HELLP will risk out of a home birth/mw care and even regular OB care and you get stright to a Peri.

I think this really depends on what you're comfortable with. I had a history of severe HELLP and preeclampsia, but I was comfortable with my subsequent homebirth, as was my MW (and I did have to somewhat look for a MW who I felt was very supportive and not neurotic about my history). I felt like I would probably be THE most neurotic and overly worried about developing it again, knowing the signs in retrospect. I did not ever develop either HELLP or pre-e this time around, I feel in some small part due to my own diligence and self-care.

I did have two blood draws for platelet checks this time around; and they were responsible about checking for protein, swelling, asking about headaches, etc at each visit. During labor they also monitored me closely, but weren't taking my BP every 10 minutes either. I felt like they trusted me to contact them with ANY warning signs, which I would have. And they would've taken them seriously, unlike my doc in my previous pregnancy.

But dude, I hated my hospital and NICU experience and was not going to go through that again...unless necessary.

Edited to add: Two other factors that greatly increased my comfort - MW carried mag sulfate with her; and hospital is literally two blocks from my house. I'm not sure how I'd feel if I didn't have these two reassurances.


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## greenmansions (Feb 16, 2005)

I am having a hospital birth attended by a midwife, with a back up OB. I was not comfortable with homebirth w/ previous c/s and pre-e. I think this is a good compromise, and I feel they are actually watching me more closely than my previous OB did.

I am wondering if since I got pre-e and all so late in the pregnancy (last day) if that might mean I am more at risk for having it show up after delivery this time? I don't think there's any data on this, just data that says that because it was so late I am less likely to get it again in pregnancy.

From what I read about HELLP, the platelets drop first, then the hemolysis kicks in, then the liver enzymes go up last, roughly in sequence. So maybe it was "early" in this process? What else would make the platelets go so low, given presence of pre-e? I believe I read the stuff about sequence on the AAFP site, tho it may have been someplace else. So it's not actually considered HELLP til you have all 3, full blown?

Thanks for the advice and info, as usual. This thread has been very helpful to me during this pg.


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## funnygrace (May 24, 2005)

Hi, I'm not sure where to post this question, but many of you seem familiar with clotting disorders, so I'll start here.

I'm ttc #1. I've never been pregnant before (as far as I know) and I'm 34. My half-sister has tested positive for Factor V Leiden. She had a sucessful pregnancy before having a thrombosis event that prompted the testing. I've resisted getting tested, because I didn't want the pre-existing condition, but now that I am ttc, it seems like a good idea.

But here I am in the 2ww. I have an ob/gyn appointment around the time that I will find out whether or not I am preg. My reason for the visit is to ask about FVL and get a referral to a hemotologist. But I read something in this thread about not being able to do tests for clotting disorders during pregnancy. Did I misread? Would there be any reason for me to rush to a hemotologist now before implantation (positive thinking!)? Or will they still be able to do the blood test if I am (just barely) pregnant? Thanks!


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## shannon0218 (Oct 10, 2003)

Factor V can be tested while pregnant, it's more the auto-immune related clotting factors that are difficult to test for while pregnant such as anti-cardiolipin antibodies. The biggest documented dangers with Factor 5 are later in pregnancy although MANY people believe it also results in early pregnancy loss.
This is a yahoo support group for Factor V leiden and other clotting disorders in pregnancy.
http://groups.yahoo.com/group/FVL-PG


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## funnygrace (May 24, 2005)

Thanks for the information. That makes sense--pregnancy shouldn't change your genetics. I'll definitely look into the yahoo group if I test positive.


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## Satori (Jan 30, 2003)

Well ladies, i've been following this thread since it started forever ago and it looks like i'm headed for a repeat, I ended up with severe pre-e/hellp with my dd and i'll be 24 weeks on wednesday and i've had some sudden weight gain/swelling issues this weekend, facial swelling last night that thankfully is gone today (vain I know but I start a new job today!) but I woke up with pitting edema in my feet and hands this morning. OB's office is closed but I managed to snag an appt with my family Dr this morning before work to check BP/weight/urine dip and labs if I need them. I pray this is just a normal pregnancy thing but my instincts are telling me there not.


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## flyingspaghettimama (Dec 18, 2001)

I am sorry, Satori. Also, sometimes you can check your BP & weight at least at a pharmacy...I did this a lot during my pregnancy, although I see you will be able to get into the doctor's today.

This is a wild shot, but have you tried upping your cal-mag intake and drinking more water? Sometimes that can help flush things through, if it's normal water retention. If not though, best to get it checked in any case. Let us know how things turn out, ok?


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## gossamer (Feb 28, 2002)

Satori, how are things? What did the Dr. say?
Gossamer


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## Satori (Jan 30, 2003)

Quote:


Originally Posted by *gossamer*
Satori, how are things? What did the Dr. say?
Gossamer

ugh, I'm ready to slap some medical "professionals"! I finally saw the OB today and I've gained 16lbs in 19 days! My BP is rising fast and was actually high for ME last night when I went to the ER for pain under my right rib. Dipstick wouldn't check my liver functions because I wasn't jaundiced looking so I was obviously fine and decided I needed a friggin tox screen instead









: Anyway, my OB kinda blew me off today and just suggested bedrest and paying a visit to the high risk clinic on Thursday since I'm not presenting with "typical" pre-e, why the heck do they think protein should be the first thing to show up? He wont even order a 24 hour urine to check for it! Says his dip sticks are just fine when I know they can be wrong and miss it. I mean honestly, I've got all this:

16lb gain in 19 days and not eating enough to account for that much and its not helping that its staying distributed in my body but at night I swell up like crazy and my poor feet and hands burn like there on fire.

vision blurring on occasion (keep thinking my glasses are really dirty when there not)
pain under my right rib and right shoulder pain
indigestion from hell
rising/high BP
swelling with occasional pitting in hands and feet
nausea is back

and i'm only 25 weeks, i've got a right to be concerned! I know this baby will be here very early at this rate but I also know they can do things like give steriods to help the baby out even if I manage to hold out another couple weeks.

At least the baby is active to reassure me she's ok.


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## acrathbun (Apr 27, 2004)

Quote:

ugh, I'm ready to slap some medical "professionals"! I finally saw the OB today and I've gained 16lbs in 19 days! My BP is rising fast and was actually high for ME last night when I went to the ER for pain under my right rib. Dipstick wouldn't check my liver functions because I wasn't jaundiced looking so I was obviously fine and decided I needed a friggin tox screen instead Anyway, my OB kinda blew me off today and just suggested bedrest and paying a visit to the high risk clinic on Thursday since I'm not presenting with "typical" pre-e, why the heck do they think protein should be the first thing to show up? He wont even order a 24 hour urine to check for it! Says his dip sticks are just fine when I know they can be wrong and miss it.
Umm, time to find a new OB? Maybe immediately?


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## gossamer (Feb 28, 2002)

Go to the pre-eclampsia website , preeclampsia.org, print off the symptoms of pre-e and run as fast as you can to the emergency room.
Gossamer


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## shannon0218 (Oct 10, 2003)

Satori, I completely agree with the pp's, you need to get into a hospital right now. Tell your OB to smarten the heck up!


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## Satori (Jan 30, 2003)

Yippee! Just saw my regular Dr to get copies for my BP/weight increase since my OB didn't have crap and yesterday I weighed 149 on there scale and today I'm down to 143 and my BP is down to 122/68







The cause? I doubled my potassium and magnesium intake (the prescription level I'm supposed to take but don't because it causes GI upset) because my labs showed they were really low again and my body is flushing everything now. Lets hope it keeps up! I'm going to be in the city for the next day or 2 so if something's up I'll go to L&D but otherwise I have my appt at high risk tomorrow morning.


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## massaginmommy (Mar 5, 2005)

whew Satori I am glad to hear that.
I have a Gyn appt today, finally for a yearly. I am going to talk to here about getting some testing done as DH and I are ttc #5 right now. I am going to ask for a liver function panel a 24 hour urine output and blood tests for clotting issues? Anything else I should get tested? I have never seen her before as we moved after YDS was born. She is a highrisk OB/GYN so I am hoping she will be familar with what tests I need but I would like to sound informed when speaking to her.
I have had pre-e with all my births and hemorraging after my first sons birth 21 years ago. My bp's run super high during labor (225/170 the last time) and I was induced for all my births. BTW I am almost 43
TIA Laurie


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## massaginmommy (Mar 5, 2005)

SO the appt was kind of disappointing. She told me clotting factors had nothing to do with pre-E and we didn't need a urine or liver fundtion until I was actually pregnant. She did order some blood work, a fasting liipid for cholesterol because I am 42 and had this checked over 5 years ago and she ordered a comprhensive Metabolic panel. She said that would show liver function or something. I just feel like I didn't have the kind of appt I was hoping for. I amwaiting ot hear how my pap and HPV turn out.
WHy is it that sometimes with our research we seem to know more than the medical doctors?????


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## flyingspaghettimama (Dec 18, 2001)

Could you find a different doctor who would be willing to work with you on prevention and/or figuring out some root issues? Perhaps someone who knows about Factor V or other thrombophilias? Maybe a ob/gyn perinatologist who specializes (you could interview a few first and find out who knows the most)?

Have you ever had a blood clot?

Have you tried different nutritional/exercise approaches in previous pregnancies?


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## massaginmommy (Mar 5, 2005)

I hemmoraged after DS #1. I was passing clots bigger than my fist. I have had PIH or Pre E with all three of my births. I tried dietary stuff with the last pregnancy High protein, plus herbs. I am going to look into other docs. She is actually listed as a high risk and on her website it says she has experience with Pre-E. How do you know who is good? I need a list of questions to ask or something. I definitely want to find some answers.


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## flyingspaghettimama (Dec 18, 2001)

Yeah, they don't mean that kind of clots with a underlying clotting issue - it's like, you have blood clots during your pregnancy in your body (i.e. in your leg, etc). Do you have other underlying issues i.e. high blood pressure? It might be good to get in as good as health as you can before TTC.

As far as questions go, I asked the docs and midwives what their personal opinion was as to what caused pre-eclampsia. I sought people who seemed to have a better answer than "I don't know, it's a mystery. You can't do anything but pray." The high risk doc I saw had definite opinions about it and suggested watching sodium intake from processed foods (which is different than salt to taste) and extra calcium and folic acid during TTC and throughout pregnancy, said he'd seen really amazing results due to folic acid supplementation.

So basically, having some _sort_ of opinion about the matter and willing to investigate possible underlying issues and causes and solutions with you...


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## massaginmommy (Mar 5, 2005)

My placenta fell apart upon delivery with my first. I have recently been doing some reading about the link between the placenta and Pre-E
With my last I watched my weight gain ate healthier than I ever have in my life had no BP issues until about 4-6 weeks prior to EDD They induced 2 weeks early. I haven't had blood clots in my body. I have had High BP but when we monitor at home it is much lower and within the normal ranges. Maybe white coat syndrome. I have wondered if I should be on BP meds during my pregnancy. I did extra calcium and herbs for bp. I walked a couple miles everyday and did yoga. We also used accupuncture to try to keep the BP down.
With the clotting factors though what would be the harm in testing for them anyway? I am sure some of them are hidden. Many women have issues with miscarraige due to clotting and never know that is the culprit until someone tests for it. KWIM? I figure they could at least rule that out.


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## flyingspaghettimama (Dec 18, 2001)

Bummer. I agree with you. They could at least check due to your request and the severity of your preeclampsia in the past. Maybe this isn't a doctor who isn't open minded enough to listen and/or investigate your request? If you stay with your doc you might want to bring her info on Factor V, etc.

The baby aspirin regimen at bedtime is supposed to help many previously preeclamptic women, and they think it has something to do with clotting issues. Same with the folic acid. I dunno, when I was trying to prevent a recurrence I was on baby aspirin (18-35 weeks), mega doses of folic acid, calcium, B vitamins, and magnesium, high protein/low carb, heavy exercise, and constant management of my weight and BP. Oh, and beet juice! Whenever I started getting puffy, I'd drink some fresh beet juice and pee it all out. Sounds weird, but it worked for me.

In any case, hugs to you - it sounds like you're trying everything humanly possible to get to the bottom of it all. You just need a great doc partner in your mission!


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## massaginmommy (Mar 5, 2005)

You are right. I am gonna keep looking until I find a great doc. Thanks for all the great tips.


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## clavicula (Apr 10, 2005)

hey mamas,

i have a q for you, flyingspaghettimama.
i am ttc#2 now, and trying to prevent a recurrence. (with dd i had severe PE started @36w, delivered @37w3d) your ideas are great







, i wrote it down for myself!

Quote:


Originally Posted by *flyingspaghettimama*
I dunno, when I was trying to prevent a recurrence I was on baby aspirin (18-35 weeks), mega doses of folic acid, calcium, B vitamins, and magnesium, high protein/low carb, heavy exercise, and constant management of my weight and BP. Oh, and beet juice! Whenever I started getting puffy, I'd drink some fresh beet juice and pee it all out. Sounds weird, but it worked for me.

what do you mean on heavy excercise?


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## flyingspaghettimama (Dec 18, 2001)

Clavicula,
I went to the gym at least every other day for at least thirty minutes of exercise (elliptical, yoga, bike, walking), exercising until I was sweating, all the way until the day I went into labor. I was also running (outdoors) until my 7th month of pregnancy at least once a week. I skipped a few weeks in the middle of summer, but that was it. The reason why - there was a great study that explained the role of exercise in prevention of preeclampsia. I can post it to you if you're interested.

The best part, I was hardly ever sick! It felt super good, I would stop if I felt icky or too hot or something...and it was a great confirmation that I was doing the right thing when my son was born and he was huge and the placenta was huge - plenty of nutrients getting in there.

Here is a longer version of what I wrote:
http://mothering.com/discussions/sho...&postcount=351


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## mimi_n_tre (Jun 15, 2005)

Has anyone here had Pre-e and then a stillborn? I just delived my second son at 26 weeks in September, he was stillborn and they never did anything to see if there was something wrong with either him or I ( Well, they lost my tests anyways...). My first son I had a slow rising blood from about 28 or so weeks, and ended up with HELLP and delivering my son at 35 weeks. He had IUGR, and only weighed 3 1/2 pounds. I was supposed to be on bedrest for the last three months or so, but continued to work until the night I delivered, as I was young and naive...

I am currently 24 weeks and very concerned... I had read about clotting as a possible cause of pre-e, and I know that clotting can cause stillborns also. I just don't want to have to go through either again. I just started to take baby aspirin, but that is the extent of it. Most of the students I see don't really do anything to see or check on if something is wrong, but I only put up with them because I want to have a VBAC.

Mary.


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## acrathbun (Apr 27, 2004)

So, wait a minute, you are seeing Students as your care providers? Do I have that right?

With your history I would think they would at least want you to consult w/ a perinatologist. And if I were you, I would insist upon it.


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## clavicula (Apr 10, 2005)

Quote:


Originally Posted by *flyingspaghettimama*
I can post it to you if you're interested.

yes, i do! post it!
you did a wonderful job!!







it is really encouragigng to read your experiences!thanks!


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## mimi_n_tre (Jun 15, 2005)

Yes, they are students, in which in many cases it seems like I know more about this whole pregnancy thing than they do... I go to a large hospital, but it is where they train the med students, so it sucks.

I just had a change in insurance, so I was thinking I can change hospitals to one where I can actually see a good doctor. Where should I go on MDC that I might be able to find a good doctor and hospital?

So, about the clotting diseases, if I did go to a different hospital, Is it too late to find out?? When I asked them at my 6 week check-up if I could have get the testing done again, they told me I had to be pregnant. (Little to know, I was being fertilized that day...) My old insurance gave me a run around about the genetics testing, which I had schedule since about the 9th week or so... I can have it done now, but I would rather it be done at a better hospital, with the real doctors.

Mary


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *clavicula*
yes, i do! post it!
you did a wonderful job!!







it is really encouragigng to read your experiences!thanks!

http://www.medicalpost.com/mpcontent.../3807/29B.html

"Women who were physically active in the year before and during pregnancy were 41% less likely to develop pre-eclampsia than their inactive counterparts.
Risk of pre-eclampsia also tended to decrease with the intensity and amount of energy the women expended in activities. *Women who exercised vigorously during pregnancy experienced a 54% reduced risk of pre-eclampsia*, when compared to sedentary women."

mimi'n'tre - YES, I would change providers if in your situation. I agree with PP, perhaps you should see a high-risk perinatologist who specializes in preeclampsia for a consult. Is a home VBAC not available in your area, can you find a good midwife? Sometimes they are more educated in the area of preeclampsia than the med students...but for the testing, yeah - see a perinatologist.

From my reading, BTW, the baby aspirin is something to be taken at night before bedtime. It is not as effective (some studies showed, actually completely ineffective) if taken at other times of the day. The studies think it had something to do with resting nighttime environment.


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## gossamer (Feb 28, 2002)

I am stunned that they told you you had to be pregnant to do the dna testing, most perinatologists would rather test while not pregnant. Knowing that you have had pre-e and a stillborn, I would absolutely suggest a perinatologist. Also check out www.preeclampsia.org. ypou could go into the Finding you tribe forum and pose a question in you geographic tribe about good dr.'s in you area.
Gossamer


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## mimi_n_tre (Jun 15, 2005)

Thanks,
I would love a homebirth, but am quite scared of something going wrong, and having another dead baby, and possibly a dead me... I have to go about an hour away to the hospital as it is, none of the hospitals around here allow for a VBAC, and there are three of them.
I didn't know about having only students when I first transferred there, but my baby ended up dying before my first visit, as I tranferred to have the VBAC.
I will look under the finding your tribe to see about a different hospital or something but am scared that this one will again die before I see the new doctor.

Thanks,
Mary


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *mimi_n_tre*
Thanks,
I would love a homebirth, but am quite scared of something going wrong, and having another dead baby, and possibly a dead me... I have to go about an hour away to the hospital as it is, none of the hospitals around here allow for a VBAC, and there are three of them.
I didn't know about having only students when I first transferred there, but my baby ended up dying before my first visit, as I tranferred to have the VBAC.
I will look under the finding your tribe to see about a different hospital or something but am scared that this one will again die before I see the new doctor.

