Order of Events in PE

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Order of Events in PE

Postby Scottishgirl » Sun Mar 24, 2013 03:47 pm

Hello everyone, I'm 32+2 in my 2nd pregnancy & finding it pretty nerve-wracking.

In my 1st pregnancy, I had severe PE diagnosed at 28.5 weeks & delivered at 29 weeks due to my baby having severe IUGR & me developing HELLP syndrome. I didn't have any symptoms at all (or risk factors) so was just on the standard low risk pregnancy protocol. Everything was fine at 22 weeks, but I only found out at my next appt (28 weeks) that I had severe PE. I had no idea anything was wrong, it was such a shock. My little boy survived against the odds, and we're so lucky to have him, but it has not been an easy journey.

So I am wondering about the chain of events that leads to PE. My question is: is hypertension always the 1st indication that something is wrong? (or can it be something else eg low fluid around baby, slowing growth, etc). Does PE have an "order" of events unfolding, or can it be random?

I am being seen weekly & having blood pressure/urine tests weekly too, plus fortnightly growth scans & dopplers.

Last week my BP was good 115/75 (it's usually about this level or lower), there was a trace of protein (which I have had on & off the whole pregnancy so far) and the baby's abdominal circumference centile had dropped a little, the doppler was good (o.56 resistance). But I was in a bit of a panic, and wondering if it was the start of things again?

I just feel like a bit of a time-bomb, waiting for things to go wrong.

Thanks for reading, I'm interested to hear what others think.
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Re: Order of Events in PE

Postby MomTimesThree » Tue Mar 26, 2013 04:19 pm

From reading stories here, and our two pre-e pregnancies there doesn't seem to be a strict order to things. Each case seems very individual.

I so hear you on feeling like a time bomb! It's no way to go through a pregnancy, and yet it seems thats the way it happens for so many of us. I tried best I could to focus on one day at a time, and when that sometimes felt like too much- just one foot in front of the other.

Keep posted when you can!
Lauren
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
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Re: Order of Events in PE

Postby Scottishgirl » Wed Mar 27, 2013 03:05 pm

Hi Mom, and thanks for your reply. It's good to "talk" to someone who understands.

I saw my midwife earlier & she answered my question: PE doesn't always start with high blood pressure. Mine is still good at 120/68 & I had a trace of protein. My midwife said that it can start with proteinuria, raised dopplers etc. So I thought I was doing well, when I might not be.

I got to see the hospital's notes from my appointment last week - baby's abdominal circumference has dropped over the last few scans, from the 95th centile to the 50th. The head is around 50th, so I wasn't too concerned, but I will be if there's a further drop next time.

I'm being scanned again next Wednesday & will know my answer then. I'm wondering if I'll get steroids & a date for a section - or how long they'll let me go. Am terrified of intra-uterine death & also worried for my baby (my son measured 24/25 weeks at 29 weeks).

If I could get to 36 weeks I'd be having a party!
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Re: Order of Events in PE

Postby MomTimesThree » Wed Mar 27, 2013 06:38 pm

Glad you got further reassurance from your midwife. I'll be keeping all crossables crossed that you continue to have smooth sailing and make it to 36 weeks and even beyond without any complications! Please keep posted after Wednesday's appointment- I hope baby levels off at the 50% level- a great place to be, especially close to delivery! :) A baby in the 95%... oy! :)

Lauren :)
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
MomTimesThree
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Re: Order of Events in PE

Postby aundapenner » Thu Mar 28, 2013 12:00 am

I had PE in both of my pregnancies. Though my 2nd pregnancy was a worse case of PE, I felt much better, partly due to the fact that I knew what I was up against.

In my 2nd, I was here in Germany, where I was seeing someone quite regularly - which is sounds like you are too! Good for your docs and midwife to keep track of things. My first pregnancy went haywire right around Easter weekend - that was when I was put on bedrest.

Good luck and try to enjoy as much as you can. :) Waiting for the other shoe to drop was a standard for me too, but knowing it was probably my last pregnancy, helped me to enjoy more than I had during my first (where I just felt fat and bloated, not pretty and certainly had no clue how serious things really were.)
Alice - survivor of PE twice and mama to Heinrich (Henry), May 2006, born at 34+2 at 4lbs 5 oz and Sofia, February 2009, born at 37+1 at 6lbs 5oz.

Very thankful for the PF - who I found after Henry was dealing with preemie issues.
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Re: Order of Events in PE

Postby Scottishgirl » Sat Mar 30, 2013 03:17 am

Thanks again for your replies.

I had a look through my notes last night; I noticed that my AFI is on the lower side of normal (it was 9.9 at 32 weeks) so that, in combination with the reducing abdominal circumference, is concerning me. Initially I was quite pleased the AC was reducing - 97th centile was a bit much & I was worrying about GDM.

I have to admit I'm not enjoying this pregnancy at all - after nearly losing my little boy 1st time, then 2 miscarriages (one of which was a molar pregnancy), I just want baby out safely.

Will keep you posted on how Wednesday goes.

Thanks for listening!
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Re: Order of Events in PE

Postby MomTimesThree » Tue Apr 02, 2013 09:46 am

Hope tomorrow goes well and those numbers all level off right where they should be. I know AFI can really bounce around.

I hope you're able to find moments to enjoy the pregnancy, I know its so hard to do after complications.

Lauren
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
MomTimesThree
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Re: Order of Events in PE

Postby Scottishgirl » Wed Apr 03, 2013 03:19 pm

Thank you, Lauren.

Today went well :D

BP was good, urine clear, CTG tracing five, good end diastolic flow, baby on 50th centile. The only "fly in the ointment" is the AFI - it's around 10.

So I see my consultant next week & will have all of the above tests repeated before I see her - fingers crossed!!!
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