I am nearly 45 years old and facing an unexpected second pregnancy. I experienced toxemia in my first pregnancy at age 41 and delivered a 5lb 12 oz. baby 36 1/2 weeks early. I have a strong family history of heart disease (my father died at age 43;grandfather age 55) and I have started to see a cardiologist for preventive measures. My concern is the risk of getting pre-eclampsia again, particularly at an earlier phase in the pregnancy and possibly delivering a severely premature baby. My OB is nonchalent about the chances of getting toxemia/pre-eclampsia again and says I got it late in pregnancy last time and we handled it and not to worry. My cardiologist is equally nonchalant but does say pre-eclampsia does increase my probability for high blood pressure earlier in my lifetime. But everything I've read says I should be concerned especially given my family history of heart disease. What should I do or what can I do at this early stage? Am I being too concerned as my OB and others suggest? Is it a huge risk to be pregnant at age 45? Can I get pre-eclampsia earlier in pregnancy even though the first time was later in the pregnancy? What are my risks compared to women who do not have a family history of heart disease?