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Re: Pregnant after HELLP - lots of questions

Posted: Wed Jul 15, 2015 06:56 pm
by laney_p
Yeah, you'd think after all these years of studying preeclampsia, there'd be more that we can do! But at least it sounds like you are in good hands.

Re: Pregnant after HELLP - lots of questions

Posted: Tue Jul 14, 2015 04:34 pm
by KeepSwimming
Thanks for the responses! I had my 1st appt today w/ my OB, who is already a MFM. I am kind of surprised because he said other than baby aspirin, we won't really do anything different this pregnancy unless I start showing symptoms again. He always listens to me though so I know if I'm feeling off and just ask him to, he will order lab right away. I will definitely be buying my own BP monitor b/c that was one of the issues last time. The nurses only do manual BP there and I think they read lower than they should (today I was 90/60 supposedly).

I wanted to take the fish oil for my own health and DHA for the baby, so that's reassuring. I will definitely be prepared and all packed up for a RCS as I learned my lesson last time...just really really hoping I can VBAC, especially since I will have a toddler to chase around this time too.

Re: Pregnant after HELLP - lots of questions

Posted: Mon Jul 13, 2015 05:03 pm
by laney_p
Hi there,

First of all, congrats! We will all be hoping for a totally PE-free pregnancy this go-around. :)

JenH gave a great response, but just to add to that, the U.S. Preventive Services Task Force (USPSTF) published a review last April talking about the relative risks versus benefits of aspirin to help lower women's risk of preeclampsia ( Generally speaking they found that the benefits outweighed the risk, and found that there was no statistically significant impact on risk of placental abruptions, postpartum hemorrhage, or miscarriage to the mother.

And yeah, we wish there was an easy way to prevent preeclampsia, but hundreds of studies of calcium, protein, vitamin D, vitamin C, and other supplements found no real benefit to a population with good nutrition, like most of the developed world. :/ But the studies keep going, and we really are at a much better understanding of the disease even than we were five years ago! So hopefully we will have more treatment options and preventatives down the road.

Re: Pregnant after HELLP - lots of questions

Posted: Mon Jul 13, 2015 02:09 pm
by jenh
Welcome and congrats on your pregnancy!

1. I would make a plan for both a VBAC and a RCS. It's good for any woman, regardless of risk factors and best-case wishes, to think through what she would want in various situations.

2. The most recent research I saw found low dose aspirin does NOT increase the risk of abruption. However, if you happen to have an abruption while on LDA, the bleeding will be worse than if you had an abruption without LDA.

3. Fish oil and other dietary supplements won't help with PE/HELLP. If you want to take them for your general health or because you have a specific deficiency, go ahead, but don't count on them to save you from PE.

Pregnant after HELLP - lots of questions

Posted: Sun Jul 12, 2015 10:02 pm
by KeepSwimming
I've been reading through the forum trying to gather info after finding out I'm pregnant w/ #2, and was hoping to find the most current evidence on a couple of issues. I had an emergency C/S at 38 wks for HELLP. I never had protein in my urine and my BP, while elevated for my baseline, only got up to 140/90. I'm now pregnant with #2, completely naturally after doing IVF w/ my first! The only difference is I have been on Metformin to manage my PCOS.

1. Am I totally crazy to hope for a VBAC? I expect them to monitor me more closely, especially w/ labs, but I already go to a high risk OB. I wonder if my pre-e was linked to IVF triggering an immune response, and/or insulin resistance, and if things will be better this time as my body worked on its own and I take Metformin.

2. I saw some discussion about the possible benefits of low dose aspirin not outweighing the increased risk of abruption. What is current thought on this? I had a lot of workup done for infertility, and my only issue revealed from labwork was the PCOS. I know my OB plans to put me on baby aspirin as a general protocol.

3. Also wondering about fish oil/omega 3 supplementation as that seems to be discouraged here?