Outcomes after first preg. w/sPE + deliv. before 34 weeks

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Expand view Topic review: Outcomes after first preg. w/sPE + deliv. before 34 weeks

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by caryn » Mon Mar 04, 2013 04:36 am

Welcome. I'm so sorry to hear that you lost your son to this brutal disease.

LDA is low-dose aspirin. There are some meta-analyses of research data that suggest it might lower risk slightly; there are some trials that suggest that it does not, except maybe in a small subset of women who could not be identified from the studies. In any case it does not harm (or at least no harm showed up in the very large trials that were conducted.)

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by luizaiulia » Fri Mar 01, 2013 09:39 am

jean » Lost my son also at 36 weeks due to PE, 10 days ago. My hart is broken. What is LDA? >>You wrote :


{Our second son was born at 39 weeks gestation in Nov of 2011. No HELLP or pre-e! Took LDA starting at week 12 and went off of it at week 38!}

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by kaxy » Sun Jan 27, 2013 10:14 am

So interesting. I conceived my daughter when I was around 16ish months postpartum, and had PE with both kids. I'm now expecting my 3rd, conceived when my daughter was 25m. I hope it'll improve my outcome somewhat! I've gotta have something positive here :)

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by caryn » Sat Jan 26, 2013 01:01 am

Trophoblast is *weird* so no one is really sure. It is difficult to research because it's adapted for an environment that's difficult to recreate in a lab (inside a uterus, in the lining, which is mostly natural killer immune cells from another individual) and we can't really go looking during a pregnancy. I've seen some studies showing persistent remodeling effects up to seven years postpartum and others (like this one) that suggest that the majority of the remodeling is gone by 2 years postpartum.

I wonder if some trophoblast are carrying genes that mean they persist longer, or their remodeling effects persist longer. I would like to know!

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by jean » Sat Jan 26, 2013 09:08 am

And when does the trophoblast die off? After 26 mos pp?

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by jean » Sat Jan 26, 2013 09:06 am

I'm not sure if my first was a decent sized kiddo or not...he was behind in growth a week..born at 29 wks at 2lbs 1 oz.......then with my second he was decent sized, but was FT...so if we were to try for a third, would it still be best for us to try to get pg within 26 mos of the previous pg?

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by angieb » Tue Jan 22, 2013 09:12 am

Hmm.

So would this change after multiple pregnancies? (Based on the theories), or would every pregnancy be the same/ "starting over"?

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by caryn » Thu Jan 17, 2013 01:42 am

We're not anywhere close to an exact science on this yet... :( There are something like 240 genetic networks involved, and all we've got at this point is guesses about strategies. The ways to protect the life and health of an IUGR baby are more robust than the ways to protect the life and health of both participants in a HELLP case, so if I were a doc and having to give my best advice on a strategy, I'd probably pick the same one they recommended, for what that's worth. I'm so not a doc, though, just a curious voracious reader.

This is just a really rough decision for anyone to have to make. Gentle good wishes to you and yours.

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by LeosMom » Thu Jan 17, 2013 11:40 am

Thanks for the explanation Caryn! Unfortunately, I had HELLP with an IUGR baby (born 1 lb 15 oz at 29 weeks). So, I'm not sure where I fit in. Blargh, I hate this condition so much!

Re: Outcomes after first preg. w/sPE + deliv. before 34 week

Post by caryn » Wed Jan 16, 2013 05:34 am

I also had a decent-sized kiddo with sPE at 34 weeks - and prior miscarriage. My guess there? My kid *would* have been a HELLP baby with a standard implantation - because he was metabolically demanding - but the placenta couldn't implant quite that well, because my immune system was cranky and kept it from doing so.

This syndrome is weird - but I think of it as a targeting problem coupled to an arms race. The race is between maternal and paternal strategies designed to control depth of implantation, and the targeting problem is getting just the right depth. At a conference this summer on this problem a lot of the researchers were saying that it might be the case that our predisposition towards some cancers might be a consequence of our need to tolerate invasive placentas to reproduce. So strange.

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