Thanks,
Mary

Sure. I hear you. In your posts, you do sound very scared about this pregnancy, and it's understandable. What would help you to feel safe? Can you ask your current student team to run the tests while looking for another doc? I am sure that if you bring the name of the tests you suspect you need, and some studies to back you up, into your team, they might accede to your request?


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## Satori (Jan 30, 2003)

ugh! So I just called the clinic where I'm getting my prenatal care, the high risk clinic is only held once a week and no one has told me what to do if I have any problems beyond go to L&D. So I called them up assuming they would be someone assigned to talk to high risk patients or something and tell the nurse I've basically had a headache for a week and I've been seeing light flashes and the other night my vision was all messed up and blurry. Guess what the nurse told me... "oh, you need to call your eye Dr because that's an eye problem!" I explain no its not, its a symptom of pre-e which I've had in the past and its why I'm going to the high risk clinic so she puts me on hold and 25 minutes later someone comes on the line who tells me I need to speak to L&D so I talk to them and they say I need to come in right now and get checked out. I basically feel fine, baby is moving, no swelling, BP is normal, no sudden weight gain, just headache and vision problems and oh yeah, the only road into the city is closed due to severe weather and multiple traffic accidents so while I will get checked out tomorrow when the weather clears and the high risk clinic is held it annoys the heck out of me that I got such a clueless nurse to begin with and it was an OB nurse no less!


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## flyingspaghettimama (Dec 18, 2001)

Satori, if it makes you feel any better, I had some blurry vision and spots towards the end of pregnancy, but in my case it wasn't signs of pree. I would have them when standing up or going up a flight of stairs...my brother (has medical training) said that it had to do with changes in blood pressure, even slight ones. The blurriness was due to blood vessel changes or something, I don't remember.

It's good to get it double-checked though...I hope everything's all right in your case.


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## earthurs1975 (Apr 25, 2006)

hi all, i'm new here and have been doing ALOT of reading. You are a great source of info and I wish I had known about this site when I was prego with daughter 8 yrs ago!








Currently I'm 27wks along and am being monitored for PE as i had it with my daughter as well as gestational diabetes. So far everything looks to be repeating itself again. I saw that there is some relationship with PCOS? I had this before my current pregnancy (reason for 8 yr gap). My OB has discussed BP Meds if it is still hi at next appointment. I have ultrasounds sceduled for tomorrow to check approx size of baby due to GD, but he also wants an internal one to check cervix cause of alot of pressure and some pain when I'm on my feet. Why? also this morning I woke up with a bloody nose, first in life.... something I should worry about? Alwys tire too.


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## 2 in August (Jan 6, 2006)

Hello everyone, I'm hoping somebody here can help answer this question. My last pg I ended up with PIH. Had swelling, high bp, protein in urine. I was heading toward pre-e but didn't quite meet the criteria. I ended up being on bedrest from 33-35 weeks and had my water break and delivered at 35 wks.

Now fast forward to this pg. My bp has been good 120/70 ish all pg long (I'm now 29 wks). I've got no swelling at all (yet). But at my appt last Friday I was 2+ for protein. She said it had happened once before 6 wks ago, but then I was back at trace 2wks ago. So this time she's having me do a 24 hr urine to get a baseline.

This time I have done some reading (all 20 pages of this thread, all the links in these posts). So I know that I don't need all the symptoms to make me at risk. I think that even scares me more.

So anyway, how is it that the protein can come and go like that? Is protein a worse symptom than the swelling and bp or are they all pretty much the same? Are there any other tests that I should ask her about? What questions should I be asking her that I'm not thinking about?

Thanks mommas!


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## shannon0218 (Oct 10, 2003)

Jen, sounds like she's doing the right thing, the only other thing I'd ask for is a blood profile so she also has a baseline for your liver levels.
If protein is the only symptom then doing a 24 hr urine is exactly right and that will give them much more reliable information than a dip stick.
That you've read all the pages of this thread means you are going to notice if you start getting sick. If you feel anything coming on, go in and get checked--don't wait it out and see what happens.
I'll be keeping you and the little bean in my thoughts, please let us know how your 24 hr urine comes out.


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## maxmama (May 5, 2006)

Dipsticks are totally useless for quantifying the amount of protein. Yes, it can come and go; some people even have what's called postural proteinuria, where you spill protein when you stand up from lying. (Ironically, it's usually young/healthy people who have this.) You need to spill 300 mg/day and have elevated BPs to coutn as preeclamptic; a 24-hour urine is a MUCH better assessment of kidney function.

I agree that you want baseline labs too at this point: I would ask for a CBC, ALT/AST and BUN/creatinine. Labs usually have a "PIH panel" (never mind that PIH and PE aren't the same thing -- grr); check and make sure it includes these labs.


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## 2 in August (Jan 6, 2006)

Well, I dropped off the 24 hr urine today. They also drew blood for creatinine. I'll ask my dr about the others when I see her next week.
Thanks for the quick responses. I'll keep you all posted.


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## boscopup (Jul 15, 2005)

Quote:


Originally Posted by *2 in August*
Now fast forward to this pg. My bp has been good 120/70 ish all pg long (I'm now 29 wks). I've got no swelling at all (yet). But at my appt last Friday I was 2+ for protein. She said it had happened once before 6 wks ago, but then I was back at trace 2wks ago.

How much water are you drinking? I ask this because last preg, I was spilling protein in my urine at 20 weeks, but like you, my bp was fine and I had no swelling at all. My midwife told me to drink alot more water (I really wasn't drinking that much). So I forced myself to drink a gallon a day, and guess what? No protein at 24 weeks or 28 weeks. Didn't make it to my next appt since my water broke, but I believe that to be unrelated.









Just thought I'd throw that out there, as it's a rather easy thing to fix if it's your problem too. Good luck!


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## acrathbun (Apr 27, 2004)

I could be wrong but I think that except in cases of severe dehydration leading to renal failure - the only thing that more water will do is dilute the protein that's already there. Am I wrong?


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *acrathbun*
I could be wrong but I think that except in cases of severe dehydration leading to renal failure - the only thing that more water will do is dilute the protein that's already there. Am I wrong?

No, this should be right, and it's one of the reasons a dipstick urine is so useless. The total amount of protein may be so diluted through the day that it won't show up on a dipstick and yet still be present in fairly large quantity.


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## gossamer (Feb 28, 2002)

Hi Jennifer,
A dipstick test only measures what is in your urine that one time you pee in a cup. At the first sign of protein, your Dr. should have done exactly what she did, order a 24 hour urine. THis gives a much more accurate picture of how your kidneys are functioning. It could be that you didn't drink enough water, had a high protein meal or any number of things. I would not worry unless and until you get your 24 hour results back.

All symptoms are important and I think it depends on the person as to what symptom is worse than others. I would not assign a value to certain symptoms, but keep an eye on how you are feeling and how your baby is growing.

I would also ask your Dr. about a complete liver panel.

After your last pregnancy, did you have any genetic tests done to test for blood clotting disorders?

I am glad your bp looks good so far. Keep a close eye on it and please keep us updated on your progress.

Gossamer


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## 2 in August (Jan 6, 2006)

Thanks Gossamer.

Well the Ob just called and my protein was sky high 1200. So she called in the order for lots more blood work to see what's going on (I'm going this afternoon to get it drawn). She wants me to take it easy this weekend and come in Monday for a bp check. She also said if anything feels weird this weekend to call her or go straight to the birth center. Now I'm officially freaking out.

I'll keep you all up to date as soon as I know more. I'm so glad you all are here.


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## acrathbun (Apr 27, 2004)

Wow, it does sound like something is wrong. Please keep us updated.


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## gossamer (Feb 28, 2002)

Is there anyway you can check your blood pressure yourself over the weekend? Like at a drug store or something? Just to keep an eye on it. If it gets too high, like 140/90 then head for the ER. It is better to be safe than sorry, and pre-e kills mothers and babies. It is not something to be taken lightly.
Gossamer


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## flyingspaghettimama (Dec 18, 2001)

ITA with Gossamer. Also, you can get not-too-spendy home BP monitors that work allright at the drugstores. I had one with my first pregnancy when I was borderline day-by-day.

Take care!


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## 2 in August (Jan 6, 2006)

Quote:


Originally Posted by *gossamer*
Is there anyway you can check your blood pressure yourself over the weekend? Like at a drug store or something? Just to keep an eye on it. If it gets too high, like 140/90 then head for the ER. It is better to be safe than sorry, and pre-e kills mothers and babies. It is not something to be taken lightly.
Gossamer

There is a drug store right around the corner so I could go over there for a quick check. Also, my family dr is at a med-stop so I'm pretty sure I could go over there if I need to do a quick check too.

Thanks!


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## maxmama (May 5, 2006)

oh, please don't check your BP at a drugstore! The machines are never calibrated and are notoriously inaccurate. Try a fire station.


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## flyingspaghettimama (Dec 18, 2001)

Oh, I don't know about that. The ones I used were always very accurate. I imagine if you know your baseline, it's pretty easy to tell if it's off or not.


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## maxmama (May 5, 2006)

But with preeclampsia, "pretty good" or "close enough" are not adequate, and baseline is completely irrelevant. If you're using an inaccurate machine, how do you know that your BP isn't really 150/100, the machine says it's 135/80, and your baseline is 120/70? What difference does the baseline make if the data you're now getting are unreliable?


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *maxmama*
But with preeclampsia, "pretty good" or "close enough" are not adequate, and baseline is completely irrelevant. If you're using an inaccurate machine, how do you know that your BP isn't really 150/100, the machine says it's 135/80, and your baseline is 120/70? What difference does the baseline make if the data you're now getting are unreliable?

Sorry - I meant your baseline on _that machine_. I don't know, I just haven't had the problem of inaccurate drugstore machines. The ones that I checked at weekly were accurate, both in relation to earlier readings on the same machine and readings at the midwife's office. I dunno. I guess if anyone really wants to go to the firestation they could.


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## maxmama (May 5, 2006)

The firemen are pretty hot.

I'm sure some drugstore machines are accurate, but I know ours are calibrated every three months by biomed engineering. I would not be comfortable basing treatment decisions (like whether to call your provider) on a machine with no oversight or maintenance whatsoever.


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *maxmama*
The firemen are pretty hot.









But..but...wouldn't that contraindicate keeping the BP down?


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## maxmama (May 5, 2006)

Oh, fine, take away EVERYTHING I have going in this pregnancy.

No, really, I HAVE to see the firemen. REALLY.


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## 2 in August (Jan 6, 2006)

Quote:


Originally Posted by *maxmama*
Oh, fine, take away EVERYTHING I have going in this pregnancy.

No, really, I HAVE to see the firemen. REALLY.











Actually, in my neighborhood, the fire station is across the street from the drug store (how's that for convenient?) I would feel kind of weird just walking in and asking them to do it though. I never knew you could do something like that. Lucky for me the hospital's birth center is only 10 min away too. Although, I'd have to make it to 35 wks for them to keep the baby there. Otherwise he'd be taken to a hospital about an hour away.


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## gossamer (Feb 28, 2002)

If you were having bp issues already and if it were for a longer period of time, I might be wary of a drugstore machine. But since it's just for the weekend, and since your bp seems to be fine so far, I would suggest going now to get it checked so you can figure out your baseline on that machine and then just check it saturday and sunday. MOre often if you are not feeling well. If you notice a change of 15 points on either number or it gets above 140/90, then go to the ER.
Gossamer


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## 2 in August (Jan 6, 2006)

I haven't gotten my labs back yet but my bp was still ok. So far so good. I'll keep you posted!


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## Satori (Jan 30, 2003)

Good news! I had severe pre-e/HELLP with my dd #1 and last week on 6-1-06 had dd#2 at 38 weeks with no signs of pre-e or HELLP!


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## flyingspaghettimama (Dec 18, 2001)

:


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## 2 in August (Jan 6, 2006)

Well, I don't know how to feel...









My dr appt was this morning. My blood pressure was still ok 130/80, it had been 128/78 so not too bad. All my labs (pre-e screen) were within normal limits. Interestingly the urine sample that I gave last Friday at the lab said no protein. I don't have any swelling or any other symptoms. My dr says this is pretty unusual and that she's going to treat me as having pre-e. So she said she won't put me on complete bed rest if I agree to do nothing. I can't go get groceries, do laundry anything strenuous. I can live with that. I'm doing another 24 hr urine now to see how it compares to the one I did for the original post. I'm also going Tuesday for an u/s to check how big he is (which I don't have a whole lot of faith in since the same office was way off on my friend's baby's size). I'm going to start weekly visits and NSTs after 32 wks.

I'm just confused. I know she's being extra careful and I appreciate it. I just don't understand why if nothing has changed really from 2 wks ago, why is she's putting more restrictions on me?

I will follow her directions. I've got my dh, parents and lots of friends who will help with what I need. I know how serious this is and I'm not taking it lightly. Also, my parents said they have a home bp monitor so they're going to bring that over and I'll take it to the drs office and have it checked against what the nurse does to see if it is accurate.

I'll keep you posted.


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## flyingspaghettimama (Dec 18, 2001)

Maybe she wants to see if your BP becomes more normal (decreases) or you lack signs totally after two weeks on bedrest? Maybe she has a gut feeling? I thought the 80s were starting to be not-good, from my understanding. I never had a reading over 75 in my last, normal pregnancy, but they started inching up by 25 weeks in my first, pre-e pregnancy to around the 80s.

Why not just ask your doc why the concern and bedrest if no signs? Perhaps there is something she's not sharing with you? You shouldn't have to feel confused, that's not right. I would call and ask for more information.


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## maxmama (May 5, 2006)

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.


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## gossamer (Feb 28, 2002)

A lot of times labile bp can be an indication of pre-e. Plus, didn't you have protein in your first 24 hour urine? It is absolutely better to be safe than sorry. I know several women who were able to carry their babies for a couple weeks longer because they were on bedrest, so I wouldn't completely knock it. I think that your previous experience with pre-e might also have to do with her being more vigilant. PLease keep us updated.
Gossamer


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## acrathbun (Apr 27, 2004)

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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## 2 in August (Jan 6, 2006)

Quote:


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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## maxmama (May 5, 2006)

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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## 2 in August (Jan 6, 2006)

Thanks maxmama!!!


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## 2 in August (Jan 6, 2006)

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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## 2 in August (Jan 6, 2006)

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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## shannon0218 (Oct 10, 2003)

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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## 2 in August (Jan 6, 2006)

Quote:


Originally Posted by *shannon0218*
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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## prettypaws (Jun 11, 2005)

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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## acrathbun (Apr 27, 2004)

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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## maxmama (May 5, 2006)

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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## 2 in August (Jan 6, 2006)

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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## shannon0218 (Oct 10, 2003)

Oh Jen, that's so great!!!


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## Mamatoto2 (Sep 2, 2002)

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?


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## shannon0218 (Oct 10, 2003)

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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## sarah9774 (Feb 19, 2005)

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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## gossamer (Feb 28, 2002)

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.
Gossamer


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## bradleybirth2mom (Apr 21, 2006)

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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## 2 in August (Jan 6, 2006)

Quote:


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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## gossamer (Feb 28, 2002)

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.

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.
Gossamer


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## sarah9774 (Feb 19, 2005)

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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## maxmama (May 5, 2006)

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.


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## flyingspaghettimama (Dec 18, 2001)

Quote:


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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## sarah9774 (Feb 19, 2005)

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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## maxmama (May 5, 2006)

Quote:


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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## shannon0218 (Oct 10, 2003)

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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## flyingspaghettimama (Dec 18, 2001)

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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## shannon0218 (Oct 10, 2003)

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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## flyingspaghettimama (Dec 18, 2001)

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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## shannon0218 (Oct 10, 2003)

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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## flyingspaghettimama (Dec 18, 2001)

I getcha. But I also enjoy my naturopathic medicine too, which has little in the way of peer-reviewed studies but plenty of long-term anecdotal and historical support. So that's why I did BD the whole way through - my MW's opinion and experience. She was a very intuitive and cool woman, and she was one of the few that would take me on with a history of severe PreE and not be a paranoid freak about it.

Because there was only room for one paranoid freak in that relationship, and that would be me.


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## gossamer (Feb 28, 2002)

I will say again, that a good healthy nutritional diet is always the best way to go, and if you have no underlying conditions that could put a strain on your kidneys, why not eat more protein. If you are eating protein, those are calories you are not wasting on simple carbs and sugar. Of course we all have to do what we can to survive our subsequent pregnancies and I don't think any one of us will discount the benefits of a healthy diet and lifestyle. Just don't discount the other unknowables, like blood clotting idsorders, high homosystine levels, and poor implantation of the placenta, that cannot be "cured" by diet alone. Until I lost Mary Rose I had no idea how serious pre-eclampsia is. I didn't know it is the number one cause of premature birth and the number two cause of neonatal death (behind domestic violence). SO yes, do what works for you, but whatever you do, don't take the diagnosis lightly.
Gossamer


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## taradt (Jun 10, 2003)

I think for many following the BD also makes us feel we are "doing something". I don't have clotting disorders but I do have high homocysteine that I feel led to pre-e with my daughter. This time I am following the BD (trying I can never get the whole 100g of protein) as well as taking high levels of B6, B12 and folic acid as well as fish oils and calcium and baby asprin the first many months. Did any of it make a difference? who knows but I can say in 5 pregnancies (including a loss in every trimester of pregnancy) this is the healthiest one I have had, I am now past the 35 weeks mark.

tara


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *flyingspaghettimama*
Well, maybe shaking a rainstick at the sky and eating donuts nightly won't work too well.

Damn it, there goes my anti-preeclampsia diet!

Seriously, I agree that there are so many approaches and it's important to find one you're comfortable with. I'm on an atenolol/lasix protocol right now (because I have elevated cardiac output hypertension, and the idea is to reduce the risk of vascular endothelial damage) and my BPs are 100-110/60-70. Will that keep me from getting pre-e? Maybe, maybe not. What it might do is get me to term (I had late-onset pre-e with early-onset hypertension last time). a lot of people wouldn't be comfortable with that protocol, and that's fine. I love the side effect of no edema with the lasix though -- it's so nice to have ankles. Ones that bend, even.


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *maxmama*
I love the side effect of no edema with the lasix though -- it's so nice to have ankles. Ones that bend, even.

