stillbirth due to PIH, no symptoms of PE??

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Re : stillbirth due to PIH, no symptoms of PE??

Postby laura » Wed Sep 08, 2004 11:01 pm

Dear Amanda-- I am so sorry about the loss of your sweet baby! I'm no doctor, but I think that if you look at preeclampsia/gestational hypertension as one big picture, it becomes a little easier to understand why the doc was so quick to pass the blame off on PIH.

They're (I mean researchers) are starting to think that preeclampsia begins in the earliest stages of pregnancy, when the placenta starts to form and attach to the uterus. The thought is that the vessels that "feed" our placentas are faulty-- they're not "deep" enough to feed the placenta. Sometimes it is worse than others- and some placentas are going to be worse than others. It is not a problem at the beginning- it is as the baby starts to get bigger and needs "MORE" that the vessels can't keep up, and the placentas begin to fail our babies.

Some speculate that the hypertension from Preeclampsia comes from a 'distress call' from the baby-- the baby needs more blood, more nutrients, more oxygen from the placenta, so the body rachets up the blood pressure to try to respond to this call.

There are two sides to these hypertensive disorders of pregnancy-- the first is, obviously the baby. This particular forum is a testament to how dangerous preeclampsia (and by that I mean the hypertensive disorders of pregnancy) is to babies. The other side of the disease process is danger to you. The proteinuria usually comes after the hypertension. The proteinuria is just a sign that this disease process has begun to damage *your* organs, and is not necessary to cause all the different dangers to baby- abruption, growth restriction, hypoxia, stillbirth-- which are all far more common with hypertensive pregnancies, even in the absence of diagnosed preeclampsia. And the weird and horribly scary part of it is that it seems to me like "too high" is a subjective thing-- some women can tolerate incredibly high pressures and suffer seemingly few effects, for others disaster came incredibly early- there's no ryme or reason to it.

I wish there was some way of predicting what will happen, of understanding what has happened- and I hope you find the answers you're looking for and the support you need. Please take care...

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Alicia (severe PE) 5/98 ~ Camille (htn, oligo) 4/03

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Re : stillbirth due to PIH, no symptoms of PE??

Postby angelkat » Wed Sep 08, 2004 08:20 pm


I am so sorry to have to welcome you to the grief and loss forum for the foundation.

I wish I could answer your questions but so much is still unknown about PE and causes.

Most women after having suffered a loss are desperate to start trying again to have another baby. My advise would be to see a high risk doctor (peri) first for a pre conception consult. To go over all your medical records, and to do some extra blood work. After the death of Katlyne I wanted nothing more than to start trying again for another baby. I think I drove my husband off the deep end with my desire and obsession. It wasn't until my daughters first birthday that we were both ready to start trying again.

My thoughts and prayers for comfort and peace are with you...

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Drew(14)PE 37 wks
Ky (12)PE 34 wks
~i~ Katlyne(12/9/02-04/02/03)25 wks
Casey - 34wks Born 7/29/04
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stillbirth due to PIH, no symptoms of PE??

Postby amcyates » Wed Sep 08, 2004 06:49 pm

Hello everyone. I've been exploring this site for the past week or so, waiting for a response from the "Ask the Experts" forum, and just now found this forum. I just recently lost my daughter, Lillian Grace, at 31 weeks on Aug. 11th and I'm increasingly confused about what caused her death and wondering if anyone here has a similar story or has heard of anything like this. She was my 3rd baby. With my first two pregnancies, my BP rose to near 140/90 (not sure exactly)right at the very end of my pregnancies. I was never diagnosed with PIH (or not told if I was), never had proteinuria or swelling, and went on to have two healthy, full-term babies. With Lillian, at my 25 week appointment, my BP was 90/60, which was on the low side for me (I normally run 120/80). 4 weeks later, at 29 weeks, my BP was 130/86 the first time my midwife took it. She seemed slightly concerned and took it again, this time she got 120/80 and seemed satisfied with that. I had no proteinuria. At 30 weeks I had some swelling (for the first time the entire pregnancy but that was after being at an all-day outdoor party in 90 degree weather. I wasn't a bit concerned, assumed it was normal and drank a lot of water and put my feet up. I do remember remarking to my husband that I wasn't peeing much considering how much water I was drinking. Anyway, the swelling was pretty much gone the next day. At 31 weeks, I noticed the baby wasn't moving and went to the E.R. to hear the dreaded words, "I'm sorry, there's no heartbeat." Shortly after finding out Lillian died, they took my BP for the first time. It was 190/120. I'm sure some of that was due to stress, but not sure how much. Again, I had *no* protein in my urine and no swelling. After delivering Lillian (she was 2 lbs, 13 oz. and 16 inches and absolutely perfect and beautiful), I was put on mag sulfate, as my pressure was still pretty high (running around 150/90 or so, with a few spikes every time I had an emotional breakdown). My BP was back to normal within 48 hours or so. We had an autopsy done and numerous blood tests. The only thing that came back abnormal was the placenta report. 25% of the vessels were occluded, which my doctor says points to PIH as the cause of death. Here is where I am confused. I had no protein in my urine ever, as far as I know, so I'm assuming that my PIH never progressed to PE. I can't find a single reference anywhere of PIH causing fetal death in the absence of PE. I don't know how my pressure could have been high enough to kill my baby, yet have no effect on my kidneys at all. Could something have been wrong with the placenta to begin with? Also, I've read so much on this site about headaches, vision problems, not feeling "right", swelling, right quadrant pain, etc. with PIH. I had none of this! In fact, I felt extremely well during this pregnancy. Better than I did in my first two. I remember commenting to my husband that I could hardly believe that I was in my 3rd trimester because I felt so good. I almost wish that we never discovered the occluded vessels in the placenta and the cause of death remained a mystery, because now I feel more confused than ever. In addition, I'm desperate to have another baby, but how in the world could I ever do this, when I don't *really* know what caused Lillian's death, and how could I ever know if I were in danger again, if I have absolutely no symptoms? Any thoughts or similar stories? All comments are welcome! Thank you, Amanda


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