Second Pregnancy Advice after Early Severe Pre-E?

[Nickipetersen@hotmail.com]

Hi everyone-
I have finally managed to repress enough memories of my pre-e experience with my first baby that I am actually trying (and excited) to get pregnant again! I was wondering if I could ask some of you who have been through a second pregnancy after having early onset pre-e a few questions...

1. What should I expect/demand from my high risk obgyn during this pregnancy? (frequency of visits, tests, etc.)

2. Based on all of the research and your own personal experience, is there anything that you would recommend that I do during this pregnancy (i.e. certain diet, supplements, vitamins, etc.)? I have tried to research this for the past 18 months (that's how old my daughter is now) and I can't seem to find anything consistant so I'm curious to hear from people who have probably also done a lot of research.


Thanks in Advance for any advice, insight, or ideas!!!
-Nicki, my daughter Ellie is now a very healthy 18 month old after being born at 28 weeks due to severe pre-e

[angieb]

Personally, I see an OB and MFM. Mainly because my MFM has a partner in her practice that I don't particularly care for (bad previous experience), and if I had her doing my delivery, if she wasn't on call or was out of town or whatever, I could end up with any of her partners. (My OB delivers most of her own patients and only has 1 partner who I like well enough.) Also, personally, for me, having more eyes watching me (my OB and MFM don't mind working together and will talk to each other as needed), made me feel better, though for some people I guess that could be confusing or too much. I see both doctors starting about 6 weeks, every 4ish weeks, with monthly growth ultrasounds as well. My appointments are staggered so I see my OB one week, then two weeks later see my MFM, then see my OB again, so I see *someone* every 2ish weeks generally. My OB generally kept me on the 4 week schedule until I was 30ish weeks, while my MFM started seeing me every other week once I got to 23 weeks (when I developed hellp in my first pregnancy), and then once I got around 29 weeks, I started seeing her every week.(So it wasn't really that necessary for me to see both in the same week, especially when my blood pressure was normal and I had no suspicious symptoms.) I started NST's and BPP's and fluid checks at 29 weeks, 2x weekly, it was not really the best idea to start them so early because DS routinely failed them (and stressed me out!) until 32 weeks when magically he started passing them and was perfect the rest of the time. So I think 29 weeks, for us, was just a little early and overkill for the monitoring, it didn't reassure me he was okay since he wasn't passing them, and I wasn't having any symptoms or signs of anything wrong, so really, all it mostly did was stress me out. Next time I will ask to wait until at least 32 weeks, as long as I don't have any symptoms or signs of trouble.

I was on blood thinners- low dose aspirin and lovenox. Certainly ask your doctors about it. (I don't have a known clotting disorder, but they strongly suspect I have one that they may not have a test for.) I didn't diet or do anything differently except was closely monitored.

Good luck!

[alexis]

Welcome to the forums!

Often, how OBs and MFMs split duties is down to the specifics of their practice (ie, some MFMs do sole care, some MFMs only do consult). So visit frequency, who does what, etc, will depend on that. Clear as mud? Generally, they will want a baseline 24 hour collection in your first trimester. They'll also do a color doppler with your anatomy scan to check blood flow.

So far, we don't have any general purpose preventatives. Some MFMs recommend low dose aspirin, but not all. Lovenox is recommended if you have clotting factors. Did they do blood work to see if you had any underlying risk factors? These may warrant treatment individually.

Diet has not been shown to do anything for preeclampsia. Vitamin supplementation has not panned out (though if you've been told to supplement for other reasons--low iron, low vitamin D, extra folic acid--do continue to do as your OB/MFM recommends).

Have you had a preconception consult? This might be a good idea if you are not yet pregnant and your MFM can lay out a plan for how s/he would manage your next pregnancy.