Oh dear, I seem to have missed this thread. :(

Preeclampsia means the placenta is busted. The very first thing that happens in pregnancy is that the cells that go on to form the placenta implant, and in women who develop any of the variants of preeclampsia (PE, PIH, HELLP, whatever your care provider labeled you as having) that implantation goes wrong in a way that means that the mother's immune system has trouble tolerating the placenta.

They actually use the term "breakdown of maternal tolerance induction" a lot in the research papers. It means just that the placenta isn't able to coax the mother's body into a normal pregnancy. We - the human community, including the scientists who work on this - have frankly *no idea* how immune systems tolerate foreign organs through an entire pregnancy. And not just tolerate, but supply with oxygen and nutrients. With any other foreign organ, you'd see graft-host disease and rejection and dead people within a few days, at most, without powerful drugs designed to suppress the immune system. And investigating this scientifically is very hard, for practical and for ethical reasons.

No, it is not something you did. Promise.

I don't smoke and my placenta was very small too.

My understanding is that preeclampsia effects the placenta, in whatever way...hopefully Caryn will chime in on that.
I don't think that smoking at the very beginning would be the cause, here's a link to a thread about smoking during pregnancy reducing the risk of HELLP by 80%:
https://www.preeclampsia.org/forum/viewtopic.php?f=85&t=38605
HTH,
Mindy

Yep, mine was small too. And I did everything by the book in my pg. I don't think your smoking caused it.

I think that preeclampsia and HELLP are incredibly complex issues and not caused by one thing like smoking. (in fact I think a couple studies have even shown lower rates of PE in smokers) The pathology report on my placenta also remarks about how small it was, even for at placenta at 24 wks. My baby also had IUGR. I always assumed that the process of preeclampsia contributed to the size of the placenta, not the other way around.

After I had my daughter almost 6 years ago, now, I can remember the doctor remarking how small my placenta was. She was born with IUGR...4 lbs, 8 oz at 38 weeks. The pathology report said I had a small placenta, but no clots. I also hate to say ...but before I was found out I was pg, and I was not TTC, it was a total oops, I was a smoker...but as soon as I saw the positive pg test, I have not had a cigarette..so now it has been almost 7 years and I have not smoked one. I quit cold turkey.

Could the smoking of caused the small placenta and caused the pre-e/HELLP...or did the pre-e/HELLP cause the small placenta.

This seems like an endless search for answers.

thanks.