Can bed rest help with pre eclampsia??

This section is for discussions with other women who have probably been through the same signs/symptoms that you may be experiencing. Please note, we cannot offer medical advice and encourage members to discuss their concerns with their doctors. New members, come on in and introduce yourself!
User avatar
caryn
Forum Moderator
Posts: 10203
Joined: Fri Jun 25, 2004 06:36 am

Re : Can bed rest help with pre eclampsia??

Postby caryn » Sat Apr 22, 2006 00:49 am

There's a new Cochrane database update on this issue:

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

It concludes:
"Current evidence is insufficient to support recommending rest or reduced activity to women for preventing pre-eclampsia and its complications. Whether women rest during pregnancy should therefore be a matter of personal choice."

fnaz
Registered User
Posts: 280
Joined: Mon Mar 20, 2006 02:18 pm

Re : Can bed rest help with pre eclampsia??

Postby fnaz » Fri Apr 21, 2006 06:05 pm

i have the same symptoms. My BP elevates 15-20 mmhg, if i sit up from lying position. it make a huge diffrence. It is next to impossible to have total bed rest at home..

deerhart
Registered User
Posts: 3282
Joined: Thu Jan 30, 2003 08:54 am

Re : Can bed rest help with pre eclampsia??

Postby deerhart » Fri Apr 21, 2006 04:39 pm

Another point on bedrest, unless your in the hospital, you would be REALLY suprised by how much rest your actually getting.

Even though I was on strict bedrest with my oldest, I was still getting up every 20-30 minutes for either a snack, drink or to use the restroom (restroom usually LOL). It was well documented that, for me, even moving into a prone position, from a laying down position, would elevate my BP back up to around 140/98 after roughly 30-60 seconds. It would then take 10-15 minutes AFTER laying back down for it to drop down below 140/90.

What that meant, was if I had to get up every 30 minutes for 5 minutes (thus 5 minutes up 25 minutes down), over half the time I spent laying down was not giving me the desired benefit of a lower BP.

User avatar
caryn
Forum Moderator
Posts: 10203
Joined: Fri Jun 25, 2004 06:36 am

Re : Can bed rest help with pre eclampsia??

Postby caryn » Fri Apr 21, 2006 04:14 pm

Actually, bedrest *can* hurt -- bedresters are at much higher risk of bone demineralization, pulmonary embolisms, muscle loss, depression... and so forth.

megansmom
Registered User
Posts: 768
Joined: Tue Nov 11, 2003 06:16 pm

Re : Can bed rest help with pre eclampsia??

Postby megansmom » Fri Apr 21, 2006 01:55 pm

I personally think it depends on the situation. With DD#1 it seemed the longer I laid there, the higher my bp went up. So it didn't help at all. With DD#2 it stayed down as long as I didn't get up. I managed to get in 4 weeks on bedrest before delivery. I did get up to go to the bathroom and take a shower, but that was it. They didn't even let me sit up to eat. So, yes, I think it can help, and definitely won't hurt.

countrymom2e
Registered User
Posts: 134
Joined: Mon Nov 14, 2005 09:05 am

Re : Can bed rest help with pre eclampsia??

Postby countrymom2e » Thu Apr 20, 2006 09:59 pm

I was diagnosed with PIH at 27 wks and put on bedrest - and my protein was elevated at 30 wks. My p-e has been mild, and my BPs labile. They vary from 120/70 to 160/95. When I sit up for any length of time, my BP rises. When I rest, my BP is lower. My protein was also lower during my last 24 hr urine.

That said, I am certain I would have had to deliver earlier if my BPs were not low on bedrest. With severe p-e, I don't think that bedrest would make a difference. But for borderline or mild p-e, I think it has helped. Not only are my BPs lower on bedrest, but my son is measuring 90th percentile, and is very active on my NSTs and u/s.

As my MW said - not sure it will help, definately sure it can't hurt. I'm now in my eighth week of bedrest and am grateful to have made it this far. But I don't have any preconceptions - I know my p-e is progressing, I can feel the changes in my body as it does.

marybees
Registered User
Posts: 24
Joined: Tue Apr 27, 2004 03:49 am

Re : Can bed rest help with pre eclampsia??

Postby marybees » Thu Apr 20, 2006 06:48 pm

For me I don't think bedrest really did that much good.Basically within 10 days of my blood pressures elevating and despite bp meds and bedrest my son had to be delivered at 30 weeks.my protein skyrocketed,my liver enzymes shot up and my platelets began to fall.I don't think there was an intervention that would have changed the end outcome.Believe me I have tried to find a reason why everything went so crazy so fast.I studied over my medical records,labs etc...I asked myself could I or the docs have done anything different and the answer was no.It is so hard to accept at times.
mary

User avatar
caryn
Forum Moderator
Posts: 10203
Joined: Fri Jun 25, 2004 06:36 am

Re : Can bed rest help with pre eclampsia??