Braggart!







I didn't even have that last time, with the "normal" pregnancy!


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## flyingspaghettimama (Dec 18, 2001)

fwiw, there's a very interesting article in this week's New Yorker about preeclampsia and recent research into causation.


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## Mamatoto2 (Sep 2, 2002)

Here's a link to that article:

http://www.newyorker.com/fact/conten.../060724fa_fact


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## 2 in August (Jan 6, 2006)

Very interesting article. Thanks for posting it.


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## Katana (Nov 16, 2002)

I posted this in Birth and Beyond, and at a suggestion, am now posting it here.

My SIL had to have an emergency C section at 31 weeks because of her placenta detaching from the uterine wall and also high blood pressure.

Two days before her birth, her eyes got blurry. It's almost five weeks after, and they're still blurry.

The doctors are telling her, it's fine, you can have blurred vision up to six weeks after.

Is this true? Is there anything she can do to help her eyes?

She's scared they're going to be blurry for the rest of her life.

Any thoughts?

Oh, edited to also mention, her bp stayed high for at least the first three weeks, but the doctors kept monitoring it, and once it went down, said it was okay.


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## 2 in August (Jan 6, 2006)

Hi ladies,

It's been awhile since I posted an update. I'm now 37 wks and honestly never thought I'd make it this far. My protein is bouncing between mid 300s and mid 400s. My bp is still ok but the last time is was 129/82 before that 140/82 then when I layed down it went back down.

My ob is talking about doing an induction at 38 wks just in case. I want to meet my baby and I'm all for being safe, but I'm kind of worried about inducing. Last time my water broke at 35 wks, I had cytotec, pit, epidural, mag for my high bp, an iv for GBS and it was miserable. I'm scared to go through all that again. But, I don't want to risk going to long and having my bp go higher or any other complications that pre-e can bring.

Any thoughts from those of you who have btdt?

Thanks, Jen


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## 2 in August (Jan 6, 2006)

Well, I went to my appt today and she has me scheduled for an induction on Friday. I had a nst today and baby is fine, my bp is still good too. So we'll have him before anything has a chance to go wrong.


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## shannon0218 (Oct 10, 2003)

Oh Jen!! That's so great!! You be sure to let us know the wee guy's stats once he's born!!
Congrats on gettiing to the end


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## chilliepepper (Oct 14, 2005)

Hi all, I'm new here. I read pages 1-11 of this thread, and plan to read the rest when I get a chance, but I'm just wondering if someone could give me a quick checklist of things I should be talking over with my midwife/perinatologist now, given my past experience and current circumstances:

DS#1 was born last July 1. I developed severe pre-eclampsia and HELLP during labor (or at least that's what the ob claims---I wonder if I had undiagnosed pre-e before that, as DS was born full-term weighing only 5lbs5oz). Thank God, everything turned out fine. DS had great apgars, didn't spend any time in NICU, and they got my bp, platelets, etc. back to normal within a couple of days. It wasn't until reading part of this thread a couple of months later that I realized just how serious this condition was.

I had none of the symptoms, until I showed up at l&d at 40 weeks with high blood pressure (168/91; it later escalated to 180/100).

Fast forward to now, I'm 11 weeks pg with #2. I've had one appt. with a new midwife at which I told her about what happened with #1, so she referred me to the perinatologist, who I saw today. I'll be seeing him again in 2 weeks to have blood drawn and screened for the blood disorders that can predispose a person to pre-e.

Today, I forgot to ask him how often they would be doing labs on me. And now I'm just wondering, how soon do we need to start monitoring everything really closely...now? Given that I had no symptoms last time, I'm really scared that it could come on again with no warning. And when we do start monitoring, what all do we need to be looking at, and how often, etc.?

When I wondered these things aloud to my midwife at our first visit, she didn't seem to think we would be doing much extra monitoring. Should I be looking for a different midwife, or is she just leaving all that to the perinatologist?

Yesterday, I felt kind of "contractiony" all day. It felt kind of like the BH contractions I had very often from about month 5 of my first pregnancy. It got worse when I climbed the stairs, lifted DS, or had a full bladder. Today, I've felt like I've had a big rock in the pit of my stomach all day. The perinatologist said not to worry, my cervix was small on the u/s, it was probably just my bowels or who knows what. Do you agree with him, not to worry?

Well, I guess that's enough questions for now. Thanks in advance.


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## gossamer (Feb 28, 2002)

I would suggest asking for a base line 24 hour urine and complete liver panel while it seems obvious that you don't have pre-e. I had a 24 hour urine and complete liver panerat least every trimester and an ultrasound every month with the perinatologist to make sure the baby was growing because my daughter also suffered from IUGR (Intr Uterine Growth Restriction). I think your midwife is probably expecting yout perinatologist to deal with anything that falls outside the range of an uncomplicated pregnancy.

As far as how you feel today, have you had enough water to drink, even slight dehydration can cause contractions.

Please post if you have more questions or want some clarification.
Gossamer


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## taradt (Jun 10, 2003)

After having HELLP with my daughter. I am so thrilled to announce my new baby boy born yesterday after a very very uneventful pre-e free pregnancy









tara


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## chilliepepper (Oct 14, 2005)

Quote:


Originally Posted by *gossamer*
I would suggest asking for a base line 24 hour urine and complete liver panel while it seems obvious that you don't have pre-e. I had a 24 hour urine and complete liver panerat least every trimester and an ultrasound every month with the perinatologist to make sure the baby was growing because my daughter also suffered from IUGR (Intr Uterine Growth Restriction).

Thanks for answering...and by the way, like everybody else, I want to thank you for starting this thread and posting so much info. I looked at your pictures of Mary Rose and I can't even imagine. Thank you for bringing something good from such a devastating event.

Just a couple follow up questions:

I'm pretty sure my regular doctor did a complete liver panel last August when I told her I had had HELLP. That would work as a baseline, right?

Dumb question here...what is 24 hour urine? I get that it would test urine throughout the day instead of just getting one sample, but how is it done?

My insurance deductible is $2000, so I guess I'll be paying for every ultrasound out of pocket.


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## gossamer (Feb 28, 2002)

With a 24 hour urine you take a container home, save your urine for 24 hours and then return it to the lab. It is far more accurate than a urine dip at the Dr's office. If you were not pregnant in August, that blood work would work as a baseline.

THank you for sharing my Mary Rose with me.

taradt,
caongratulations on a pre-e free pregnancy and a beautiful new healthy baby. That is the best news I could ever get.
Gossamer


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## chilliepepper (Oct 14, 2005)

Here's a follow up question. I'm trying to decide if we should travel for the holidays in Nov. and Dec. as is our normal custom. If we do it, it would mean flying cross-country and being on the opposite coast at around 31-32 weeks. Given the 1 in 4 chance of developing pre-e again, do you think I should stick close to my medical team here?

Last time, it didn't show up till I went into labor (as far as we know, see above post), and I think that makes it less likely that it will develop early in this pregnancy...but I know it is possible.

What do you think?


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## 2 in August (Jan 6, 2006)

Hi all,

Sorry to be MIA for so long. Ian was born 8-4-06 at 7:39. The induction took about 12 hours. My bp stayed stable the whole time so I didn't end up having mag this time (yay!!!). There were a couple scary dips in his heart rate but he was fine. He ended up with jaundice after we came home and we had a portable bili-light here at home (we just barely made the cut-off for not getting admitted to the hospital). He's nursing really well. Thanks for all the support the last couple months mommas!!!


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## MicheleVet (Dec 3, 2005)

Thank you for this thread. I had very mild pre-e symptoms that could easily be "just pregnancy" (swelling, occasional lightening bug floaters, mild hypertension 135/95) and saw the doc. They sent me home for a 24 hr urine to return in 11 days at my next regular appt. The day I collected the urine I started feeling a little crappier and figured I had overdone it the day before trying to help paint the nursery...I was more swollen (but it was hot!) and tired and started having what I thought was gas pain in my upper abdomen (it waxed and waned like gas). I went to my regularly scheduled appt the next morning to turn in my urine and be checked out...instead, I was admitted and had an emergency C-section that night. My 24 hr urine protein level was crazy high (25g) and the pain was epigastric pain from the HELLP syndrome. My BP was 180/120 and I never had any headaches. I'm doing better now (sx was Tuesday the 22nd), and my baby boy is doing ok for a 31-weeker. It was scary to say the least.

I wanted to bump this thread, and encourage anyone who isn't sure about their symtpoms (or lack there-of sometimes) to talk with their health-care provider.

Michele


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## 2 in August (Jan 6, 2006)

Michele,
Glad to hear that you and baby are doing ok. It's scary how pre-e can sneak up on you like that. Keep us updated on your little guy. I hope he grows up big and strong so you can get him home soon.


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## catgirl1007 (Feb 9, 2005)

Hi ladies, I definitely need to join this thread! Another mama recommended it to me and I'm so glad. I'm afraid I have HELLP and that my OB's are brushing it off...

They told me that I had mild pre-e with my DD - erratic BP and swelling, never spilled urine or any other symptoms.

This time around my BP was 110/upper 60s until about 3-4 weeks ago (I'm 32 weeks PG right now). Since then it's been low 140s/mid 80s. If I lay on my left side for awhile, it goes down (that's happened twice). I'm now going weekly for NSTs. At my last 2 appts I was spilling protein into my urine - it was 1+, so they have me doing a 24 hour urine collection. I take it in tomorrow. I had blood drawn on Monday and will have another draw tomorrow. Oh, and my urine collection has been pitiful. I drank 60 ounces of water today and the collection bottle is only 1/4 full. I've urinated 6-8 times and haven't spilled any of it. What's up with that?? It's 8pm and I'll probably only go 3 more times.

So all the pre-e stuff is being monitored. I'm very concerned about this upper rt abdominal pain I've had. It started the last week of August and occurred everyday for about 1 week. I saw one of my OBs and she thought my abdominal wall was tearing from polyhydramnios (excessive fluid - which has now regulated itself). Well, I still occasionally have that pain... probably 2-3 times/week. It's a stinging/burning pain and sometimes it's so bad I have to clutch it and sit down. Today and yesterday I've also had really bad low back pain.

What do you all think? I'd appreciate any feedback/suggestions. TIA!

*Gossamer* ~ I'm crying over Mary Rose. I read your post and looked at her beautiful pictures. She's a precious little angel.


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## gossamer (Feb 28, 2002)

Thank you for your kind words about Mary Rose. As high as your blood pressures are, I think you need to shake your OB and request a transfer to a high risk OB or Perinatologist. My only symptom for aobut 3 months was high bp. BY the time anybody did anything about it, It was too late and they delivered Mary Rose the first time I visited my perinatologist.
Gossamer


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## catgirl1007 (Feb 9, 2005)

Thank you, *Gossamer*. I'm going back today to drop off my 24 hour urine collection, meet with a nurse practitioner and get another blood draw. The two nurse practitioners there seem to be much more conservative/cautious than at least the one doc I've been the last 3 times. I'm going to talk with her and see what she can do to help. I'm also going to mention HELLP to her. BBL with hopefully a good update.

Thanks again!


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## catgirl1007 (Feb 9, 2005)

Thankfully I had a really good appt today. I went in, dropped off my 24 hour collection, a nurse drew blood and said I could leave. I asked if I was meeting with a nurse prac and she said, "no", but I insisted.

So I met with a nurse prac, told her all of my concerns, and she assured me that everything is fine. From my bloodwork on Monday she said that my liver antigens (I think that's what it was) are great. They are normal and even on the low side of normal which is good. So no sign of HELLP from the bloodwork. She said the pain that I'm feeling in my abdomen is probably from DS pushing on my diaphragm. I only had a "trace" amount of protein in my small urine sample from today and my BP was 138/86 the first time and 127/78 the second time they took it.

I feel reassured. I feel a lot better after I hear the results from my 24 hour collection tomorrow. The OB that I saw on Monday had me totally freaked out. I don't want to see him anymore.


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## lenore80 (May 21, 2005)

Im a little late on this, but wanted to thank Gossamer (and everyone else) for starting this thread.

My doctor was very worried that I was about to come down with preeclampsia. I had all the symptoms of spilling protein, swelling, high liver levels, BUT I did not have the high blood pressure or headaches.

Honestly, I didnt think it was a big deal before reading this thread. I didn't have all the symptoms, and I was following the Brewer Diet. From what we understood from our birthing classes preeclampsia was rare, and it didn't happen to people who followed this diet.

We decided to induce labor August 2nd, based on the information I read from this thread and preeclampsia website. That was such a hard decision, since I was hoping for a natural childbirth. The baby's head got stuck (DH could see her head & hair) and I had an unplanned csection.

I later found out from my mother that most of my cousins have had preeclampsia. One of my aunts lost her child to this, and almost lost her own life. Is there research about this being hereditary?

Just wanted to share my story.


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## gossamer (Feb 28, 2002)

I am so glad you and your baby survived pre-eclampsia. I am sorry you did not have the birth you wanted, but thank goodness you got to bring your baby home.

SInce you have such a strong family history of pre-e, I would suggest asking your OB-Gyn for some genetic testing to see if you have any blood clotting disorders.
Gossamer


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## lenore80 (May 21, 2005)

Would they be able to test me for the bloodclotting disorders? Technically I could not be diagnosed with Preeclampsia because of low bloodpressure.


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## StrongSingleMama (Jul 18, 2005)

Wow I just found this thread. I had pre-e with my daughter and she was born at 28 weeks. I had a very severe case. I was diagnosed at 22 weeks with pre-e and spent the following 6 weeks on strict bed rest until having my daughter via emergency c-section. It was horrible. I felt so sick. Before having her I had horrible headaches that wouldn't go away, lots of pain in my rib area, very high bp, saw lots of spots, was dizzy all the time, my entire body was swollen and I gained a lot of weight very fast. I gained about 15 lbs in 3 days right before I had my daughter. After I had her my bp went up even more and I was put on 3 different bp meds plus Lasix...not to mention it was so hard to see my tiny little baby that was struggling and sick and couldn't even breathe on her own. It was such a scary experience. I am now 15 weeks preggo with my second and as I am approaching 20-22 weeks I am getting more and more nervous. I know pre-e is usually more common in first pregnancies but in my case it is hereditary. My mom had pre-e with me and I was born at 28 weeks. She also had it with my sister but made it to 38 weeks. I am REALLY hoping to have a less severe case this time if I do get it.


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## gossamer (Feb 28, 2002)

Quote:


Originally Posted by *lenore80* 
Would they be able to test me for the bloodclotting disorders? Technically I could not be diagnosed with Preeclampsia because of low bloodpressure.

I think because of the strong family history and your experience with your first pregnancy, they would be willing to do the tests. There are a lot of mommas on the board who have been diagnosed with a blood clotting disorder after losing a child and then go on to have a full term pregnancy with proper treatment.
Gossamer


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## chilliepepper (Oct 14, 2005)

My perinatologist has recommended that I be tested for the blood disorders that could be a factor in my risk for a repeat performance of pre-e/HELLP syndrome; specifically the congenital and acquired thrombophilias. I plan to go to the lab tomorrow morning. I'm just wondering if I need to fast for these tests. I called his office last week and the assistant/front desk person who answered the phone said no, I do not need to fast, but I just wanted to double check. The flip side of the question is if I DO fast (to be on the safe side) but didn't really need to, would that mess up the test results in any way?


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## shannon0218 (Oct 10, 2003)

Fasting shouldn't make a difference.


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## sarah9774 (Feb 19, 2005)

HELP ME!!!

My abdomen around my belly has been feeling tender and almost numb like.. and my belly feels like it is really bloated.. I don't know if this is something to worry about or not.. I am 32 weeks and 1 day preg and am not sure if this is normal.. I do not remember having this last time.. I called the nurse and she said if it got any worse to go to L & D to get checked out.. does this sound familiar to anyone.. placental abruption starting???? HELP!


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## gossamer (Feb 28, 2002)

Sarah,
That does not sound familiar to me. I will keep you in my prayers. If you have any doubt, go to L & D.
Gossamer


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## sarah9774 (Feb 19, 2005)

Thanks- I did go to L& D and they don't have an explination. Baby looks good though..


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## sarah9774 (Feb 19, 2005)

gossamer- I found out why my belly is so tender.. I have too much fluid.. To much amniotic fluid.. do you know anyone else who has experienced this?? Dr. is sending me to get glucose test again to rule out GD..


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## chilliepepper (Oct 14, 2005)

Ok, just for review: I delivered a healthy (but small---5lbs 5oz.),
full-term baby 16 months ago, despite being diagnosed DURING LABOR
with severe preeclampsia and HELLP Syndrome. I had no symptoms prior to that, and have had no lingering effects that I'm aware of.

Nobody suggested testing for thrombophilias until I was several weeks
(I think 9 or so) into this (my second) pregnancy, and then due to poor
communication between me and my perinatologist, the tests did not
happen until a couple of weeks ago (when I was 20 weeks) and I just got the results today---I am now at 22 weeks. I am compound heterozygous for MTHFR, and I guess I'll be starting Lovenox on Monday. I am TICKED that we didn't catch this sooner and the more I read, the more amazed I am that DS#1 came through with no problems and that I haven't lost this baby already.

I'm freaking out a little bit here, because from the reading I've done
today I'm gathering that the standard dose of folic acid in my
prenatal vitamin has probably done me no good whatsoever, and that I
should have been on a LOT bigger dose starting months ago (ideally
before I even conceived), and I should have started Lovenox months ago.

So I guess what I'm wondering is, is the damage already done (I think I read that the course for these things is really set during the first trimester or even before conception, at which time I was blissfully ignorant), and is there anything else I can/should do besides go see the doc on Monday and learn how to give myself shots?

Also, this week I had what I assumed was a stomach bug, but was just reminded that vomiting can be a symptom. That was four nights ago. I also had some diahhrea and stomach cramps, leading to dehydration which lead to a LOT of BH contractions and the baby jumping around like crazy for two days (low amniotic fluid due to dehydration I suppose?) Do you think that if it was pre-e or HELLP, I'd be seeing some more serious effects by now?

Oh---also, we just booked tickets to fly cross country on Nov. 2-7.
Now that I know I have this, I'm wondering if that was a bad idea.
Thoughts?


