I don't think there is a standard workup. Many docs seem to check for APS, but I'm not sure why, or just what - apart from history of PE - leads them there! Absent any particular persisting complaints, screening for autoimmune conditions can be like taking a shot in the dark...

Do you think there's additional pre-conception testing I should seek? I don't know what autoimmune disorders might be relevant or any of that. I'm not sure if it would change anything, though.

At any rate, if I am pregnant again I'll see someone else!

Yeah, see, I would want a *plan* that took PE seriously, 'cause I'm like that. I don't really find it reassuring when docs are casual about this at term, because anyone who gets it is still really, really sick.

He didn't really have a plan for me, just said they'd watch me close. I think it would be reasonable to consider induction if I was full term and my BP was already starting to go up, but I didn't have full-on pre-e yet. It's a good question to ask future care providers, what they'd want to do with me!

Did the MFM suggest inducing a bit earlier - 38 weeks or so - to avoid the onset of PE? Our Experts have mentioned that as a strategy for women who develop PE postpartum: http://www.preeclampsia.org/forum/viewtopic.php?f=19&t=224&p=58286

Since you've developed it twice during labor, you've got *something* going on, because it is generally a disease of first pregnancies. If it shows up in a subsequent pregnancy, odds are you have an underlying condition (which could just be the genes for being susceptible to it developing in labor) which makes it more likely that you'll get it again. But usually women who develop it at term do not scare docs at all; they are used to seeing it in about one of twenty pregnancies and don't worry about it the way we do. I'd say anyone who's had this is justified in wanting to gestate in the hospital if that would help, and that if you haven't found a doc you trust to care for you in a subsequent pregnancy, to find someone that you *do* trust to take this condition seriously.

That is good to know your experience.

If there's nothing else they can really *do* for me right now, then I probably wouldn't want another pre-conception consult. But, if I found out that I had some really crazy underlying disorder, I might reconsider going for another baby. It's just hard to say.

Many of these ladies use an OB and an MFM or just and MFM... I think maybe it is just personal preference and doctor preference. I was not overly impressed with the MFM I saw for our pre-conception consult before my 2nd pregnancy either. She didn't have much to tell me, really. I learned more from the PF website and the ladies on this forum! I would have had to specifically ask for testing of underlying disorders - my OB only mentioned it casually as something we *could* do if I wanted to. (I opted out because my first pregnancy -when PE commonly strikes- was also a multiple = double whammy.) Honestly, that sounds like what many doctors would say, from what I have heard.
But I'm sure some other ladies who have used MFMs can weigh in more on this.

I saw a MFM for a pre-conception consult. I had pre-e with both of my 2 children, and the onset was practically identical -- borderline high glucose levels for my one-hour glucose, suspected IUGR, and BP creeping up once I was full term.

No protein spilling until active labor, thankfully. I am so blessed to have been full-term and already in labor both times when it was diagnosed.

Scary stuff, though.

I would like another child. I went to the MFM to have them run labs and see what they wanted to do with me. He did a 24-hour urine collection and some misc. bloodwork and it all came back fine. I'm not sure if he checked for any specific autoimmune diseases or other underlying causes.

He said I most likely would develop pre-e again and didn't have any suggestions for me.

Not really a fan of that guy. Not sure if anyone else would tell me anything different?