to induce or not to induce...

[expert@preeclampsia.org]

My wife was diagnosed with PE recently at 30 and 5/7 weeks. She has been in the hospitalized for 2 days now and has been honored with the designation of severe HELLP syndrome. The physicians have asked us if we would like to have labor induced or a c-section. My wife of course wants a natural child birth. I on the other hand would like to have a wife and a baby. I am concerned for my wife since tests indicate her liver is hemorrhaging and compounded with other HELLP symptoms a lengthy induced labor could make thing very difficult. The physicians have not advised me which is better for my wife and/or the baby even after asking the direct question, "Which method of delivery will give the mother and child a higher chance of survival and less complications considering the diagnosis of severe HELLP syndrome and bleeding liver?" They say, "I don't know." This makes me very uncomfortable hearing this reply from her doctors. I have asked for a specialist of course but would like the input of experts on his site.

Latest test results:

Liver enzymes in the 3k, BP 160/100, platelets in 120-130 range. Trending upwards.

[expert@preeclampsia.org]

There are two basic reasons to have a cesarean section in a patient with HELLP: 1) the baby cannot tolerate labor. It has decelerations with contractions; 2) the disease process in the mother is getting worse rapidly; BP no controlled, plt count falling rapidly.... That said, most women we care for are too sick (mother or more commonly baby) to have a vaginal delivery.

It can take days to get a woman at 30 weeks into labor. This depends on how favorable a cervix that you have. The decision to have (or really need) a cesarean is usually not a casual decision based on patient preference. You look for indications for cesarean. Ask your doctor, what would be the "indications." If an induction of labor is attempted, you must be prepared to change course rapidly and have a cesarean if the baby's or mother's condition begins to deteriorate.