risk of PE again after twins

[expert@preeclampsia.org]

With my first pregnancy, I developed PE at 27 weeks and made it to 31 weeks on strict bedrest. At the time of delivery, my BP was 210/110 and I had 3+ protein in my urine. I was also in preterm labor (which was a surprise to me). My MZ twin boys were born by emergency c-section with no benefit of steroids for lung development and were in the NICU for about 6 weeks. The only long-term effect on my twins is that they both have severe asthma.

It is now 5 years later and I am pregnant for the 2nd time (in a different city with a different OB). I am currently 21 weeks pregnant with one baby. My OB and perinatologist do NOT feel that I am at high risk for either PE or preterm labor with this pregnancy because both of those were most likely caused by having twins in my first pregnancy. The perinatologist said that I didn't need to see her at all for this pregnancy (after I saw her for an Ultrascreen for Down's at 11 weeks).

Should I be worried that neither doctor is too concerned about my history with PE? Can having PE with twins negate the increased risk for PE in subsequent pregnancies? Or am I just being paranoid because of the difficult experience I had with my first pregnancy?

[expert@preeclampsia.org]

A prior pregnancy with preeclampsia is, in general, a risk factor for recurrence. It may not be great, but it is there. Prior preterm labor is also a risk for recurrence of PTL. Your doctors are probably thinking that since this is not a twin gestation and not the first pregnancy, the risk is low for recurrence. You doesn't necessarily need an MFM, but your OB should be attentive to possible recurrence from 28 weeks onward in my opinion.