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Pregnant again- High Risk

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Pregnant again- High Risk

Postby abell » Sun Dec 28, 2003 01:37 pm

Hello Everyone,

Just want to say this is an awesome website.
I had preeclampsia with my first pregnancy and gave birth to my daughter who was born at 34 weeks gestation and weighed in at 3lbs. 7 oz. 16 inches long. She was a whopper [:)]
I'm pregnant again and only in my 6th week. I still have high blood pressure and I'm on BP medicine. I was diagnosed with HB about 5 months ago.

I'm feeling good so far, but had some disturbing news last week- my blood tests came back that progesterone level is too low- only at an 11 and the Doc. wants it at least 20. The progesterone is what keeps you from losing the baby. I am on progesterone now but am concerned that this is only a sign of what's to come. I had this same thing with my first child- only at 7 weeks I almost lost her and that's when they put me on the progesterone.

I just want to know if there is anyone out there who had preeclampsia with their 2nd pregnancy. I have several factors - 1) Overweight- unfortunatly I gained a lot of weight with Madison and I haven't lost much of it. 2) Have pre diagnosed HB (usually runs about 140/100)
3) had Preeclampsia with 1st child.

If anyone can give me any advice- I'd appreciate it.

Thanks-

Amanda
1st pregnancy - preeclampsia @ 33 weeks gestation- and pregnant again!
abell
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Re : Pregnant again- High Risk

Postby momathelete » Sun Dec 28, 2003 06:41 pm

Amanda,

Congratulations!!! I actually went the opposite direction with my three pre-e pregnancies. They got better, the more I had. The last one I ended up with just PIH, which even though does not help the baby too much (smaller gestation growth), I was in pretty good shape. I would start to prepare/focus on what would happen if you have to be on bedrest. I know, your first thought is -how can I do that? I felt the same way! I went on complete bedrest at 22 weeks and I had a boy who just turned 3 and a girl who was 17 months. It was hard and stressful, but it was doable. It is doable!! You need to help this baby stay in you a long time!!! I don't want to scare you, maybe you will be fine, just high bp. That would be great. Just try to do everything the perinatologist tells you, take your supplements and go easy on yourself. My first baby, I had HELLP and my second just went to pre-e. Still scary, but how great is that? It is great that you are searching for information, that is your best weapon against pre-e! Stay in tune with your body, demand diligent care. Don't be afraid if you sound like a whining annoying pregnant lady. You are protecting your baby. Wouldn't you jump in front of a moving train to save your daughter? Picture yourself doing the same with this little sprout inside you. I am very excited for you! Congrats and hang in there!!


Michelle
mom to Cole Thomas -former 28.5 weeker (3-5-99, 3 lbs)due to HELLP and Madelaine Grace "Lainey" -former 29.5 (10-11-01, 3lbs 4oz)weeker due to Pre-E and had PIH with Elisabeth Rose (Ella) -37 weeker,born June 30th 2003 weighing 5 lbs 12 oz and beautiful.
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Re : Pregnant again- High Risk

Postby akemt » Sun Dec 28, 2003 10:45 pm

Amanda,

The stats on getting PE with chronic hypertension is 1 in 4.

Congratulations on your pregnancy! Our due dates are very close! Hopefully things will go well for both our pregnancies this time around!

Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo
Baby #2 due August 11, 2004
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Re : Pregnant again- High Risk

Postby abell » Wed Dec 31, 2003 01:47 pm

I'm so appreciative that you 3 replied to my message. It's nice to talk to others who have been or are in the same situation.

I had a little scare this week. Monday I went in for some blood work and I guess with it and the Progesterone meds I'm on I got real dizzy and my speech was slurred, I was stumbling and so I visited my OB and they took my BP and it was 144/100 so they had me to go to the ER.
The ER ran some blood work and urinalysis and everything came up fine. I was scared.

I have noticed my fingers are already swelling. They did a test for protein and said that I didn't have any. I asked them if it was possible to get PreE this early in a pregnancy- they said it's rare but possible. Have you ever heard of that???