Postby caryn » Thu Apr 20, 2006 00:51 am

The thing about bedrest is that we often try it in second pregnancies, when we're already known to be at risk of PE. But second pregnancies are also much less likely to be PE pregnancies, so we can't say that the bedrest necessarily helped -- maybe it was just that it was a second pregnancy, and it was going to be easier on our bodies anyway.

There's a lot of research support these days for the idea that PE is an immune system response, and that the immune system is likely to respond less to the foreign placenta in subsequent pregnancies, though that doesn't always happen. In PE the placenta is usually shallowly implanted into the uterus, and can't get enough blood to the baby after the baby starts to really put on weight -- which is also likely why PE babies are usually small for gestational age.

Although there are lots of reasons bedrest might be biologically plausible, it hasn't turned out to actually help much in any of the studies that have been conducted. That means it's likely that even though those reasons sound like they make sense, that they're not actually going to affect the process of the disease much. Science's best guess at this point is that the symptoms of PE happen when the placenta finally can't get enough blood to the baby for whatever reason. Bedrest won't necessarily fix that problem if the placenta is too small, or if it's shallowly implanted into the uterus -- there will be a limit to how much blood the placenta can ultimately ferry regardless of whether or not you have lain down.

Aside from that, as everyone else said, in severe PE cases bedrest just really isn't an option. Severe PE is defined as a patient past the threshold for multiple organ failure -- the high proteinurea is a sign of kidney failure, the bad liver values are a sign of liver failure, the high bp is into stroke category, the visual disturbances and seizures are a sign of cerebral swelling, and so on. There are severe PE cases where hospital bedrest on mag sulfate has postponed delivery -- by a few days at most, until the placenta fails enough to stop transferring enough blood to the baby to keep it alive, and it abrupts from the uterine wall.

My bedrest lasted 48 hours -- long enough to get steroid shots for my DS -- and at the end of it my bp had spiked up to 220/116 on IV mag sulfate and labetalol, and my platelets were borderline HELLP, and my baby's BPP had come back at a 4/10 ("if past 26 weeks, deliver"), and he'd started having heart decels. I was just really lucky to go haywire at 33 weeks 5 days -- and my heart breaks for all of the women here who were not so lucky.

Be gentle with yourself, and take care,

deerhart
Registered User
Posts: 3282
Joined: Thu Jan 30, 2003 08:54 am

Re : Can bed rest help with pre eclampsia??

Postby deerhart » Thu Apr 20, 2006 00:35 am

I spent 13 weeks on bedrest with my oldest. It did not stop my condition from progressing, but it did help to lower my BP for about 4-6 weeks. But as time passed it lowered less and less.
Despite the bedrest, my son dropped from the 80% in weight prior to onset to 5% in weight at birth (in comparison, with my youngest son I had liable BP from 30 weeks on that was still staying relatively decent except when it would swing every once in a while, my doc delivered as soon as my BP went up and stayed up because I was 36 weeks. He was a week earlier then my oldest and weighed well over a pound more then him).

The only reason my doctor kept me on bedrest as long as she did was because I was getting a benefit of having my BP drop when I was laying on my side. We also allowed my health to deteriate pretty seriously to give him as much time as possible. I did have pretty much every symptom under the book except protein. Even with a good outcome, I still question what was the right decision and when as my health was horrible for the next few years after my oldest was born (and it took another complicated pregnancy and about another year after that so 4-5 years after my first bout to get my health straighened back around)

PE does not present the same way in all woman and there is no way to determine how its going to progress in a given situation. All that can be done is to take what is in front of you and apply the best logic and reasoning to deduce how to achieve the best outcome possible at the time. Hindsight is always 20/20 and there are always things in all of our experiences we can look back on and say.. hmm maybe if they had done this or that things would be different now. But what you don't know is even if they did those tings if it would have really changed the outcome at all.

thw75
Registered User
Posts: 509
Joined: Mon Oct 31, 2005 06:45 pm

Re : Can bed rest help with pre eclampsia??

Postby thw75 » Wed Apr 19, 2006 09:48 pm

Ditto to what everyone said. Personally, I delivered at 27 weeks with #1 and no bedrest and 36 weeks with #2 and 3 mos of partial bedrest.


Return to “Ask the Experienced”

Who is online

Users browsing this forum: No registered users and 2 guests