how do you determine recurrence risk?

[expert@preeclampsia.org]

So before I was discharged from the hospital I had one ob tell me that PE wouldn't happen again... it wasn't likely and he still went with the old rule of if you switch partners the risk went up (which I've read research since that completely disputes this).

Then at my 6 month post partum appt the ob (a new one, I moved) said, oh you have maybe a 10% chance of developing it again, usually only in people with underlying high b/p. She hadn't even read my old chart yet and I had told a resident my story... so I don't even know what she knew.

So how do they get these numbers? My b/p is still not down to normal and I'm unsure if it every will be (baseline was 90/60, now I stay in 100-115/ 70-low 80s range)... everytime the diastolic is 80 I hear well, maybe it's from being in the office (at home I was getting 72-78 diastolic). I had s/s starting at 32wks w/o showing protein on the dipstick, at 35-36wks it worsened and I had a 24 hr urine that showed 1150 and then one started 24 hrs later showing 1350.

How do they determine risk? I definetly think my chances are lower than someone who developed this much sooner... and in my head I tell myself it won't happen again. I just feel like this new ob just poo pood it like, oh it's not gonna happen... like if you don't put it in the patient's mind, it won't happen.... I guess I want to know the risk for sure. It's different now that I have my daughter to think of when trying for a second. I will be trying another ob from the group. I just didn't feel comfortable with the first one I saw for many reasons.

So is there a tool you use to determine risk? Is this something widely used and approved by your professional organization (is it through an association of OBs or Peris)?

[expert@preeclampsia.org]

To the best of my knowledge there are no industry standards for assigning specific risks for the individual patient to develop preeclampsia again. They vary according to the author, to the type of preeclampsia under study, and the patient. In general and according to my experience and understanding, the earlier a prior instance of preeclampsia occurred during gestation, and if severe, increases the chance of a patient to have it in a subsequent gestation. We have not reached the point of having enough specific endpoints to reliably risk assess the individual patient, so a given patient is likely to receive variable responses from different physicians.