What IV Fluids should be avoided during delivery with pre-e?

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brandib
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Re: What IV Fluids should be avoided during delivery with pr

Postby brandib » Thu Jul 20, 639256 12:28 pm

haha Laura, I guess I'm just realllly special lol :0)

laura
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Re: What IV Fluids should be avoided during delivery with pr

Postby laura » Thu Jul 20, 639256 3:32 am

@brandi: the good news is that plenty of women with preeclampsia are able to avoid the mag! Most of it is determined by how sick you are when they decide to deliver and whether they suspect that there's central nervous system involvement- which can lead to eclampsia. I've often said that the forum is a repository of worst case scenarios- but statistically, most women won't get as sick as many of us have! It helps sometimes to keep that in perspective.

Big picture: 10% of all pregnant women will have some sort of hypertension. 5% will have the diagnostic criteria for preeclampsia. 1% will get severe preeclampsia. A fraction of that will get HELLP. an even smaller fraction of that will develop eclampsia. Mag would be expected in that 1% with severe disease.
Mom to Allie (1998, severe PE)| Camille (2003, oligohydramnios )|the Dude (2007, chronic hypertension)
The Captain is my hero!

brandib
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Re: What IV Fluids should be avoided during delivery with pr

Postby brandib » Sat Jul 08, 639256 11:02 am

I believe the swelling is mainly due to preeclampsia. You have to stay hydrated so they have to give you the fluids and if you ever get preecampsia again, I don't think you can delivery without the mag or at least avoid it....I have heard of women getting to deliver without it and then running it 24 hrs after delivery, but I think you still get it reguardless.

laura
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Re: What IV Fluids should be avoided during delivery with pr

Postby laura » Tue Jun 27, 639256 8:57 am

Me! Me! I know about this! For some reason, after I have my babies, I swell up like the Stay-Puft Marshmallow Man- in large part because of the extra fluids they give you for Csections. I ended up readmitted with severe HTN and PP preeclampsia with my first, and with pulmonary edema after my third.

I asked my doc about why I do that and she said that after you deliver your hemodynamics go a little haywire as your system starts to adjust back to normal blood volume and for some reason my system tried to hang on to the fluid. If I were to have another, I'd just mention it to the anesthesiologist and ask that they reduce the fluid given via IV to the minimum. I'd also talk with my primary ob and peri about it early on, so that they can take some time and absorb how that plays out and factor it into your treatment plan.

Hopefully, if you have another child, you'll deliver *before* you need mag, so they'll be able to reduce your fluids if only for that. I can say with complete honestly that each delivery for me has gotten easier, as I learned more about how my pregnant body acts, and use that information with the doc to come up with the best course of action for me specifically. hope that helps- just remember you know so much more now than you did the first time and that can make it easier.
Mom to Allie (1998, severe PE)| Camille (2003, oligohydramnios )|the Dude (2007, chronic hypertension)
The Captain is my hero!

alviarin
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Re: What IV Fluids should be avoided during delivery with pr

Postby alviarin » Thu Mar 16, 639256 12:13 am

Hi I was given mag and saline with pre-e with my first. I was also extremely swollen. I was on restricted fluids (I think they were concerned about possible pulmonary edema and the fact my fluid ouptut had dropped). The saline was just to keep me hydrated. I was given a diuretic after delivery.

I'm not a doc but the swelling associated with preeclampsia is because your blood vessels become a bit "leaky" so that fluid leaks into surrounding tissue. So unless they were pushing a ton of fluids I'm guessing the swelling was due to preeclampsia not fluid intake.

If you decide to try again you could schedule a pre-conception appointment with a MFM specialiazing in high risk pregnancies. I saw a MFM during my second pregnacy. She answered all my questions, tested me for underlying disorders, and laid out a more frequent monitoring schedule.
Hypothyroid mom to
Connor (severe pre-e at 38 weeks)
Claire (dx'd with pre-e and induction at 37 weeks)
Annabelle (chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)

vit9109
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What IV Fluids should be avoided during delivery with pre-e?

Postby vit9109 » Wed Mar 15, 639256 3:55 pm

Hi Ladies,

I had a severe case of PP Pre-e after the birth of my first son. He is now almost two. Of course the thought of having another child weighs heavily on us, and we want it very much yet want to make a very educated decision on how to go forth. So today I started thinking of my previous experience and for some reason focused very much on how I looked after I gave birth. My face was extremely swollen, hands, feet,etc. When I smiled I could almost feel my eyes shut because of all the extra fluid. I was in labor for about 27 hours and pushed for 6. Which most people tell me you should not go beyond 4 hours of pushing. I feel the doctors should have looked at me and thought this amount of swelling is not normal. Days following my blood pressure sky rocketed to 220/110. I was put on Mag for 24 hours as well as IV BP meds. I was on BP meds 6 months and am now BP med free. My BP runs 1 teens/59-69 So my question is this.....

1. If someone has a history of pre-e, are there certain IV fluids that should not be given. For example, would you give a Pre-e patient normal saline? I was given that before they knew I had pre-e. All my symptoms presented after delivery. But it makes me wonder if the normal saline that I received for 27 hours exacerabated my condition??

2. After pre-e with baby #1, how would they monitor you baby #2? I guess I am worried about the delivery in what IV fluids they would choose and how they would monitor me so that I am not fluid overloaded? ( My husband and I are not pregnant at this time).

Wanted to get thoughts on this to see what others have experienced.
As a side note, I needed the IV fluids because I was receiving an epidural.


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