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## sarah9774 (Feb 19, 2005)

I know another girl who did not find out that she had clotting d/o until 18 weeks pregnant. She started Lovenox shots then and everything turned out ok.

I would not recommend any flying though.. just my personal feelings.. I will not stay in the car more than 30 minutes at a time...

I take 3 mg extra folic acid (plus the one in my PNV) and heparin shots 2 x's a day (lovenox is good due to 1 x a day, but I could not afford it) I also take 81 mg baby asp. 1 X a day.. it just depends on the Dr. you have.. try and stay hydrated... hang in there. you will be in my thoughts..


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## chilliepepper (Oct 14, 2005)

Is the flying issue related to the altitude, or to the sitting in one place for so long?

Also if a person is on their blood thinners, shouldn't it be ok?

One more question (sorry)---I just went out and bought some baby aspirin, but on the box it says "it is especially important not to use aspirin during the last 3 months of pregnancy unless definitely directed to do so by a doctor because it may cause problems for the unborn child or complications during delivery." I know we're not in the last 3 months yet, and of course I'll talk to my doctor about it before I'm in the last 3 months---but I'm wondering if it's even safe now, because it also says to ask a doctor before use if you're taking a blood thinner. So maybe I should just wait till I see the doc on Monday before I start the baby aspirin, eh?


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## sarah9774 (Feb 19, 2005)

I would talk to your Dr. first, if he hasn't alreadly told you to take it (Baby aspirin). Some Dr.s recommend it others do not. I know people who have taken it with the thinners and others that have not. It may depend on the clotting d/o you have.. I would ask 1st though. I know that I will be taking the BA up until just before I deliver.. I will be 34 weeks on Tues. I may be delivering at 37 weeks due to excess amniotic fluid, but don't know.. I am having a c-section so I can go off the heparin like the day before, I need to clarify with my dr.

As far as the flying, I think it has to do with the sitting, but could also have to do with the altitude.. I don't think it matters if you are on thinners or not, there is still a risk of clotting. Hope that was helpful.. I am not an expert.. this is just what I have been doing as directed by my dr. Oh yes, and he should be checking your platelets monthly to be sure they are at an acceptable level.


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## flyingspaghettimama (Dec 18, 2001)

Hi! I do not have a blood clotting disorder (that I know of - never tested) but did have Pre-E.

In my last pregnancy, I flew to Europe (16 hr flight total). I did take aspirin (baby aspirin only, at bedtime); I also wore support hose, which you can pick up at most pharmacies. They are GREAT for flying and helping with possible blood clotting issues. I also got up and walked around a lot (1x hour) and drank tons of water.

I took baby aspirin throughout pregnancy, right before bed; and lots of folic acid (I think 1000 mg/day? It was a lot).


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## 2 in August (Jan 6, 2006)

bumping to keep on the first page...

...update, my ds is now 5mo, very healthy. Still kind of small (13lbs) due to nursing/supply issues. But gaining good now. Meeting all his milestones on track.

Dh and I decided no more kids for us. Not worth chancing pre-e for a 3rd time. So we are done. Thanks again to the helpful mamas here. I'll try to remember to check in more to help other mamas going through this.


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## ani'smommy (Nov 29, 2005)

I just read most of this thread and I wish I had read it two years ago when I was pregnant with Ani. I would have noticed I had most of the warning signs of pre-e. I had a pain in my upper right abdomen that I thought was the baby's feet poking me in the ribs. It never occured to me that it might be my liver. I was induced at 40 weeks and had a small, 5lbs 14oz healthy baby.

I'm now pregnant with #2 and hoping and praying for a homebirth this time. Is there anything I can do to avoid pre-e this time? I plan to start doing some kind of exercise soon, but would that make my bp go up? Should I be monitering my pb? urine?

I'm really hoping that there is somethind I can do to be proactive about this.

Gossomer, I am so deeply sorry for your loss. I can't fathom the pain.







Thank you for this thread.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *ani'smommy* 
I just read most of this thread and I wish I had read it two years ago when I was pregnant with Ani. I would have noticed I had most of the warning signs of pre-e. I had a pain in my upper right abdomen that I thought was the baby's feet poking me in the ribs. It never occured to me that it might be my liver. I was induced at 40 weeks and had a small, 5lbs 14oz healthy baby.

I'm now pregnant with #2 and hoping and praying for a homebirth this time. Is there anything I can do to avoid pre-e this time? I plan to start doing some kind of exercise soon, but would that make my bp go up? Should I be monitering my pb? urine?

I'm really hoping that there is somethind I can do to be proactive about this.

Gossomer, I am so deeply sorry for your loss. I can't fathom the pain.







Thank you for this thread.

This may not be a route you want to try, but I did a prophylaxis of atenolol and lasix from 12 weeks on to treat increased cardiac output. I had normal BPs and never developed PE, after having had severe PE/HELLP at 36 weeks last time. But at least 85% of women who had PE won't repeat anyway, so was it the meds? I'll never know.


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## yogamommy (Feb 18, 2007)

I've been reading this thread since last Thursday (have made it thru pg.7) when my bp went from a normal 100/70 to 130/90 and I had 2+ protein in my urine. Today I went for a follow up with my mw, my bp is still high and my protein is now 3+. My mw is turning my care over to an ob she works closely with because of the concern of pre-e, and she has ruled out my possibility of a homebirth...

A few questions for those of you with experience. The two above symptoms plus no change in my hemoglobin are my only major symptoms. I have swelling, but it has not moved to my face or hands. Today, my swelling has been primarily in my left leg only, is this normal? Is there anything else that could cause these symptoms? I am 35.5 weeks and others in my due date club have mentioned that true pre-e usually shows signs earlier?

Also, from what I have read so far, it seems many mommas were induced at 37 wks. Why is this? Is it because their bp spiked too high? If my bp maintains at its new higher level, will my ob still want to induce and/or schedule a c-section? I am afraid of being induced with pitocin if my body is not ready, then laboring for too long and ending up with a c-section. I don't see why if the ob feels I need to be induced, why should I not decline and just go immediately to c-section if there is any danger for me or the baby? Why go thru a struggling labor and open the door for more drugs if my body is not ready?

Any advice you all can offer would be appreciated!


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *yogamommy* 
I've been reading this thread since last Thursday (have made it thru pg.7) when my bp went from a normal 100/70 to 130/90 and I had 2+ protein in my urine. Today I went for a follow up with my mw, my bp is still high and my protein is now 3+. My mw is turning my care over to an ob she works closely with because of the concern of pre-e, and she has ruled out my possibility of a homebirth...

A few questions for those of you with experience. The two above symptoms plus no change in my hemoglobin are my only major symptoms. I have swelling, but it has not moved to my face or hands. Today, my swelling has been primarily in my left leg only, is this normal? Is there anything else that could cause these symptoms? I am 35.5 weeks and others in my due date club have mentioned that true pre-e usually shows signs earlier?

Also, from what I have read so far, it seems many mommas were induced at 37 wks. Why is this? Is it because their bp spiked too high? If my bp maintains at its new higher level, will my ob still want to induce and/or schedule a c-section? I am afraid of being induced with pitocin if my body is not ready, then laboring for too long and ending up with a c-section. I don't see why if the ob feels I need to be induced, why should I not decline and just go immediately to c-section if there is any danger for me or the baby? Why go thru a struggling labor and open the door for more drugs if my body is not ready?

Any advice you all can offer would be appreciated!

I had PIH that became "true PE" and then HELLP at 36 weeks, within about 6 hours.

C-sections have risk. If you can hold out a few days to have cervical ripening, the chances of a pit induction are improved. Sections without labor are more likely to result in breathing difficulties, esp. in pretermers.


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *yogamommy* 
I've been reading this thread since last Thursday (have made it thru pg.7) when my bp went from a normal 100/70 to 130/90 and I had 2+ protein in my urine. Today I went for a follow up with my mw, my bp is still high and my protein is now 3+. My mw is turning my care over to an ob she works closely with because of the concern of pre-e, and she has ruled out my possibility of a homebirth...

A few questions for those of you with experience. The two above symptoms plus no change in my hemoglobin are my only major symptoms. I have swelling, but it has not moved to my face or hands. Today, my swelling has been primarily in my left leg only, is this normal? Is there anything else that could cause these symptoms? I am 35.5 weeks and others in my due date club have mentioned that true pre-e usually shows signs earlier?

Also, from what I have read so far, it seems many mommas were induced at 37 wks. Why is this? Is it because their bp spiked too high? If my bp maintains at its new higher level, will my ob still want to induce and/or schedule a c-section? I am afraid of being induced with pitocin if my body is not ready, then laboring for too long and ending up with a c-section. I don't see why if the ob feels I need to be induced, why should I not decline and just go immediately to c-section if there is any danger for me or the baby? Why go thru a struggling labor and open the door for more drugs if my body is not ready?

Any advice you all can offer would be appreciated!

1) Preeclampsia can show up at any time, but the earlier on (before third trimester), the worse it will usually be, supposedly. There are women who develop PreE while delivering, with no previous signs, and have seizures. It can happen at any time, although it's usually a gradual process.

2) Most women are induced after 34 weeks if possible (at 35 weeks the fetus' lungs mature), as close to 38 weeks ("full term") as possible, whether that's accomplished through bedrest, whatever. They usually take into account a combination of factors, not just BP - including your urine protein, and the function of your internal organs. It's a delicate balance - they don't want to induce too early, and end up with a premature baby; but they don't want to wait too long and end up with a seizing mama either.

You can labor with a very high BP - I think that indeed, preeclampsia can cause issues with blood clotting and they prefer NOT to do c-section (that's what they told me, at least). You just labor on your side, and with a whole buncha mag sulfate. If you are in that situation, I suggest GOING FOR THE EPIDURAL. I can't stress that enough. And I had my second at home, naturally.

If you are looking for a reason to go C-Section, then I'm sure it's possible. The possible downsides are recovering from a c-section and the issues that go with that; whereas if you deliver vaginally, you're mostly over the worst of it once you deliver. Unless you get post-partum PreE, but we just won't worry about that right now.

I would get that left leg checked, pronto. Assuming everything is OK, for temporary relief, I assume you're on bedrest; and taking epsom salt baths and extra magnesium supplements certainly won't hurt anything.


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## myjulybabes (Jun 24, 2003)

I can't believe I read the whole thread!

First of all, Gossamer, I so appreciate you sharing your story and helping other women. Mary Rose was so beautiful, and I can see that her story has helped others here.

So, quickie history for me: First pregnancy at 19, all seemed normal until about 31ish weeks. I just wasn't feeling right, but I let the doctor blow me off, because I was clueless (rule #1, trust your body and your instincts!). Went for the 32 wk appointment, did the whole nurse routine, weight, bp, urine dip, then met a new doctor in the practice who introduced himself with "Hi, I'm Dr. D____, you're going to the hospital today." BP 154/100, had gained 30lbs in less than 3 mos, high protein, didn't ask, can't remember from the records. We were able to keep Nick in for 4 more days until I developed HELLP and he was delivered emergency c-section under general. Same brilliant doctor, who hadn't kept me updated at all on the seriousness of my condition, discharged me a week later with the sage advice "Now don't go feeling all sorry for yourself because you almost died..."







Thankfully, the steroids had time to take and he just had to get bigger and keep his temp up, came home after only 17 days in the NICU.

Second pregnancy: very healthy and normal, modified bedrest around 38 weeks due to slightly elevated BP and protein. VBAC at 40wks, the pre-e kicked in during labor but resolved quickly with the nasty nasty mag.

Third pregnancy: Doctor was on the ball after 2 cases of pre-e. Caught it this time at 29 weeks, went on home bedrest with monitoring from a home health care company, induction scheduled for 37 weeks. BP went haywire (ultimately topped out at 170/110) at 36 weeks and wouldn't come down, so we went ahead with the induction, ended up with a c-section when he decided to flip from the vertex position we KNOW he was in when the induction started to completely transverse 12 hours later. It was too late for steroids and sadly, he was suffering from a case of "wimpy white boy syndrome"...ie respiratory distress even though he was very close to term. 2 weeks in the NICU with that one.

Fourth pregnancy: A rather happy oops that I just found out about!









Which, if you had the patience to read all of that, brings me to why I'm here. I'm on a little bit of info overload after reading 25 pages of this thread in one night, so I want someone to double check my plans here.

So. I want to get a baseline 24 hour urine and liver panel. Ask about potentially testing for clotting disorders. Dig out my home BP monitor and make sure the cuff is big enough. And in the "couldn't hurt, might help" category, think about eating more protein and supplementing with extra folic acid, Vit C, and...? I know I'm forgetting something here. And exercise. Perfect timing, the weather's getting good to walk!

I've obviously got time to decide, but any thoughts on VBA2C vs scheduled c-section as far as how it relates to the pre-e? I am really undecided on this one. In a perfect world, I'd want the VBA2C, but alas, this is not a perfect world.

Much love and peace and health to those expecting! If I can be of any help, or anyone wants to know more about my experiences, please don't hesitate to ask.


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## Synchro246 (Aug 8, 2005)

I don't know if this has been brought up before in this incredibly long thread, but because it's Cochrane I consider it to be of decent quality:

Calcium supplementation
http://www.mrw.interscience.wiley.co...059/frame.html

Quote:

Authors' conclusions
Calcium supplementation appears to almost halve the risk of pre-eclampsia, and to reduce the rare occurrence of the composite outcome 'death or serious morbidity'. There were no other clear benefits, or harms.

--------------------------------------------------------------------------------

Plain language summary
Calcium supplements help prevent pre-eclampsia, lowers the risk of the woman dying or having serious problems

Pre-eclampsia is a major cause of death in pregnant women and newborn babies worldwide. Preterm birth (birth before 37 weeks) is often caused by high blood pressure and is the leading cause of newborn deaths, particularly in low-income countries. The review of trials found that calcium supplementation during pregnancy is a safe and relatively cheap means of reducing the risk of pre-eclampsia in women at increased risk, and women from communities with low dietary calcium. Women were also less likely to die or have serious problems due to pre-eclampsia. No adverse effects have been found but further research is needed into the ideal dosage for supplementation.

and another

Antioxidant supplementation
http://www.mrw.interscience.wiley.co...227/frame.html

Quote:

Authors' conclusions
*These results should be interpreted with caution*, as most of the data come from poor quality studies. Nevertheless, antioxidant supplementation seems to reduce the risk of pre-eclampsia. There also appears to be a reduction in the risk of having a small-for-gestational-age baby associated with antioxidants, although there is an increase in the risk of preterm birth. Several large trials are ongoing, and the results of these are needed before antioxidants can be recommended for clinical practice.

--------------------------------------------------------------------------------

Plain language summary
Antioxidants in pregnancy, like vitamin C and vitamin E, for preventing pre-eclampsia

Pre-eclampsia can occur during pregnancy when women have high blood pressure and protein in their urine. In some cases, it can lead to serious complications for women and babies, including mortality. A possible contributing factor to the development of pre-eclampsia may be the presence of excessive amounts of chemicals called 'free radicals'. Antioxidants, such as vitamin C, vitamin E, selenium and lycopene, can neutralize free radicals and may help prevent pre-eclampsia. The review of trials found studies of not the best quality, which indicated antioxidants might reduce the risk of pre-eclampsia. However, although antioxidants appeared to reduce the risk of having a small baby, there was an increase in the risk of the baby being born too soon. Further studies are needed to confirm whether or not antioxidants do more good than harm. Several trials are currently in progress on this topic.


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## gossamer (Feb 28, 2002)

Quote:


Originally Posted by *myjulybabes* 
I'm on a little bit of info overload after reading 25 pages of this thread in one night, so I want someone to double check my plans here.

So. I want to get a baseline 24 hour urine and liver panel. Ask about potentially testing for clotting disorders. Dig out my home BP monitor and make sure the cuff is big enough. And in the "couldn't hurt, might help" category, think about eating more protein and supplementing with extra folic acid, Vit C, and...? I know I'm forgetting something here. And exercise. Perfect timing, the weather's getting good to walk!

I've obviously got time to decide, but any thoughts on VBA2C vs scheduled c-section as far as how it relates to the pre-e? I am really undecided on this one. In a perfect world, I'd want the VBA2C, but alas, this is not a perfect world.

Much love and peace and health to those expecting! If I can be of any help, or anyone wants to know more about my experiences, please don't hesitate to ask.

Wow, you have sure been down the pre-e road haven't you? I would absolutely recommend getting the genetic testing done. There are some results that aren't quite accurate when you are pregnant, but you should get good results on most of them. I would also agree about the baseline 24 hour urine, liver panel and blood pressure. Monitor you bp at home at least three times a day. I also faxed my results to my cardiologist and ob every week so they could see what my bp's were doing. I would ask my Dr. about extra folic acid, there has been some research that extra Folic Acid, if it is not needed could be harmful. Ask your Dr. about taking a baby aspirin a day. I would take as much Vitamin C (sodium ascorbate) as you can handle and maybe even some extra Vitamin E. Have epsom salts on hand for taking baths. Eat healthy, cut out sugar and simple carbohydrates. Don't load up on protein, because you don't want to over work your kidneys, just eat sensibly and healthy. ANd of course keep us updated on how your pregnancy goes. We have had several success stories in this thread of little babies that have been brought home healthy and happy, we hope to include yours.
Gossamer


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## taradt (Jun 10, 2003)

For the extra folic acid you can ask to have your homocysteine levels checked. If they are then high folic acid and b vitamins are what is used to lower it.
There were some studies done that showed corelation between pre-e and high homocysteine, but like all pre-e things there is no concrete data on what helps and each pregnancy is different.
That said I am sure that was what made the difference for me last time


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## myjulybabes (Jun 24, 2003)

Thank you for the advice! I'm sure to drive my doctor nuts now.









It's just so frustrating that so little is known when so many women get this. I really want to be able to bring my baby right home with me, but not knowing what I can do to better my chances of that really stinks. I'm hoping that I might get "lucky" this time because this is my second baby with my husband and first baby or first with a new partner seems to be somewhat of a risk factor. Also, things were easier with my girl, and the timing of O vs BD this time seems to favor a girl. Then again, I knew a woman who had 3 girls, with worsening pre-e each time. Seems like a crapshoot.

