Finding a peri for second pregnancy

[Mari2012]

Hi everyone--I am new here. I have a 10 month old daughter, delivered at 28 weeks due to severe HELLP. Fortunately, we are both healthy and doing great now. I would like to have a second child, but am afraid of dying, losing my kidneys and/or liver. As a first step, I would like to consult with a perinatologist and have some questions for those of you who have been there and done that.

First, how did you find your doctor? Do you think it would be worth it to travel out of time just to do a preconception consult with an expert? Has anyone done a phone consult with an out of town doctor?

Thanks so much for any info. you can share about your experience with second pregnancies.

[angieb]

I like the www.smfm.org website for finding a peri/mfm. (Just an fyi, maternal fetal medicine specialist/perinatalogist are the same thing, pretty much.)

I might travel out of town for an opinion if necessary, but I would stick to my area first. You will find that since there is no cure/prevention, MFM's opinions can differ even within the same practice. For me, it was important to find an mfm who was comfortable managing my pregnancy (they don't see a lot of HELLP at 23 wks), that I was comfortable with, and a plan that I was also comfortable with. I saw 2 different doctors pre-conception and had 2 totally opposite opinions. It ended up working out.

[Mari2012]

Thank you so much for responding and congratulations on Baby #3. Did your doctor prescribe the Lovenox for the HELLP or another underlying condition? Were there any differences in how your second pregnancy was managed?

[alexis]

The SMFM website is a good resource (just FYI, we are not allowed to name/recommend specific doctors on the forum).

Does your OB have someone s/he consults with? That might be a good start because that would be who you would deal with if problems arose in a subsequent pregnancy.

I would personally be fine traveling for a one-off consult, but the possibility of continuing care would factor into my decision.

Lovenox is normally prescribed for women with underlying clotting disorders. It doesn't prevent preeclampsia/HELLP as such (which is why it's not used on everyone) but on women who have specific issues.

I am a chronic hypertensive and my MFM pre-conception consult was basically "Stay on your meds, yes, those are fine; nothing else to do, we won't see you if you don't develop problems." BUT, I had a known risk factor, no sign of anything else, and the treatment for what I have is known, so my experience is not really applicable to you. If you have not been tested for underlying issues, then an MFM would be the person to see.

[Mari2012]

Thanks Alexis, appreciate the information.