Anyway- Wanted to say Thanks to those that replied. You guys are great. What is HELLP? And PIH? I wonder if I had something more severe- that what I knew. Honestly my Dr's weren't very informative. I'm not going to a perinatologist- just an OB. But my friend is a nurse in that office so I know they are watching me close and will take good care.

I know it's a waiting game to see how things work out. I go in next Friday for my 1st real ultrasound. Hopefully we will be able to see the baby.



Amanda
Mommy to Madison- born 05/24/02 34 weeks gestation due to severe PE. 3 lbs. 7 oz. 16 inches.

Pregnant Again! EDD 08/20/04
abell
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Re : Pregnant again- High Risk

Postby mada » Wed Dec 31, 2003 02:19 pm

Hi Amanda,
Wow that must have been scary for you. I am glad you are feeling better. It osunds like the docs are doing a good job for checking all the things that should be checked. (bp protien ect.)Pih is a form of preeclampsia. It is pregnancy induced hypertension. Hellp syndrome is a very serious form of pe that causes the liver and kidneys to stop working. This is why they look for protien in the urine and do blood work to see how liver and kidney funtions are. It sounds like all that turned out okay. I would remain vigilent and ask lots of questions. I hope all is good and let us know how you are doing...

Mada Harpster

Sam 6-29-00 36weeks P.E.
Ben 11-03-01 No P.E.
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Re : Pregnant again- High Risk

Postby laura » Wed Dec 31, 2003 02:29 pm

Hi Amanda- my (non-medical[:)])guess would be that if you were to develop protein at this point in your pregnancy, it would probably be more of a function of the chronic hypertension than necessarily developing PE- And it also seems that I remember that one of the docs mentioned that people with chronic hypertension often are sensitive to progesterone.

I found this interesting article about hypertension and sensitivity to progesterone here:
http://www.hhmi.org/news/lifton2.html

Hopefully soon, they'll be able to stop the supplemental progesterone and maybe your pressure will drop![:D]

I did have severe preeclampsia with my first pg, but with treatment for my hypertension I did not develop it again with #2, even though it looked pretty scary for a while.

Are you on antihypertensive medication? It's entirely possible and even likely that if you have chronic hypertension and you developed PE, it was especially severe- that is considered chronic hypertension with superimposed preeclampsia, an especially dangerous kind of PE.

PIH would be pregnancy induced hypertension- new onset pregnancy hypertension without proteinuria.

Chronic hypertension is preexistant hypertension and hypertension appearing before 20 weeks.

Preeclampsia would be new onset hypertension (140/90) after 20 weeks with 300 mg protein in a 24 hour urine.

Superimposed preeclampsia is preexisting hypertension and proteinuria- in one sense it's harder to diagnose, because the hypertension was already there. It's hard to tell if it's "just" chronic hypertension or actual preeclampsia until a person is already sick.

Hellp is a little different- it stands for the changes in liver function that often accompany this type of PE- Hemolysis, elevated liver enzymes, and low platelets. It is a more rare form of PE, and doesn't always follow the most common path of PE.

Hang in there- you're asking all the right questions, and I'm keeping my fingers crossed that you have a nice, long, uneventful pregnancy!

Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/
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Re : Pregnant again- High Risk

Postby laura » Wed Dec 31, 2003 02:32 pm

Sorry my post was so hastily composed! My youngest is just embracing the crawling stage, and is apparently fearless. I'm forced to post quickly as if expecting the next disaster presently[:p] talk about waiting for the next shoe to drop! *sigh*

Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/
laura
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Location: Anchorage, AK

Re : Pregnant again- High Risk

Postby abell » Wed Dec 31, 2003 02:56 pm

My goodness- you are smart!!! Are you a Dr??? Man
I have Chronic Hypertension with this baby.
With my 1st I didn't have hypertension before I got prenant- so I guess I just had Pre E- b/c I did have the protein in my urine. My baby also had stopped moving (acidosis) so they had to induce.

You were so informative- keep the info coming. The fact that my BP got so high the other day while I was on BP meds scared me- b/c I'm only 7 weeks along. I'm thinking OH bOy= what is to come??

quote:


Hi Amanda- my (non-medical[:)])guess would be that if you were to develop protein at this point in your pregnancy, it would probably be more of a function of the chronic hypertension than necessarily developing PE- And it also seems that I remember that one of the docs mentioned that people with chronic hypertension often are sensitive to progesterone.