I'll probably be checking in with this thread regularly, if noone minds. It's just nice to talk to other people who can understand my worries.

Gossamer, if it's not too personal, may I ask if you saw a cardiologist specifically because of the pre-e, or was it due to unrelated/pre-exisiting problems? I would love, love, LOVE to have a beautiful home waterbirth with just a midwife and my husband and all that...but if it means a healthy baby, I'll see as many doctors as I need!


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## gossamer (Feb 28, 2002)

I saw a cardiologist, perinatologist, and OB Gyn during my pregnancy. Yes, I saw the cardiologist specifically because of the pre-e.
Gossamer


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## myjulybabes (Jun 24, 2003)

Where do I look for a bigger cuff for my bp monitor? Is that something they might have at Walgreens, or will I need to go to the manufacturer's website or something? Also, does it matter that the one I own is over 5 years old? It's just been sitting in a cabinet, shouldn't have gotten damaged in any way. I'll buy a new one if I have to, but budget is a bit of an issue, so it'd be better if I could keep using the old one.

Nothing to update, still only 6 wks, first appointment is 2 wks away yet. I'm getting extra Vit C and taking the kids on walks. Have some Epsom Salts, probably gonna start taking baths with them soon.

Thanks again to all those who contributed to this thread, I enjoy reading back and seeing the recommendations and stories!


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## gossamer (Feb 28, 2002)

They might have it at Walgreens, if not, ask them where they think you could find one. I took my bp machine in to my Dr.'s office, had them check my bp and then had the machine check it to see if it was the same or if the Dr. thought I needed a new one. Both times, my machine was fine. HTH.
Gossamer


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## flyingspaghettimama (Dec 18, 2001)

myjulybabes, do you have a high-risk specialist you can see for a consult at this point?

There is a ton of research on different prophylaxis - baby aspirin, folic acid, etc that a high risk specialist might know about whereas a regular doctor might not. If you worry that you will "annoy" your doctor, I might look for another doctor. With three previous bouts with preeclampsia, I'd hope your doctor would seriously be _suggesting_ many of the tests that women here have done. Sometimes it's a mystery, but with such a high recurrence for you personally, it might be a blood issue as it has been with some have tested positive for.

In the meantime, I think folic acid and a very good nutritional supplement with extra vitamin C is sooo important. I personally would also watch weight gain extremely closely during pregnancy and self-monitor for sudden jumps in weight due to fluid retention. I did eat a primarily-protein diet, but I'm a vegetarian and it was hard for me to get enough protein. I am also a heavy exerciser.


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## gossamer (Feb 28, 2002)

If you are taking the folic acid, taking a vitamin B supplement will help your body process the folic acid, but check with your Dr. first because there is now some research that unnecessary folic acid in your diet can be harmful.
Gossamer


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## myjulybabes (Jun 24, 2003)

Thanks. Got the new cuff at Walgreens, woohoo! I am gonna take the machine with me to my first appointment for sure, as it seems to be reading bizarrely high right now. Like, higher than I get at the doctor, and I have a serious case of "white coat hypertension".

I'm taking Rainbow Light prenatals, fish oil, a calcium supplement since I tend to be lacking in that, and Vit C. I just got some B-6 to help with nausea too. And I'm making sure I get at least a short walk every day, no matter how tired I am. I wasn't a heavy exerciser before, so I don't want to dive in now, but I'm making sure I stay active.

My doctor does high risk. She's not a peri, but takes all the cases that are borderline between needing a peri and regular OB. If she gets seriously annoyed with my requests for extra testing and questions about supplements, I may start looking for someone new, I was pretty much just joking about that bit.

ETA: Just tested my monitor on dh, and it's reading high on him as well, though not quite as high as mine. I'm starting to suspect something's off with the monitor.


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## alliteration (Dec 10, 2006)

Medical supply stores can adjust or fix your existing blood pressure cuff. I don't think Walgreens will, if you live in a city there should be several listed in the phone book.
Pre-eclampsia sucks!


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## myjulybabes (Jun 24, 2003)

First appointment today. BP was already reading high, but I wasn't as assertive as I should have been about sitting in the chair, not on the table. I was in the chair when she took it, but had been sitting on the table before that. Next time she can bite me, I'm sitting in the chair the whole time. I was just too nauseated to fight today. I did insist on the large cuff though.

Gave a ton of blood for testing. 10 vials by the time I was done I think. On the bright side, Doc was ahead of me on the clotting factor thing, put me down for the tests right away, and suggested I start baby aspirin now, and will let me know about extra folic acid when the test results come in. She didn't seem to think the baseline liver panel was necessary, but went ahead and did it anyway since I asked for it. Holding off on the 24 hour urine until next month.

Not a bad visit, all in all. Thanks for your suggestions everyone, made it a lot easier!


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## dynamicdoula (Jun 11, 2004)

Quote:


Originally Posted by *maxmama* 
This may not be a route you want to try, but I did a prophylaxis of atenolol and lasix from 12 weeks on to treat increased cardiac output. I had normal BPs and never developed PE, after having had severe PE/HELLP at 36 weeks last time. But at least 85% of women who had PE won't repeat anyway, so was it the meds? I'll never know.

I'll be goign to the hypertension clinic at the University of Washington sometime in the next few weeks and I'm sure that I'll have to at least consider the possibility of taking the Atenolol (how the heck do you pronounce that?







). From what my OB says, they'd want to induce me between 37-39 weeks because it decreases blood flow through the placenta, thus causing IUGR and placental calcification. He says NSTs aren't enough to know for sure that baby is doing okay (to avoid the induction). I have high concerns about this and wonder if you know anything about it?


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## flyingspaghettimama (Dec 18, 2001)

myjulybabes - the baby aspirin regimen has only been shown to make a difference if you take it BEFORE BED, at night. I can find the study for you if you want, but basically it made no difference whatsoever if taken at any other time of day other than right before bed.

dynamicdoula - is there any way you can also consult with the midwives at UW? The high-risk docs there are pretty intervention happy, in my experience. If you need the name of a second opinion, I met with a high-risk perinatologist specializing in preeclampsia on the Eastside who was GREAT, very supportive of midwifery, and has a more nutritionally-focused approach to preeclampsia, but is definitely within the traditional OB realm. He's just European, so I guess more open-minded. I loved him. And I distrust most doctors.


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## dynamicdoula (Jun 11, 2004)

Quote:


Originally Posted by *flyingspaghettimama* 
is there any way you can also consult with the midwives at UW? The high-risk docs there are pretty intervention happy, in my experience. If you need the name of a second opinion, I met with a high-risk perinatologist specializing in preeclampsia on the Eastside who was GREAT, very supportive of midwifery, and has a more nutritionally-focused approach to preeclampsia, but is definitely within the traditional OB realm. He's just European, so I guess more open-minded. I loved him. And I distrust most doctors.

Well I don't know. I'm meeting with dr. easterling and that's all I know at this point. I am working with a midwife here in Kitsap, too. I guess I'll start planning my birth once I get the cardiac output testing and see where that puts me.


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## flyingspaghettimama (Dec 18, 2001)

Yes, of course, that sounds good. But I meant, if you wanted also to meet with someone who might be able to help with prevention of preeclampsia, this guy is a good second opinion. I only met with him once but he was very helpful.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *dynamicdoula* 
Well I don't know. I'm meeting with dr. easterling and that's all I know at this point. I am working with a midwife here in Kitsap, too. I guess I'll start planning my birth once I get the cardiac output testing and see where that puts me.

EAsterling is an interesting man. If you don't like him, ask to schedule a follow up with Darcy Carr, another perinate at UWMC. I like her very much, and she was very supportive of my desire to VBAC.

The CO thing is supported by Easterling and Carr's research, but there isn't another UltraCom being used anywhere else, so the data haven't been reproduced. I happen to believe in it, but it needs to be reproduced.

By the way, I had a fabulous, utterly normotensive full-term pregnancy this time on their lasix/atenolol protocol.


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## myjulybabes (Jun 24, 2003)

Quote:


Originally Posted by *flyingspaghettimama* 
myjulybabes - the baby aspirin regimen has only been shown to make a difference if you take it BEFORE BED, at night. I can find the study for you if you want, but basically it made no difference whatsoever if taken at any other time of day other than right before bed.


Oh how interesting! Fortunately, that's when I tend to take pills anyway, and what I have been doing. Was there some time frame specified? Usually I take them and am in bed within 30 min, but sometimes I end up staying up later than I planned, so maybe I need to just put off the baby aspirin until right before I go up the stairs.

Had my first u/s today. Just one babe, measuring right on time (9w4d) and a heartrate of 184. So far so good!

Still fighting with my bp monitor to get an accurate reading. I think I'm going to make an appointment with a nurse at the OBs office and compare my machine to their reading, and see if I'm maybe putting the cuff on wrong or something. Also still waiting on all the blood test results. They said the "thrombo panel" takes quite awhile though, so maybe that's what's holding things up.


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## flyingspaghettimama (Dec 18, 2001)

http://www.medscape.com/viewarticle/442092 has a summary of the research:

Quote:

Sharpening that focus, a separate study by his group showed that low-dose aspirin prevented preterm labor in pregnant women at risk for high BP, but only if they started therapy before the 16th week of pregnancy, and only if they took it at night.

"This is the first study to show that aspirin at bedtime works and aspirin at awakening does not," Hermida says. Earlier studies may have had conflicting results because they used lower aspirin doses, started therapy later in pregnancy or gave it at different times of the day.

In this double-blind, controlled trial, 341 pregnant women at high risk for BP problems due to obesity, family or personal history of gestational high BP or preeclampsia, or a history of miscarriage were randomized to treatment with 100 mg of aspirin or placebo at one of three times: on awakening, eight hours later or at bedtime, starting at 12 to 16 weeks of gestation.

Compared with placebo, there was no effect of morning aspirin on BP. However, BP reduction was highly statistically significant when aspirin was given eight hours later and to a greater extent at bedtime (mean reductions of 12.6/8.5 mm Hg in 24-hour mean for systolic/diastolic BP at delivery). Compared with placebo, aspirin given at bedtime reduced the incidence of preeclampsia (1.7% vs. 14.3%), gestational hypertension (6.8% vs. 30.4%), intrauterine growth retardation (3.4% vs. 16.1%), and prrreterm delivery (0% vs. 17.9%; P < .001 for all).


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## AuroraB (Jan 10, 2007)

I am so glad I found this forum. I am confused about getting conflicting information and hope that you ladies can help me. I have a clotting disorder and since have been labeled for high risk for pre-eclampsia. I am only 5 weeks preg. and have been told to eat 9 fruits and veggies a day, avoid sugar, and avoid foods high on the glycemic index. I was told to have 2 servings of dairy. This is all by my doctor - but then I went online and found that I should have an enormous amount of protein. What is up with that?

Thanks for telling me to take the aspirin at night - I have been taking it in the middle of the day.

I am on heparin, aspirin, prenatals, and extra Vit. C, Calcium, vit. E, and fish oil. I am also on thyroid meds and now on progesterone because my temps. are too low. Any suggestions for a very early scared preg. woman? I have had 2 mc this year and this is lucky number 3. Thanks for any help you can give me.


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## flyingspaghettimama (Dec 18, 2001)

I think there are other mamas with expert advice on clotting disorders, but I thought folic acid was also part of the mix of recommended supplements?

The protein thing is just really controversial. The person who proposed the protein fix (Brewster) is controversial, and his program is totally sworn by some mamas, and others say it's just a false promise. I'm not sure there's any evidence for it beyond anecdotal, which is enough for some. You'll have to come to your own conclusions on that.

Are you vegetarian? I did go for at least 75 grams of protein per day, which was difficult for me being a mostly-vegetarian (I eat salmon once a week).


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## javamama (Dec 5, 2001)

flyingspaghettimama said:


> myjulybabes - the baby aspirin regimen has only been shown to make a difference if you take it BEFORE BED, at night. I can find the study for you if you want, but basically it made no difference whatsoever if taken at any other time of day other than right before bed.
> QUOTE]
> 
> Wow, I didn't know about the before bed instructions! I am 30 weeks and have been dutifully taking my baby aspirin every MORNING! I wonder if I should even bother switching??
> ...


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## myjulybabes (Jun 24, 2003)

Got my bloodwork results back finally. All the standard prenatal testing was fine, not anemic, no STDs, blah blah blah. But the tests for the MTFR (is that right, I was scribbling so fast I can't read my handwriting!) mutation and the antiphospholipid...thing....were positive. My OB is calling in a scrip for prescription strength folic acid, and I've got an appointment with the maternal fetal docs in a couple weeks. I may have to transfer to their care entirely. My OB does some high risk, but apparently, I may be too high risk for her even.







She thinks I can avoid heparin and/or lovenox since I've never had problems with blood clots previously, but ultimately, it'll be up to the maternal fetal guys.

Looks like I have a lot of research ahead of me tonight.


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## dynamicdoula (Jun 11, 2004)

This is posted from an email so forgive me for any references to people you don't know.









Quote:


I went to a pre-conception visit with my OB/GYN and talked with him about my history and whether he felt that I was at risk for developing pre-e again. He said he felt that my chances were very high and that with my history, I would be sent to the new maternal hypertension clinic at the UW with Dr. Easterling. He was very excited about this program saying that his clinic had seen a dramatic reduction in the number of women with pre-eclampsia, and those who did get it, it wasn't as severe as it might have been in previous pregnancies.

After I got pregnant we discussed the clinic again. He said that I would go between 15-16 weeks to get baseline information and to talk about taking Atenolol, a blood pressure medication (beta blocker). He said that if I were to go on it that the chances were good that I could stave off getting pre-eclampsia all together, and that instead of a pre-e induction I would have an induction between 37-39 weeks, because this drug runs a risk of IUGR and placental aging. Basically, he explained, it reduces the blood flow through your body, and consequently through the placenta, leading to a small(er) baby. I said, "It would be hard to get me in here for an induction just because I had reached some arbitrary date by which somehow everything was supposed to go to pot&#8230; what about if I'm taking NSTs 2 or 3 times a week (or more?)" He said that NSTs weren't a good indicator for health and that it wasn't worth the risk that something was going on that we didn't know about, that the NST didn't catch.

I was pretty nervous about all of this and after reading up on the drug found that it is a Class D and not recommended for pregnant women, and the reason I found was because of fetal size. I was pretty nervous after reading this. I went to the preeclamsia.org site and asked a few questions and the women there were incredibly enthusiastic (like&#8230; jumping up and down, practically) over Dr. E and this protocol and how it 'saved their pregnancies' and sent me private emails off the board about how lucky I was to have this option so close, etc etc. Not a SINGLE negative story. Not one. That kind of scared me, to be honest- I want both sides of things and I got nothing but glowing support and enthusiasm from the women there. I wasn't really convinced but they sent me links to a study that Dr. E did on this protocol. (http://www.greenjournal.org/cgi/content/full/93/5/725 and http://www.greenjournal.org/cgi/reprint/98/3/427). I was struck by the small samples and while it was good to see something published on this, I just was withholding judgment until I had a chance to meet with them and ask my questions and judge for myself.

I had my first appointment with them yesterday, here's how it went (in case anyone has a client expecting to go to the clinic, women come from several states away to see this doc):

When I arrived and checked in, I was met by two nurses. One had me lie on a table and turned on a machine which measured blood flow, I believe. She held a wand to my sternum area for a few minutes and monitored the results while the other nurse asked me questions.

After that, another wand was held to the base of my neck, measuring flow through my carotid artery. This lasted 3 or 4 minutes or so as we continued talking. The nurse gathered the results right there in the room and placed my data on a chart. The chart showed the 'high and low' range of cardiac output between I think it was 4 and 7. My cardiac output was high at around 9, which meant that I was at increased risk for pre-eclampsia, based on their findings of how cardiac output relates to hypertensive disorders. She talked about my vasodilation and how that also was outside of a normal range and explaned how the Atenolol would put me into a closer to normal range for both cardiac output and vasodilation. I asked her if it was true that they want their patients to be induced between 37-39 weeks and she (the nurse) said, "Well there's no benefit to the fetus to be in there longer than that so yes, we do recommend an induction." I asked if that was based on individual patient circumstances or just a blanket recommendation, and she said it was a blanket recommendation. I started to cry&#8230; I think this was the whole thing I am hoping to avoid, is a 'blanket induction'. So I cried for a minute and took some deep breaths and we went in to meet the doc. We didn't meet with Dr. Easterling, but Dr. Carr who I had previously spoken with concerning joining a pre-eclampsia study they were doing before I conceived. She was just as warm and personable and down to earth in person as she was on the phone- very cool lady.

We talked mainly about the drug and the studies that I had seen and my husband and I asked lots of questions about why the samples were so small, how often they were seeing IUGR, etc. She said that they had never seen a 'very small' baby, but that in the study, small babies were reported 4% of the time. She went on to explain that the data in the study could be a bit misleading because as a double blind study, the patients and docs didn't know who was taking the meds, so the meds could not be adjusted for each patient depending on how she was reacting to it. So the women who had experienced lower fetal growth would have had their meds adjusted earlier on to avoid a smaller baby, whereas in the study that wasn't possible. She also said that there was a small number of women in the study who went on to get pre-eclampsia anyway, but they tended to be the patients who started the drug later in their pregnancies and who also were not being adjusted to meet their individual needs- everyone was given 100mg.

I asked about induction at 37-39 weeks and she said the same thing, that there was no 'benefit' to the baby to be in any longer than that, but that if the NSTs were good that she would be comfortable going to 40 weeks. She said they got worried when a patient wanted to go 41 weeks because 'there was no point', as the baby was well developed and why stay pregnant longer than necessary and take on all the risk of stillbirth that she said increases at that time. I said, "Wait a second. I'm having a really hard time swallowing this "there is no benefit to staying pregnant" story. While the baby might not be growing a liver or getting more brain cells at that time, there is absolutely critical development going on. I've seen babies come out at 35 weeks and I've seen them at 41 and I can tell you hands down which baby is ready for life outside the womb." She was taken a little aback I think, but not in a bad way- I think maybe from her perspective, getting a surviving baby with the ability to breathe and survive outside the womb was the highest priority, and anything else (like 'secondary' development, I'll call it) was expendable or not even on the map. She took my comment seriously though, she didn't argue with me at all about it and just said, "it's really your choice- we don't want to induce you unless your cervix is favorable and you WANT to be induced, if we don't see anything wrong with the baby." I felt MUCH relieved after that. She said that they have midwifery patients in the clinic who also don't like to be induced in those early dates and that it's not their desire or intention to force an induction on a woman who doesn't want one. *whew, relief*

She gave us the prescription from Atenolol and set up an appointment for next month when I'll be 20 weeks. She said that it was up to us what we wanted to do, they weren't going to push us&#8230; and that made me feel better too. We agreed to discuss it more at the next appointment.

