PET help- chances of it happening again- DVT

[expert@preeclampsia.org]

I am after some help regarding pre-eclampsia. I am 19 years old, and located in Australia.

I had my first baby in July 2006, and had a fairly uneventful pregnancy until 40 weeks + 5 days when my weekly visit to my birth centre showed that my blood pressure was quite high- I have no history of high blood pressure and during my pregnancy it was mostly 115/70. This day it was quite high, arounf 135, and when the midwife gave my a urine test is showed 3+++ proteins. I didn't experience any unusual swelling that made me take notice, but over here routine weighing is no longer practice so I really wasn't watching my weight at all and looking back, none of my coats fit me around my arms, didn't catch on to me then it was with fluid.

I refused induction on that day, and discharged myself out of hospital because noone would give me a straight answer about what was going on. I knew what PET was, but I didn't think it could occur so late.

I came in the next day and my blood pressure was a bit higher. They put me on some medication and began the induction. I had a normal vaginal birth, my baby was born 40 + 6 days, and with medication my BP stabilised after four days, though I was kept on the medication a further six weeks, decreasing the amount of doseage every few days. I have had no further history of HBP. I did, however, suffer from DVT after the birth, with many clots in one of my upper arms. I was on blood thinning medications before they subsided. I had no previous history of DVT.

I am pregnant again now, baby due in January 2008, when I will be 20. I was forced to go off the pill earlier than I had hoped because the authorities were getting worried with the migraines I was experiencing and that they might be related to DVT. My husband and I did not have any other contraceptive options available to us that would still allow us to conceive again later in the year.

I am now worried that I will develop PET again, and that it might be more severe than it was before. I know the figures for women experiencing it a second time when they had severe PET the first time around are 1 in 20, but was mine severe PET? I had a grandmother have PET in her first pregnancy, does this effect my likelyhood at all?

Hope I will get some answers for my questions as I have had next to no support for this.

[expert@preeclampsia.org]

Upper extremity thrombosis is unusual, and if it is not related to previous trauma demands a medical evaluation more pronounced than the genetic evaluation of those with preeclampsia and thrombotic episodes go through. The story of migraines reinforces this. Thus one should ask the patient if she was thoroughly evaluated by a medical specialist postpartum, and hopefully checked for thrombophilias by her obstetric care givers.

At any rate this patient's second pregnancy is high risk, best handled by caregivers who specialize in these risky gestations, and they may wish to institute prophylactic anticoagulation.

Also, the incidence of repeat preeclampsia here is closer to 20% than one in 20 (even though the presentation was quite late.)