I found this interesting article about hypertension and sensitivity to progesterone here:
http://www.hhmi.org/news/lifton2.html

Hopefully soon, they'll be able to stop the supplemental progesterone and maybe your pressure will drop![:D]

I did have severe preeclampsia with my first pg, but with treatment for my hypertension I did not develop it again with #2, even though it looked pretty scary for a while.

Are you on antihypertensive medication? It's entirely possible and even likely that if you have chronic hypertension and you developed PE, it was especially severe- that is considered chronic hypertension with superimposed preeclampsia, an especially dangerous kind of PE.

PIH would be pregnancy induced hypertension- new onset pregnancy hypertension without proteinuria.

Chronic hypertension is preexistant hypertension and hypertension appearing before 20 weeks.

Preeclampsia would be new onset hypertension (140/90) after 20 weeks with 300 mg protein in a 24 hour urine.

Superimposed preeclampsia is preexisting hypertension and proteinuria- in one sense it's harder to diagnose, because the hypertension was already there. It's hard to tell if it's "just" chronic hypertension or actual preeclampsia until a person is already sick.

Hellp is a little different- it stands for the changes in liver function that often accompany this type of PE- Hemolysis, elevated liver enzymes, and low platelets. It is a more rare form of PE, and doesn't always follow the most common path of PE.

Hang in there- you're asking all the right questions, and I'm keeping my fingers crossed that you have a nice, long, uneventful pregnancy!

Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/



Amanda
Mommy to Madison- born 05/24/02 34 weeks gestation due to severe PE. 3 lbs. 7 oz. 16 inches.

Pregnant Again! EDD 08/20/04
abell
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Joined: Sun Dec 28, 2003 01:13 pm

Re : Pregnant again- High Risk

Postby laura » Wed Dec 31, 2003 07:11 pm

No doctor[8D]-but you sound just like me when I first found this place- definitely under similar circumstances, though your hypertension's starting earlier than mine!

My pressures were rising through my second trimester, and by the time I was 24-8 weeks, I was swollen and starting to spill protein and had a rapid pulse! I was terrified, to say the least. Meds helped with all of that.

I think that's why you should definitely need to see a peri. It would probably be a good idea to keep a pretty tight reign on that Blood Pressure- hypertension can influence the baby in more ways than just developing preeclampsia, and a peri would probably be your best bet for finding the right treatment for that. Please let us know how you're doing!!!

Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/
laura
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Joined: Tue Jan 28, 2003 12:17 pm
Location: Anchorage, AK

Re : Pregnant again- High Risk

Postby akemt » Thu Jan 01, 2004 10:07 pm

Laura's definately right about that! Sorry, about the high BP affecting a baby more than simply giving it's mother preeclampsia. Not that preeclampsia is by any means simple! She and I both had to go through what is called Oligohydramnios. Basically, it is low amniotic fluid caused by poor perfusion in the placenta, caused by the high bp. For me, I already had this problem when I was diagnosed and my bp's were still fluctuating...not even a consistant high. They have to watch you very closely because it can mean the baby isn't getting enough nutrients, blood and oxygen. And also if your levels get low enough, the baby's own weight could collapse it's umbilical cord. I hated the oligo even more than the PIH, even though the PIH was the cause. lol They don't just take the baby to prevent any problems, they wait untill your levels are VERY, VERY low, the baby's heart rate is showing signs of distress, or untill the baby's weight falls (in my case 3 weeks) behind. It was awful waiting for something to go wrong. I knew my daughter was healthy and just wanted them to take her before anything happened. Many people couldn't understand why I would rather have a preemie than wait and wait. Laura understands though. Love ya Laura [;)] Don't get me wrong, I'm glad Emma was able to be safely delivered at 37 weeks and wasn't preemature at all. So, here's my bit about keeping your BP under close wraps and making sure they monitor you closely...and your baby!

Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo
Baby #2 due August 11, 2004
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