We left feeling much more clear on what we were looking at. The one question she couldn't answer was whether there were long term effects on the babies due to the use of this drug during pregnancy. She said they'd like to do that study but they aren't quite there yet, they need money/staff/etc but it's on the list of things to do, basically.

We are definitely leaning toward taking the Atenolol but not starting until 20 weeks. I'll have several ultrasounds during the pregnancy to check on fetal growth but as long as my NSTs are coming back okay, there's no reason I have to be induced unless I want to be. I don't know what this means for a homebirth at all, but will talk with the midwife about that when we meet in a couple of weeks.


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## flyingspaghettimama (Dec 18, 2001)

Wow, dynamicdoula and myjulybabes, it sounds like y'all are making some great progress in your detective work. Good for you, being so proactive in your health care.

DD, I'm glad it sounds like they're very open-minded about later-term care. The only thing I would caution about is that preeclampsia board. Sometimes it's helpful, and sometimes it becomes a closed loop of hysteria and groupthink. If you know what I mean. Just mention the word "homebirth" if you really want to get them on a roll.

And if anyone wants any inspiration, check out my homebirth story, which turned out great (and pre-e free, although my midwife was monitoring very closely for it without being paranoid): http://www.mothering.com/discussions...d.php?t=433339

This was five years after my first birth, which was Pre-E starting at about 28 weeks, induced at 34 weeks, one seizure, and HELLP throughout the birth and post-partum with the usual cocktail of drugs (mag sulfate, pit, epidural, etc). It was a big bowl of bad.


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## taradt (Jun 10, 2003)

Quote:


Originally Posted by *myjulybabes* 
Got my bloodwork results back finally. All the standard prenatal testing was fine, not anemic, no STDs, blah blah blah. But the tests for the MTFR (is that right, I was scribbling so fast I can't read my handwriting!) mutation and the antiphospholipid...thing....were positive. My OB is calling in a scrip for prescription strength folic acid, and I've got an appointment with the maternal fetal docs in a couple weeks. I may have to transfer to their care entirely. My OB does some high risk, but apparently, I may be too high risk for her even.







She thinks I can avoid heparin and/or lovenox since I've never had problems with blood clots previously, but ultimately, it'll be up to the maternal fetal guys.

Looks like I have a lot of research ahead of me tonight.

For MTHFR you will also want high levels of B6 and B12 and get your homocysteine checked out, you want it to be pretty low (under 5 is what we were aiming for)

tara


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## myjulybabes (Jun 24, 2003)

Quote:


Originally Posted by *taradt* 
For MTHFR you will also want high levels of B6 and B12 and get your homocysteine checked out, you want it to be pretty low (under 5 is what we were aiming for)

tara

Aah, good to know, thanks. How high for the B6 and 12? I'm already taking 100mg of B6 for nausea, along with my prenatal when I can choke it down. Probably not quite enough, hmm? I'll ask the MFM guys about homocysteine levels.

My OB is also very insistent on a particular brand of the omega fatty acids. Anyone know off the top of their head if "Expecta" brand is really better than the others? I'm already taking fish oil, and I like the ones I have because they have a special coating so I'm not burping fish.









Seriously, cross your fingers that I can get by on just the baby aspirin. I was reading up on heparin and lovenox today and was literally in tears at the thought of multiple daily shots. I have a waaaaay beyond normal phobia of needles.







:


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## Kailey's mom (Apr 19, 2007)

GOssamer[/QUOTE]

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.

My daughter was literally starving in my womb, she had IUGR, and was born at 36 weeks just over 4lbs when we brought her home. My ob's were brushing it off, and had me on bedrest for the last 2 months, I knew something was very wrong. When she was born she had breathing problems, very low blood sugar, heart murmer and jaundice and had to be in the NICU..I don't know if it's related, but she still suffers from acid reflux (gerd) , which was so painful for her during the first 7 months. I don't know when she stopped growing, but when she was delivered the neonatologist said that she looked like a 32weeker. I don't know what "could' have happened if I didn't insist on a ultrasound, I was going to go elsewhere and pay for a 4D if the ob didn't do one. Thank god things are okay now..Pre_E/eclampsia is scary. My urine protein was a plus4, and my b/p's were running on average 210/140 until 6 weeks post partum.


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## taradt (Jun 10, 2003)

I am in no ways an expert, but my natropath had me on 50mg B6 2x a day, 1000mcg B12 once a day, and 5mg folic acid.
I took my same fish oils I always do (begrudginly because I am vegetarian, but anything for a healthy baby), and the baby asprin.

Thankfully I was negative for the antiphospholipid so I know nothing about the shots.


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## dynamicdoula (Jun 11, 2004)

Quote:


Originally Posted by *flyingspaghettimama* 
DD, I'm glad it sounds like they're very open-minded about later-term care. The only thing I would caution about is that preeclampsia board. Sometimes it's helpful, and sometimes it becomes a closed loop of hysteria and groupthink. If you know what I mean. Just mention the word "homebirth" if you really want to get them on a roll.

You know, I did bring that thread up about a year ago. A _very_ passionate debate ensued where I got lots of private emails that were gently but firmly stating that I shouldn't put my birth experience before my life (well DUH). The women there are very, very knowledgeable. All 100% enthusiastic women who believed with their whole hearts that this protocol had saved their lives and their babies. I still haven't heard a negative story yet about this protocol (which I will be starting, I've decided- what do I have to lose, it's a chance at avoiding pre-e all together) and honestly I like to hear both sides so that I can have a balanced view to use to make my decisions. I'll keep searching.


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## flyingspaghettimama (Dec 18, 2001)

Quote:


Originally Posted by *myjulybabes* 
My OB is also very insistent on a particular brand of the omega fatty acids. Anyone know off the top of their head if "Expecta" brand is really better than the others? I'm already taking fish oil, and I like the ones I have because they have a special coating so I'm not burping fish.









Seriously, cross your fingers that I can get by on just the baby aspirin. I was reading up on heparin and lovenox today and was literally in tears at the thought of multiple daily shots. I have a waaaaay beyond normal phobia of needles.







:

Well, you'd probably just get used to the shots, you know? It would become a new sort of normal. I totally get you though, I had no worries about needles until after my first Pre-E experience and the every-half-hour blood draws. Since then...blech!

I took Carlson fish oil, because they screen for heavy metal contamination. I would just double-check that?

Quote:


Originally Posted by *dynamicdoula* 
You know, I did bring that thread up about a year ago. A _very_ passionate debate ensued where I got lots of private emails that were gently but firmly stating that I shouldn't put my birth experience before my life (well DUH). The women there are very, very knowledgeable but scary sometimes in their fanatacism. It was interesting when I asked about the UW clinic the reactions I got were ranging from how very lucky and blessed I am to have this option to "I'll give you a ride and sit with you at the appointment". All 100% enthusiastic women who believed with their whole hearts that this protocol had saved their lives and their babies. I am not saying that isn't true, but the enthusiasm without doubt was what worried me. I still haven't heard a negative story yet about this protocol (which I will be starting, I've decided- what do I have to lose, it's a chance at avoiding pre-e all together) and honestly I like to hear both sides so that I can have a balanced view to use to make my decisions. I'll keep searching.









Yeah, I guess for me it was this strange dichotomy of birth experience VS DYING! It's not necessarily the case that having a positive birth experience must be at odds with staying alive, or that one must take everything a white-coat-dude says as gospel. For me, at least, having a good deal of control over my entire experience - down to taking my excessive vitamins every day and exercising - that control was something that helped me to process the negatives of my first experience (where I felt like I was expected to be a passive participant in my child's birth).

I just remember visiting and feeling very depressed afterwards and like I was doing myself and my child a great disservice by attempting homebirth. And I didn't want to live in that place of fear throughout my entire pregnancy.

I think it sounds like you're on the right path, DD! If it seems like you truly can't find any contraindicating information, and you can do ultrasounds without them using them against you (BPPs can be like that, as I'm sure you know). I find it a little surprising that they said that a BPP wouldn't give you the info on whether or not to induce - I thought they could visualize calcification of the placenta.


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## myjulybabes (Jun 24, 2003)

Latest update: Saw the MFM specialist today. He didn't really tell me anything I didn't know. I am going to have to do the Lovenox, but thankfully, the doseage he figured for me makes it a once a day thing. I've heard of twice a day (or 3 times for regular heparin). Also, dh went with me and learned to give the shots, so at least I can just close my eyes and get it over with rather than agonizing over sticking myself. Plus that opens up more areas to inject into...spread out any bruising and hopefully find some spots that aren't too painful. The nurse did the back of my arm today and it was NO GOOD. Still hurts.









Quote:


Originally Posted by *flyingspaghettimama* 
Well, you'd probably just get used to the shots, you know? It would become a new sort of normal. I totally get you though, I had no worries about needles until after my first Pre-E experience and the every-half-hour blood draws. Since then...blech!


Yeah, I'm hoping. I was never good with needles, but I could deal, until the first bout of pre-e and all those blood draws. I swear I left the hospital looking like a drug abuser...needle marks and bruises all up and down both arms.

Turned in my baseline 24 hour urine and got that blood draw (2 sticks in one day...dh felt sorry for me and took me out to lunch.







). Anyone remember off the top of their head how long those results take? My bp was down, yay. I think it may be the beginning of the standard second trimester drop, I'm 13w2d today. But I'll take it. No meds for that yet.

I may switch my care completely over to this doc. I really like my current OB for most things, but since I've had 2 previous sections she just wants to schedule another for 39 wks. This guy said because of the issues the clotting disorders can cause with the placenta, he feels it's better not to go past 40 weeks and defintely not past 41. So he wants to pick a date that we'd go no later than, schedule the section, but if I go into labor naturally before that, he implied he'd be ok with VBA2C. He just won't induce, and I agree, I would not choose to be induced after my own research on VBA2C. It's not perfect, but at least his plan makes _sense_. He also asked if I planned to bf, and when I said YES! told me that was great, we'd just switch to Coumadin after the baby is born, since I'll need blood thinners for 6 more weeks, but apparently Lovenox and heparin are no-nos for bf.

Scheduled the big u/s for the end of June, now I just have to get back in to see my regular OB before that and decide if I'm sticking with her or transferring care.

DynamicDoula, how are things going for you?


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## chilliepepper (Oct 14, 2005)

Quote:


Originally Posted by *myjulybabes* 
He also asked if I planned to bf, and when I said YES! told me that was great, we'd just switch to Coumadin after the baby is born, since I'll need blood thinners for 6 more weeks, but apparently Lovenox and heparin are no-nos for bf.

Hmmm, I thought it was Coumadin that was a no no for bf. I hope Lovenox is ok, because I injected it for 5 months while pg and nursing my toddler, and for 2 weeks postpartum while bf my newborn! None of the docs or my research indicated any problem with it.

Did I get it all wrong?


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## NZmumof2 (Jun 22, 2006)

So who else is around having a pregnancy after major complications last time from PET? I'm 17 weeks pregnant with my second pregnancy, had severe PET / HELLP last time, GA -section at 28 weeks, 4 days of high dependency unit for me...
I'm taking aspirin, high dose folic acid, b12 injections, will have 3 weekly growth scans from 24 weeks.
Anyone else in a high risk pregnancy?
Anna, crunchy rural doc, partner to Leah for 10 years, mums to Bede 7 (28 weeker) and Emmett 3.5, expecting another in Jan 08


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## dynamicdoula (Jun 11, 2004)

Quote:


Originally Posted by *NZmumof2* 
So who else is around having a pregnancy after major complications last time from PET? I'm 17 weeks pregnant with my second pregnancy, had severe PET / HELLP last time, GA -section at 28 weeks, 4 days of high dependency unit for me...
I'm taking aspirin, high dose folic acid, b12 injections, will have 3 weekly growth scans from 24 weeks.
Anyone else in a high risk pregnancy?

Hi Anna,

I'm in high risk pregnancy as well- I am working with the hypertension clinic at the University of Washington and as a result I'm taking atenolol and clonidine to control my cardiac output. My last pregnancy ended with a 5 day long induction, during which I barely, BARELY escaped having a cesarean. I did not have HELLP but I have had onset of hypertension much earlier this pregnancy (I started atenolol at 15 weeks 50mg per day and was fine when I started it, but after 2 months of taking it I found my blood pressure was 165/79 (pulse 89), so the atenolol was increased.)

The atenolol is doing doing its job but I am still vasorestricting, hence the clonidine (.025 x3 daily). I take my blood pressure 3x per day and it's been really reassuring that things are working as they should. No protein, but I have noticed in the last few days seeing some lights/spots... eek I go to the UW for one of my 4 consults today so I'll mention it to them. I'm getting NSTs every week from here out and the goal is to see me get to full term at least, and my personal goal is to NOT be induced, but I'm not holding on too tightly to it.

I am not taking any other supplements with the medications.

I'm glad you found the thread and I also invite you to check out www.preeclamspia.org (some of the women from that site also visit here), they are incredible women who are so knowledgeable it astounds me. You would definitely find support/information there to supplement that which you'll also find here. Some really caring women on both sites!

Anyway, I'm sad to have to welcome you to the thread but welcome it is...


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## ksera05 (Apr 14, 2006)

I had my now 1 year old at 24w5d last year due to severe pre-e and am now 12 weeks pregnant again, so I really should be paying more attention to this thread









We found out yesterday that I have the MTHFR mutation. The perinatologists are putting me on a very high dose of B6/B12/folic acid(?) but said that I don't need Levanox shots, etc. So at least I don't have to do shots...







I'm also on baby asprin.

At what point in your pregnancy do they start checking your homocysteine levels? I forgot to ask.

Did anyone else spill protein really early in their pregnancy? They did a 24 hour baseline urine test at 7 weeks and I was already spilling trace amounts of protein, which makes me slightly nervous. Every time my urine has been dipped in the office since then I've shown up as having trace amounts, also. Anyone else have any experience with that?


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## NZmumof2 (Jun 22, 2006)

Hey Sarah,

As far as the protein goes, do you know if you were spilling any when you weren't pregnant? Trace amounts of protein are frequently not significant (I'm also a family doc) but a change in levels is important. Did you have a classical incision with your first? Just wondering cos you're having an elective LSCS this time.

I don't know about the homocysteine thing, it's not routinely tested here in NZ, nor is the MTHFR mutation - gene testing especially often has to be sent overseas from here and would take months to get a result.


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## ksera05 (Apr 14, 2006)

Quote:


Originally Posted by *NZmumof2* 
Hey Sarah,

As far as the protein goes, do you know if you were spilling any when you weren't pregnant? Trace amounts of protein are frequently not significant (I'm also a family doc) but a change in levels is important. Did you have a classical incision with your first? Just wondering cos you're having an elective LSCS this time.

I don't know about the homocysteine thing, it's not routinely tested here in NZ, nor is the MTHFR mutation - gene testing especially often has to be sent overseas from here and would take months to get a result.

Yeah - I had a classical...trust me, I'm not exactly ecstatic about this "elective" repeat c/s but it seems safest from all the studies I've read. Ugh.

I'm fairly sure I wasn't spilling any before I got pregnant but I'm not 100% sure on that. I am wondering though if maybe it could just be simple dehydrating. Morning sickness has been rough this time around and getting water down me has been hard.







I do know I wasn't spilling any protein this early in my pregnancy with DD#1 but on the other hand my kidneys did take a beating during her pregnancy and postpartum period.

And along those lines, off to get another glass of water.


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## NZmumof2 (Jun 22, 2006)

I'd make exactly the same decision if I'd had a classical incision Sarah! I was warned I may well need one when I had Bede, but they did manage to do a lower segment one so if I get to term I'll have a vaginal birth if possible. That said I won't consider induction or augmentation so I'm trying to get te balance right between preparing for a labour and not feeling like I've wasted my time if I have a cs. Ultimately I'm pretty clear that getting baby and I through all alive is really my only aim.

When you're dry your urine is very concentrated which does increase the chances of picking up protein.


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## ksera05 (Apr 14, 2006)

Quote:


Originally Posted by *NZmumof2* 
I'd make exactly the same decision if I'd had a classical incision Sarah! I was warned I may well need one when I had Bede, but they did manage to do a lower segment one so if I get to term I'll have a vaginal birth if possible. That said I won't consider induction or augmentation so I'm trying to get te balance right between preparing for a labour and not feeling like I've wasted my time if I have a cs. Ultimately I'm pretty clear that getting baby and I through all alive is really my only aim.

When you're dry your urine is very concentrated which does increase the chances of picking up protein.

Oh I know what you mean about induction. Some doctors are actually willing to induce VBACers, I think that's insane


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## buzzjen (Mar 8, 2004)

Hi all -

I've only gotten through a few pages of this thread, and I'd like some help from all of you. With my first pg, I had PIH (no pre-e that could be detected) diagnosed at 26 weeks, with bedrest from 30 weeks to delivery at 38 weeks with an awful, long, painful induction with failed forceps and vacuum extraction. With my second pg, I changed drs and took as many actions as I could to avoid PIH/pre-e. I did and dd was born at 39 weeks with a natural, drug-free birth.

Now, almost 3 years later and pregnant again, I can't remember what I took in terms of supplements with dd's pregnancy. I know I took baby aspirin, but can't remember at what week I started and think I took calcium. Are there other supplements I'm missing. Are there better brands of prenatals? We've since moved and therefore, I have a new doctor (who I generally don't trust a whole lot). Any links to research would be helpful - I was a grad student with my other two pregnancies, so was able to do research right at the library - not so with this one and I don't know where to start online.

Thanks for your help!


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## gossamer (Feb 28, 2002)

Hi Jen,
A good place to start researching and asking questions would be preeclampsia.org. There is a lot of information on that board. COngratulations on having one uncomplicated pregnancy and I hope you have another.
Gossamer


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## dynamicdoula (Jun 11, 2004)

Hi ladies,

I'm taking atenolol 100mg per day and Clonidine .05 3x per day to control my BP and whatnot, and I'm 32.3 weeks today. Here's a link to my BPs, they were pretty well controlled but now... not so much.

I've been making sure to stay hydrated and taking my medications on time, religiously, but my BPs are still going up. My baseline pulse is now between 80-85 and my BP is hanging out in the 130/75-80 range. I cried last night.







I am definitely seeing lots of lights/crawlies every day, too. My hands are swollen and feel buzzy. I'm still getting negative protein when I dip, when I'm well hydrated. When I'm not well hydrated I get .30 protein (more than trace, less than +1?) I'm still -3 pounds from my pre-pregnancy weight.

I will see the docs at the hypertension clinic on Tuesday, and I'm relieved about that. I'm glad I didn't go in on Friday, I really mentally needed a few days to 'try some things' at home and see if taking my meds more carefully, drinking more water, resting more, would impact things. Well if anything, they're worse! lol My hands are swollen and I took my rings off this morning, I don't want them to have to be cut off later!

I'm thinking they'll likely just increase my medication and I am hoping that brings things back under control.

One of the things most frustrating is that I actually *feel* fine! I am not uncomfortable in the traditional 32-weeks-pregnant sense, I can move around pretty well, I'm not nauseas or overly tired or emotional, etc.

I suppose she'll be born sooner rather than later- I'm due at the end of October and was really hoping for an October birth (my birthday is in October







), but I'll take a full term baby if I can get one.


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## gossamer (Feb 28, 2002)

Kristina,
Let us know what happens at the clinic on Tuesday. I hope all is well. 32 weeks is not bad for your first really bad symptoms. I hope they can keep you pregnant as long as possible.
Gossamer


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## dynamicdoula (Jun 11, 2004)

Yeah... I just took it (my hands are totally buzzing and feeling puffy), and it was 156/90 so... I put a call in to the on-call doc. *sigh* I'm sure I'll go down there and they'll just send me home after a few hours but man this is frustrating!


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## dynamicdoula (Jun 11, 2004)

The on call doc felt that one reading wasn't enough to panic over, so I'm going to just wait until tomorrow and go in and get labs done at the hospital. I'll bring my chart with me too, so she can see the progression. It almost feels like a waste of time because they don't see it the same way as the doc at the hypertension clinic, and there I have the benefit of the additional information from the cardiac output monitoring. It almost seems like a waste of time to go in before Tuesday considering the doc at the hypertension clinic will probably just increase my meds anyway.

I took another BP and it was 136/67, down from 156/90. That's good at least.

It's hard not to get emotional about it all.







:


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## gwerydd (Jun 7, 2007)

i had a similar experience at 32 weeks, but my bp was even higher (160/124). i was hospitalized over Christmas to get it down. i felt fine except for my bp being so sky high (i check it 3 times a day). i remember sobbing frequently over trying to do everything right and still having difficulties. i am so glad i found this thread, it's good to read other people's experiences and to learn more for the next pregnancy.

i knew a lot about pre-e when i got pregnant because my mother had it with my sister and my self so i knew i was at greater risk, that and i have hereditary chronic hypertension. my sister was born at 33 weeks due to pre-e.


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## dynamicdoula (Jun 11, 2004)

I did go in to the hospital today and of course my BP's were absolutely stunning- 110/55 range. Give me a break, body!!!! I did have +1 protein (which is somehow satisfying as it validates me of the mystery that is my body), so we did blood work which came back great and I'm doing a 12 hour collection of urine. I am hoping to get the numbers back before my appointment on Tuesday because I _detest_ not knowing!!!! Man, I'm more of a control freak than I thought I was. Baby was beautifully reactive, so that reassured me.

I guess we'll see what that number is (it was 186 at last check) and if it's going up.


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## myjulybabes (Jun 24, 2003)

Kristina, how's it going? Glad things went well when you did go in to the hospital.

I haven't been checking in, because things have been so uneventful-- thus far. My bps were beautiful for the second trimester, they're creeping up a bit now though. 140/96 at my last visit. I think they may want to start meds at my next visit. And I think I'm going to have to go out today and give finding a home bp monitor with a big enough cuff one more shot. I've felt ok not monitoring at home since things were going so well, but now the creeping bps added to a headache that's not going away, and I can't justify not having a monitor by saying "but we're BROKE" any more.









Two questions for the day-- anyone know if there's any correlation between pre-e and gestational diabetes? Any extra precautions I need to take? I've never had GD before, it's freaking me out!

Also, is there any point calling the doctor for just a headache with no other symptoms? It's bad enough that Tylenol isn't touching it, and I had a hard time sleeping, but no visual disturbances, no swelling, and as of Friday I wasn't spilling protein (should probably look for test strips for that while I'm out today too). I used the BP monitor with the ill fitting cuff and it read high, but no higher than it has on any other day.


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## dynamicdoula (Jun 11, 2004)

Well it's going... okay I think.







I did get my 24 hour urine back and it was 50 lower than the previous one, so that was great news! My BP used to range in the 115/55 range and now I'm hovering between 125-140/80s, on average. I got up in the middle of the night after taking both meds (I take one of them only at night) and having been sleeping and it was 132/81. *sigh* Not high per se but I'm keeping a close eye on it. I see my doc tomorrow and I might just throw out the 'let's get this over with before I need mag' discussion. Not sure yet, he's pretty conservative about intervention and won't want to induce until we're at that really fine knife point edge. Sick enough to induce, not so sick that I need mag, hopefully- that's our collective goal.

My other concern is my placenta- Had to sit in the hospital and wonder if I was having a cesarean that day because she deceled during a contraction down into the 90s and stayed there through the whole contraction. I had to go do nipple stim to bring on 3 contractions in 10 minutes (thankyouJohnnyDepp for your assistance!







) and she sailed through that- but about 10 minutes later deceled again! Ugh! Doc feels that the more information you gather the more problems you'll find and I whole heartedly agree; I was so grateful to be able to walk out of there with my uterus intact and my baby still inside of it, let me tell you. But if she's deceling I'm concerned, so I'm fighting to not be anxious about my NST's and just relax. This morning I had the whole "What if I die" conversation with myself and couldn't sleep for two hours.









On the regular pregnant lady stuff: I've gained absolutely 0 weight this pregnancy, I'm not overly swollen (my hands get a little puffy but no one can tell but me, so it's not severe, but I can feel them buzz when my BP is high), I'm sleeping well, eating well, able to poop regularly, not overly emotional (well except for these last few days







)... I don't feel 34+ weeks pregnant, I feel somewhere in the mid-late 20 weeks. It's weird to feel this good and have all this other junk going on, but that's how this goes. At least I'm not on bed rest.


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## myjulybabes (Jun 24, 2003)

Quote:


Originally Posted by *dynamicdoula* 
Ugh! Doc feels that the more information you gather the more problems you'll find and I whole heartedly agree; I was so grateful to be able to walk out of there with my uterus intact and my baby still inside of it, let me tell you. But if she's deceling I'm concerned, so I'm fighting to not be anxious about my NST's and just relax. This morning I had the whole "What if I die" conversation with myself and couldn't sleep for two hours.










Ain't that the truth??? I'm checking in now from the hospital.







The headache just felt "off" to me, and I was right, my bp was up to 168/100. But even once they got it down (I'm on labetalol (sp?) now), they just had to keep hunting, and now I don't know when I'm getting out because my amniotic fluid was "low" on the u/s. I'm trying not to worry, because I know that test isn't always reliable, and it would be a REALLY sudden decrease if it's true, but... they've already given me both shots of steriods to mature her lungs, "just in case".







:

The "what if i die?" thing never really occurs to me, I've always thought it was because I've never really had a "normal" pregnancy. Pre-e has just always been part of the deal. But apparently dh was worrying about it this time and so now I'm feeling guilty.

eh, sorry, took over with a whine of my own.









here's hoping we both (all 4 of us really!!!) make is safe and healthy through the next few weeks! No more decels for your little one and lots more fluid for mine!


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## gossamer (Feb 28, 2002)

You are both in my thoughts and prayers.
Gossamer


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## myjulybabes (Jun 24, 2003)

I'm home. Complete with labetalol, heparin instead of Lovenox (oh yeah, THIS is gonna be fun), a blood sugar monitor, oh, and glyburide because the steroids for lung maturity interfere with blood sugar.







:

I don't have pre-e YET though, thank goodness. The bloodwork all came back normal, and the 24 hour urine came in just under the magic 300 mark (I want to say 275), but I was a smidge dehydrated, so I'm hoping that if/when they do a repeat, it'll be even lower.

It's fecking amazing how FAST problems can come on though. I went from everything going swimmingly, to strict bedrest in all of a day. I had just finally gotten everything ironed out for my scheduled section date too. Blah.

I keep reminding myself that a healthy baby is THE most important thing here (and a healthy mom!), but man, I can't help but be a little disappointed with how things are going.


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## ksera05 (Apr 14, 2006)

ack! Josie, I'm glad you're home again. I hope your protein stays under that 300 mark.









tomorrow is my 18 week ultrasound...and we're touring the NICU. I'm both excited and starting to get a bit nervous. Sigh.


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## myjulybabes (Jun 24, 2003)

Quote:


Originally Posted by *ksera05* 
ack! Josie, I'm glad you're home again. I hope your protein stays under that 300 mark.









tomorrow is my 18 week ultrasound...and we're touring the NICU. I'm both excited and starting to get a bit nervous. Sigh.

Me too! I'm off for another BPP tomorrow morning, not sure if they're going to order any more tests. I've been feeling pretty good, all things considered, so hopefully I've got at least a few more weeks to go, even if it is on bedrest.

Good luck with the u/s and NICU tour! I really need to look into a tour, I'm at a different hospital this time than I was for my last 3.


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## earthmaia (Sep 22, 2007)

What I found out the hard way:
1. Pre-e can happen in your second pregnancy for the first time.
2. Pre-e can start after the baby is born, I went home 3 days after my son was born. Took my BP at home on day 4 185/120. Back to the hospital for another 5 days. (skipping long story) Came home maxed out on Procardia, Lab., and Methydopa. Ended up needing to pump and dump for 2 weeks till I could get off the meds.
--I have hypertension normally so was pretty informed on the signs and symtoms, but I didn't know you could get it after the baby is born







:


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## gossamer (Feb 28, 2002)

Yup, in fact most women who die from Pre-e die in the 24 hours *AFTER* birth.
Gossamer


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## ksera05 (Apr 14, 2006)

Quote:


Originally Posted by *myjulybabes* 
Me too! I'm off for another BPP tomorrow morning, not sure if they're going to order any more tests. I've been feeling pretty good, all things considered, so hopefully I've got at least a few more weeks to go, even if it is on bedrest.

Good luck with the u/s and NICU tour! I really need to look into a tour, I'm at a different hospital this time than I was for my last 3.

It's a boy!









The NICU tour was great. Heaven forbid we end up there again, I actually think we'll like this NICU better than the last one.

However I'm now 19 weeks and my blood pressure is still down. 21w3d is when everything started to go to pot with DD so two more weeks before I start worrying


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## myjulybabes (Jun 24, 2003)

Quote:


Originally Posted by *ksera05* 
It's a boy!









The NICU tour was great. Heaven forbid we end up there again, I actually think we'll like this NICU better than the last one.

However I'm now 19 weeks and my blood pressure is still down. 21w3d is when everything started to go to pot with DD so two more weeks before I start worrying










Woohoo, congrats on the boy and the good BP readings!


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## gossamer (Feb 28, 2002)

I am keeping my fingers crossed for everyone.
Gossamer


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## GinaRae (Mar 27, 2007)

Just sort of scanning the thread here and there and addressing things that pop out at me. Pre-e is usually according to the "rules" but not always and that's what makes it even harder to deal with!

-- I had toxemia (pre-e) with my first two and PIH (no doubt headed to pre-e) with my third. So far at almost 35 weeks there are NO signs of pre-e or PIH with this one. It could still sneak up on me...

-- I was not obese with the first three but am now. Yet I am healthier now.

-- There were NO signs of placenta problems with any of my births. The placenta and cord were beautiful and thick, no clots.

-- Eating a diet really high in protein actually made me sick. I had to scale back and am feeling MUCH better. We thought maybe pre-e was coming, but when I pulled some foods and some protein, I feel so much better.

I was really stressed to the max for several months when told to increase protein more and more. It came to a head with an egg allergy and complete sickness until I removed eggs and lowered my protein intake overall. And despite feeling better physically, what I am left with is the guilt that maybe I am still not getting enough protein and it's hurting me or the baby! So just take it easy with the protein and eat what your own body needs.

-- I have found out with this pregnancy (for the first time) that a dipstick test of urine is not a good indicator of protein in the urine. I've been told this now over and over. You need a clean catch, 24 hour urine test. For instance, my dipstick tests every appointment say at least 30+ protein, but when we swiped with an alcohol wipe first, no protein showed last time.

I am so far still in line with my homebirth and hoping for the best!


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## gossamer (Feb 28, 2002)

Gina, I am so glad things are going well for you. That's great that no signs of pre-e and no protein in your urine. Woo Hoo. Keeping my fingers crossed for you too.
Gossamer


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## dynamicdoula (Jun 11, 2004)

I just wanted to update the thread- I did have my baby, a month early. My placenta wasn't holding up for whatever reason so she was born after an urgent (not emergency) cesarean. Not what I was hoping for but about what I expected. Cesarean's blow, btw, but I'm glad we had the option.

I'm still taking Atenolol (when I remember, I'm really bad about that now) but I never did get pre-eclampsia.

We don't know if we'll have any more kids- we're already talking about it (and will continue to until we decide, I'm sure).

Introducing Eidie Grey K.
Born a month early on 9/25
4# 7oz, 17" long. Apgars 7/9, spent a week in the nursery but breastfeed the entire time. She's doing fabulously.


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## Pam_and_Abigail (Dec 2, 2002)

I'm just posting so I can find this again. I only read the first page, but it's a great resource. Thanks!


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## gossamer (Feb 28, 2002)

I am so thrilled for your baby. Sorry she had to come early, but thrilled that she made it.
Gossamer


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## tema (Nov 16, 2005)

Hi ladies,
I know this is an old thread but I am hoping some of you are still around and could help me out with some answers.

I'm currently 38 wks 5 days pregnant with my third. My first ended up in a c-section (too many interventions and a big baby) and second birth was a home waterbirth/vbac.

My blood pressure is usually around 124/78 or so...on Thursday I had a homevisit and the first time the midwife measured it was 140/90 and then the second time she re-took it with a different cuff it was 130/90...
The midwife came back on Friday to double check it again and it was 130/90 again..
Since I had no other symptoms, she said she'd be comfortable with checking up on me again on Monday...

Today (Saturday) I've kind of have had a headache whole day...but it's not that strong...and it's more like feeling nausea and I feel better if I close my eyes and just try to rest...also I had some urine strips left over and tested it...few times over the the course of the afternoon it came back positive at 30...and then tonight when I checked again it was only a trace there...

So what do I do? Do I wait until Monday or should I call the midwife earlier and go to the hospital??

I should mention that my placenta is really thick...about 6 cm...but the doctors have said that so far it hasn't caused any problems...could it maybe be related to pre-eclampsia somehow??

Thanks in advance for any quick replies.


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## gossamer (Feb 28, 2002)

My first instinct is to always call the Dr. as soon as you think something is off. The sad reality is that pre-eclampsia kills babies and mothers. It is not something to regard lightly. If you have any questions at all, call the Dr. I wouldn't worry too much about the urine results. A 24 hour urine is a much better way to determine the amount of protein you are spilling. But the raised blood pressure and the headache worry me.
Gossamer


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## taradt (Jun 10, 2003)

I would call as well, it can progress so fast. Also it is normal to feel fine up until the last second and you may or may not spill protein (I never did until after my daughter was born and even then it was a 1 time thing).
Can you take your blood pressure? I was taking it twice a day with my son.

Keep us updated


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## ksera05 (Apr 14, 2006)

I'd call as well.


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## gwerydd (Jun 7, 2007)

i would call. not to scare you but when i checked my bp at home the day my dd was born by emergency c-section it was 140/104, when i got to the hospital it was 171/119 and climbing, i felt fine except for a headache that wouldn't go away and at the hospital i started to get flashes in the eyes. there was maybe an hour between those two readings. it can happen so fast. it's better safe than sorry.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *tema* 
Hi ladies,
I know this is an old thread but I am hoping some of you are still around and could help me out with some answers.

I'm currently 38 wks 5 days pregnant with my third. My first ended up in a c-section (too many interventions and a big baby) and second birth was a home waterbirth/vbac.

My blood pressure is usually around 124/78 or so...on Thursday I had a homevisit and the first time the midwife measured it was 140/90 and then the second time she re-took it with a different cuff it was 130/90...
The midwife came back on Friday to double check it again and it was 130/90 again..
Since I had no other symptoms, she said she'd be comfortable with checking up on me again on Monday...

Today (Saturday) I've kind of have had a headache whole day...but it's not that strong...and it's more like feeling nausea and I feel better if I close my eyes and just try to rest...also I had some urine strips left over and tested it...few times over the the course of the afternoon it came back positive at 30...and then tonight when I checked again it was only a trace there...

So what do I do? Do I wait until Monday or should I call the midwife earlier and go to the hospital??

I should mention that my placenta is really thick...about 6 cm...but the doctors have said that so far it hasn't caused any problems...could it maybe be related to pre-eclampsia somehow??

Thanks in advance for any quick replies.


Thick placentas are associated with both pre-e and GDM.

Call. I went from mild hypertension to full-blown severe pre-e in six hours, and HELLP syndrome a few days later.


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## gossamer (Feb 28, 2002)

In fact *eclampsia* is derived from a greek word meaning *lightening* because it can happen so quickly.
Gossamer


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## sparklett (Nov 25, 2006)

Hi Everyone!

SORRY for the legnth of this message, but I am so exited to have finally found a place where I might get some answers!!

I can't believe that after dealing with pre-e/HELLP seven months ago, I am only just now finding this thread!

Here's my dilemma.....

I developed pre-e at 33 weeks and DS was delivered via emergency c-section and was in the NICU for 33 weeks. Up until three days before the c-section, I was fine, except for a tiny spike in BP only once and constant swelling. In the end, my BP was 117/174 and I had +3 protein in my urine, severe swelling, hyperreflexia (sp?) and abdominal pain. I was on two different hypertension meds for 3 months after the delivery. (See my siggie for the whole gory story.)

I was seeing a midwife and OB, and my midwife was the one who caught it and sent me to the hospital. I thought I had the flu!

Question1:
DH and I are going to TTC again in October and it seems like it is going to take me until then to find a good OB. We have moved, and I need to find an OB, but don't know what to look for. I was planning on interviewing OBs over the next several months, but what should I ask them about how they would treat me once I explain my history? Would I be considered high risk? What kind of answers should I expect to hear re: pre-e "prevention", testing, and monitoring? Should I priortize my search based on which OB can deliver at a hopital with a level III NICU? I really want to find an OB who will help me catch any problems early. I want to find an OB now becuase I want to at least have some sort of relationship in place before prenatal care begins and so that I can be sure my insurance will cover their services.

Question 2:
What should I be doing now, before I get pregnant, that might help me avoid a second round of pre-e? I am very overweight, so I plan on loosing the weight before we TTC again, and I'm making good progress! But what else should I be doing?

Question 3:
I have read over and over again that one risk factor for pre-e is having a new partner. Why? I might have another question about this.

I must say that before I found this thread, I was more concerned about having a VBAC than I was about pre-e. Now, the VBAC is on the back burner and I am more concerned about getting to full term with my next babe.

Thanks so much!!!


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *sparklett* 
Hi Everyone!

SORRY for the legnth of this message, but I am so exited to have finally found a place where I might get some answers!!

I can't believe that after dealing with pre-e/HELLP seven months ago, I am only just now finding this thread!

Here's my dilemma.....

I developed pre-e at 33 weeks and DS was delivered via emergency c-section and was in the NICU for 33 weeks. Up until three days before the c-section, I was fine, except for a tiny spike in BP only once and constant swelling. In the end, my BP was 117/174 and I had +3 protein in my urine, severe swelling, hyperreflexia (sp?) and abdominal pain. I was on two different hypertension meds for 3 months after the delivery. (See my siggie for the whole gory story.)

I was seeing a midwife and OB, and my midwife was the one who caught it and sent me to the hospital. I thought I had the flu!

Question1:
DH and I are going to TTC again in October and it seems like it is going to take me until then to find a good OB. We have moved, and I need to find an OB, but don't know what to look for. I was planning on interviewing OBs over the next several months, but what should I ask them about how they would treat me once I explain my history? Would I be considered high risk? What kind of answers should I expect to hear re: pre-e "prevention", testing, and monitoring? Should I priortize my search based on which OB can deliver at a hopital with a level III NICU? I really want to find an OB who will help me catch any problems early. I want to find an OB now becuase I want to at least have some sort of relationship in place before prenatal care begins and so that I can be sure my insurance will cover their services.

Question 2:
What should I be doing now, before I get pregnant, that might help me avoid a second round of pre-e? I am very overweight, so I plan on loosing the weight before we TTC again, and I'm making good progress! But what else should I be doing?

Question 3:
I have read over and over again that one risk factor for pre-e is having a new partner. Why? I might have another question about this.

I must say that before I found this thread, I was more concerned about having a VBAC than I was about pre-e. Now, the VBAC is on the back burner and I am more concerned about getting to full term with my next babe.

Thanks so much!!!

1) yes, you will be considered high-risk. It's not the end of the world. It's just a label. Some providers will home-birth a woman with a history of pre-e because the risk is so much lower for multips.

You want a perinatologist for a consult. You don't have to see them for PNC, you don't even need an OB (our midwives see women with histories of PE regularly) but a perinate (and one who specifically deals with hypertensive disorders of pregnancy) will be up on the current research and, frankly, less likely to freak out about a history of pre-e. They see truly sick people, not just people who might get sick, if you see what I mean, and OBs in general practice can freak out about things a perinate wouldn't care about.

2) there is some interesting work being done at the UW about reduction of risk of pre-e with using beta blockers and diuretics in pregnancy. The Brewer diet (in fact, diet interventions in general) have not been shown to work. Weight reduction is good, but skinny people get pre-e too. If you have any history of PCOS, consider treating during pregnancy with metformin. Remember too that pre-e is a multisystem disease, not caused by high blood pressure, but with high blood pressure as a symptom. Treating hypertension does not treat or necessarily prevent pre-eclampsia, but can be very important for other reasons.

3) The theory behind the new-partner hypothesis is that pre-e is at least in part an immune reaction to a new antigen (new partner's DNA in baby). The data are very mixed on this.

www.preeclampsia.org is a good resource.

Good luck!


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## taradt (Jun 10, 2003)

You have knowledge gong for you the second time.

For me personally, I decided to go wth a midwife after my pre-e/hellp baby. I felt that the Dr's had really dropped the ball and that a midwife would be more in tune with what was going on (especially knowing my history). I monitored my blood pressure on my own.
I also felt I needed to feel like I was doing something so I followed the "Brewer diet", took baby asprin and was on a high folic acid/b12 regiment due to high homocystene levels.
I can't say if anyone thing worked, or if we were lucky the last time, but I liked feeling I was doing something and my son was born by natural VBAC with no signs of pre-e at all









good luck to you


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## sparklett (Nov 25, 2006)

I would REALLY prefer working with my midwife again (the OB was simply stupid), but... now that we have moved, we live an hour away from the nearest hospital, so if something goes wrong during labor(attempting a VBAC, pre-c, etc.), then I'll be in serious trouble. I found a OB/nurse-midwife practice that I'm going to interview soon; the nurse-midwives have hospital privilidges and are opening a birth center just minutes away from an excellent hospital, so that may be an option. I would love to try for a homebirth again, but there seems to be so much risk. I would be more open to it if we were closer to a hospital. I thought about doing a homebirth at my MIL's house, becuase she's just a few seconds from a hospital, but the stress of just being there would make my BP skyrocket!

I never even thought about a perinatologist. Good idea. I wonder how getting a consult would work with my insurance? When I'm pregnant, how often would I check in with the perinatologist?

The reason I asked about the realtionship between partners and pre-e is that although DH and I had been together for sixteen years before TTC, we had always, always used condoms as our sole source of protection. We never had an "accident" and got pregnant on our first try. I have always wondered if that situation did something to make my body react as if he was a new partner. and contributed to developing pre-e.

Lots of food for thought so far! Thanks!


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## CountrylivinmomtoB (Oct 12, 2006)

I'm so thrilled to have found this!! I am newly pregnant. With my first i knew something was wrong during pregnancy but was blown off. At my 35 week appt, I felt like I was dying, so they sent me to the hospital for blood work. The blood results showed I should be having seizures and the doctors were shocked I wasn't. I was induced right away and she arrived 4 hours later. The doctor told me her placenta was covered in calcium deposits and if I wouldn't have delivered her when I did, she would have died in the womb by the next day.

My mom had it, my grandma had it. I ate a healthy diet and did everything they said you "should do" and still got it.

This time around I'm hoping to have a homebirth. I'm doing everything I can possibly do this time around too and I'm hoping it skips me this time.

Pre-e is scary. My aunt lost her baby from it- she was fullterm, tried convicning her obgyn something was wrong, and he wouldn't listen to her.


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## gossamer (Feb 28, 2002)

You may also want to ask your doctors aobut getting dna tests done to lookf or blood clotting disorders, lupus, rheumatoid arthritis, etc.... There has been a lot of research done on the effect these blood clotting disorders have on the placenta and their role in triggering pre-e.

I lost my baby due to Early onset pre-e and HELLP so I saw a perinatologist every month, a regular OB as often as I needed to for my sanity and a cardiologist every month. I had monthly ekgs, ultrasounds, 24 hour urines and liver panels and at 37 1/2 weeks I welcomed my miracle baby into the world.
Gossamer


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## Goddess3_2005 (Oct 20, 2004)

Hi all. I'm joining up and hoping to get some help. I'm pretty sure I'm pre-eclamtic, well my midwife hasn't diagnosed me officially, but my dad whose and NMD did. I'm 24 weeks, I have had BP in the range of 144/92 (normal is 90/60 range), Pitting edema, +1 protein, and last night I had weird wavy black lines in my left eye while driving home, it did go away and hasn't been back, but its the 2nd time I have had it. My dads been trying everything to get my BP down, I have had 2 IV's of Mag Citrate in an isotonic solution, I am giving my self weekly shots of B-12 and Folic acid (ouch!), doing the brewers diet, taking lots of vitamins and Mag citrate daily, and its still not seeming to help. Is there anything else I can do get back to normal? This is my 6th baby and I have never had these issues with previous pregnancies.


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## gossamer (Feb 28, 2002)

Are you taking any blood pressure meds?


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## Goddess3_2005 (Oct 20, 2004)

No. I was told I couldn't take anything that was pregnancy approved because I have prior liver issues.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *Goddess3_2005* 
No. I was told I couldn't take anything that was pregnancy approved because I have prior liver issues.

HArdly anything is "pregnancy-approved". Some meds, such as beta blockers, can still be used. Depends a lot on the provider.


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## Goddess3_2005 (Oct 20, 2004)

Is there anything thats safe enough during pregnancy that you can use with liver problems?


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *Goddess3_2005* 
Is there anything thats safe enough during pregnancy that you can use with liver problems?

What liver problems exactly? I have somewhat elevated enzymes left over from my bout of HELLP syndrome, and I happily took atenolol. It's cleared by the kidneys, not the liver. If you're being medicated with a beta blocker in pregnancy though, you should probably consider a perinatology consult, because the choice of antihypertensives in pregnancy is very complicated.


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## Goddess3_2005 (Oct 20, 2004)

I think I had an undiagnosed problem my last pregnancy because after birth I ended up severely elevated liver enzymes and they siad I had some liver damage. I remember telling my doctor I have horrible pain in my upper right part of my stomach and he said it was my muscles stretching. I think thats why they said I couldn't take the BP meds because of the liver damage. My dad dosen't want me to take BP meds at all and treat this naturally, but I think theres a point where natural stuff has to step aside for immediate results, YKWIM?

I'm starting to get that pain again, and my midwife said its not pregnancy related, so maybe its nothing. Theres only one perinatologist in my area and they actually fly in from Salt Lake city one day a week. I'll try to get in to see him next week though, thanks for the suggestion. I was afraid to see the OB here, is a jerk who yelled at me for not getting the flu shot, so if I can by pass him, it would be great!


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## gossamer (Feb 28, 2002)

I had HELLP with my first pregnancy and during my second pregnancy I took Aldomet and acebutelol, both of which are safe during pregnancy. I took them several times a day, so they are not as convenient as newer meds that can be taken once a day, but they worked.
Gossamer


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## ScarletBegonias (Aug 24, 2005)

interesting...........

during this pg i started to develop the following sx at about 10 wks, i am currently 36 wks:

blurry/fuzzy vision (double vision @ about 24 wks)
random rapid heartbeat
a feeling like i *will* pass out
extreme shortness of breath, like something is sitting on my chest
dizziness
higher than normal bp - i am always 90/60, this pg i am 115/80
right shoulder pain (just startd this am, actually it felt like i dislocated it)
laying on my right side makes me feel like passing out

if i sit down for a few minutes all sx go away, except the vision thing.

this pg has been COMPLETELY different than when i was pg with dd (pg #3 after 2 m/c). my pg has been a breeze in every other way physically (except hb and severe rib pain), although i have been under extreme stress. the baby is very active and growing well. does this sound like pre-e to anyone? should i be concerned?

i am not overweight, but i do have pcos. i am still nursing 23 mo dd.


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## NZmumof2 (Jun 22, 2006)

Our little girl was born by VBAC this morning, ten days past her due date with no recurrence of the HELLP syndrome I had in my last pregnancy that resulted in a c section at 28 weeks. We are so thrilled! This is a link to her birth story in my DDC hope it works haven't posted a link here before.

http://www.mothering.com/discussions...2#post10358562


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## 2 in August (Jan 6, 2006)

Congrats!!


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## gossamer (Feb 28, 2002)

Congratulations!!!!!!!!! I am so thrilled for you.
Gossamer


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## mommylovesra (Aug 16, 2007)

Wow this is a wonderful thread. I have had preeclampsia in 3 or my 4 pregnancies. My last little boy was born at 34 weeks after 3 weeks of hospital bedrest. I am currently 23 weeks pregnant with my 5th child and already have had elevated bp and I am being seen every week. This is the earliest my bp has ever went up so I am terrified of getting PE again and having to deliver way too early.


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## Changed (Mar 14, 2004)

Subbing after reading YEARS of this thread.


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## mommylovesra (Aug 16, 2007)

Well I ended up stuck in the hospital on bedrest at 27 weeks for a month and then delivered my last little boy Randall on May 7th. He was 31 weeks and 3lbs 11oz. he spent 25 days in the NICU and had RDS, chest tubes for punemothoraxes and the a bout of NEC and 10 days of bowel rest and antibiotics. Thank goodness he is homw with me now and nursing like a champ. It was awful. I wish that there was some way to cure this awful disease preeclampsia. I ended up getting my tubes tied becasuse of the threat of pre-e happening again, I would not have otherwise.


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## sparklett (Nov 25, 2006)

Quote:


Originally Posted by *mommylovesra* 
Well I ended up stuck in the hospital on bedrest at 27 weeks for a month and then delivered my last little boy Randall on May 7th. He was 31 weeks and 3lbs 11oz. he spent 25 days in the NICU and had RDS, chest tubes for punemothoraxes and the a bout of NEC and 10 days of bowel rest and antibiotics. Thank goodness he is homw with me now and nursing like a champ. It was awful. I wish that there was some way to cure this awful disease preeclampsia. I ended up getting my tubes tied becasuse of the threat of pre-e happening again, I would not have otherwise.

Welcome home to your and your baby! I'm glad you made it so far in your pregnancy, despite the odds. So sorry about the pre-e.... it's just about the most awful experience ever. I hope you have recovered and that your new babe is doing well!


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## Maggirayne (Mar 6, 2007)

Wow, Gossamer, thanks for starting this thread, I hardly knew about Pre-e while I was pg. I plan on having my babies at home, but it is good to know what to watch for. I didn't understand before why high BP was so dangerous. I missed that it was related to Pre-e.

Did this get stickied, or is it kind of a question and answer thread? I only read the first page.


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## Jojo F. (Apr 7, 2007)

Thank you so much Gossamer for starting this thread, it will prove to be invaluable. And I don't think this did get stickied, but it sure should. I can't imagine why it's not









With DS I got pre-e and the doc never told me. I swelled up soooo bad and was still working- as a waitress!!!! I was left to my own devices and searching ability on the net to figure it out on my own and was furious I was not on bed rest. And now that I look back at it it makes me even angrier my old doc didn't seem to take it very seriousl or bothered to tell me anything about it. Near the end- about the second day of pre-labor- the lab even lost a gallon jug of my urine!! Saying, ooops, sorry.

I went into labor on my own at 38 weeks and when the labor stalled a bit I almost got an emergency c/s. Thankfully that put me into overdrive and I had DS vaginally at 7 lbs even. I was allowed an epidural and of course had evil pitocin. He was a bit jaundice but not bad and my placenta was completely gray- no pink at all, he HAD to come out.

This time around I am now 12 weeks and everything looks good. I will be seeing my new doc in a couple of weeks and plan on talking about pre-e more with him. He seems very concerned and is keeping a very close eye on me so I feel that I am in good hands.

A few posts up there was a Q about things to take for liver function. I was wondering about dandelion root tea. Would it be wise to drink a little every day and combining it with other liver supporting foods/drinks like beets, etc.? I also drink just a bit of kombucha every day- I was drinking quite a bit of it before I got PG and have cut back once I found out.


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## Jojo F. (Apr 7, 2007)

OK, so this right rib pain you talk about being linked to the liver, is in the front or back? I have been getting a pian for some time now that seems to go through me, on the right side, but is more waist level originating from the back of the ribs. Is this related? I don't see my doc for another week and a half but will tell him about it.


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## gossamer (Feb 28, 2002)

Quote:


Originally Posted by *Jojo F.* 
OK, so this right rib pain you talk about being linked to the liver, is in the front or back? I have been getting a pian for some time now that seems to go through me, on the right side, but is more waist level originating from the back of the ribs. Is this related? I don't see my doc for another week and a half but will tell him about it.


To me that sounds more like a kidney issue which I would definitely bring up with your Dr. The liver pain is high up in front above your floating ribs. Good luck this time around and yeah, it sounds like you had a crappy Dr. first time around. Thank God your son survived.


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## mwherbs (Oct 24, 2004)

the trouble with abdomnal pain is that it can be from just about any where- right side could be liver, kidneys , gallbladder or intestinal - liver and gall bladder pain can be so referred your back and shoulder may be what hurts--
talk to your provider


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## mommylovesra (Aug 16, 2007)

Quote:


Originally Posted by *sparklett* 
Welcome home to your and your baby! I'm glad you made it so far in your pregnancy, despite the odds. So sorry about the pre-e.... it's just about the most awful experience ever. I hope you have recovered and that your new babe is doing well!


He is doing great now he is exclusively breastfed and up to almost 13lbs at 5 months.


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## sparklett (Nov 25, 2006)

Quote:


Originally Posted by *mommylovesra* 
He is doing great now he is exclusively breastfed and up to almost 13lbs at 5 months.

Excellent!!! And I hope you are doing well, too!


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## mommylovesra (Aug 16, 2007)

I am doing okay. I am still on bp meds and have had to try a couple different kinds due to side effects and getting one that works. It looks like I will probably be a chronic hypertensive now.


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## sparklett (Nov 25, 2006)

Goodness!!! I'm so sorry. It took about 9 months for me to start feeling better; perhaps over time things will even out for you. For me, lots of exercise and a good diet (which included going vegan) allowed me to get off the meds and start feeling a bit better. But my doctor has warned me that thanks to the pre-e, hypertension will probably be something I will always have to worry about.

Our babies are almost exactly a year apart. DS's DOB is 5/8/07.

Take care of yourself, mama.


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