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Preeclampsia Associated W/ Persistent Postpartum Cardiovascu

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Preeclampsia Associated W/ Persistent Postpartum Cardiovascu

Postby caryn » Mon Feb 27, 2012 03:41 pm

by caryn (10111 Posts), Mon Feb 27, 2012 03:41 pm

http://hyper.ahajournals.org/content/58/4/709.short

The majority of preterm preeclamptic women have stage B asymptomatic heart failure postpartum, and 40% develop essential hypertension within 1 to 2 years after pregnancy. Women with a history of preterm preeclampsia may benefit from formal cardiovascular risk assessment in the 1 to 2 years after delivery to identify those who would benefit from targeted therapeutic intervention.

Have you had a formal cardiac workup? I'm thinking I need one.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
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Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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Re: Preeclampsia Associated W/ Persistent Postpartum Cardiov

Postby alviarin » Tue Feb 28, 2012 02:20 pm

by alviarin (1635 Posts), Tue Feb 28, 2012 02:20 pm

I did after my second round of preeclampsia and my blood pressure never quite came back down to my pre-pregnancy baseline. I went to the cardiologist and my heart checked out ok. My HDL levels are low though.

Since I'm hypertensive I'm on a low dose of BP meds to help lower my long-term risks.
Hypothyroid mom to Connor and Claire
(severe pre-e at 38 weeks & "mild" pre-e at 37 weeks)
& baby Annabelle
(chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)
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Re: Preeclampsia Associated W/ Persistent Postpartum Cardiov

Postby kerisue » Tue Feb 28, 2012 05:21 pm

by kerisue (623 Posts), Tue Feb 28, 2012 05:21 pm

I didn't just have asymptomatic postpartum heartfailure, I had symptomatic heart failure during the pregnancy! My heart has since returned to normal, but my primary care doc has been very reluctant to do any more aggressive testing/treatment for cardiovascular disease. I'm guessing she is not up to date on this research, but I may push it a bit more now.
Mama to Millie
born June 2010 @ 24 wks. gestation due to my severe PE and CHF
lived 25 days, loved and missed
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Re: Preeclampsia Associated W/ Persistent Postpartum Cardiov

Postby caryn » Tue Feb 28, 2012 10:55 pm

by caryn (10111 Posts), Tue Feb 28, 2012 10:55 pm

I'm not entirely sure what to think about more screening, actually. We're already known to be at high risk of heart disease, and if it's asymptomatic but we're already doing the things we're supposed to be doing to strengthen our hearts and manage our existing risks, then I'm not sure a screening test would provide more information. I wonder if there would be anything we would do differently if they did an echo and found something, or if it would just be an expensive test that says yep, you're still supposed to get more exercise and keep your weight down...
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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Re: Preeclampsia Associated W/ Persistent Postpartum Cardiov

Postby sam10 » Wed Feb 29, 2012 11:51 pm

by sam10 (1436 Posts), Wed Feb 29, 2012 11:51 pm

I never quite found more detailed information about the type of cardiovascular disease that PE ladies are at risk for. Any reference I have found usually just mentions that women who have had PE are at higher risk for cardiovascular diseases. Is there any more info available on that?
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
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Re: Preeclampsia Associated W/ Persistent Postpartum Cardiov

Postby JB » Thu Mar 01, 2012 01:10 am

by JB (57 Posts), Thu Mar 01, 2012 01:10 am

My OB just had me get an EKG, but I haven't gotten the results yet. She is very cautious and has had me get every test imaginable to get a baseline of my health for this pregnancy, in case I develop PE again. She ordered it when she realized my nephrologist hadn't ordered one yet. I was seeing a nephrologist instead of a cardiologist for my post-PE hypertension care because I only have one kidney and need to have it checked out once a year anyway, but now my OB is managing all my care. My mom jokes that she is only ordering all these tests because I have insurance that will pay for them, but they do make me feel better (at least I know she is taking it seriously).
1st - miscarried at 11 weeks in Dec. 2009
2nd - baby girl born Mar. 2011 at 29 weeks 6 days due to severe PE
3rd - baby boy due June 19th, 2012
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Re: Preeclampsia Associated W/ Persistent Postpartum Cardiov

Postby jean » Sat Mar 03, 2012 11:29 am

by jean (675 Posts), Sat Mar 03, 2012 11:29 am

So my question is, does the pre-e cause the heart issues, or do the heart issues cause the pre-e?
Our first son was born and passed in Feb of 2010. Born at 29 weeks due to HELLP and passed due to NEC. We miss him every day. :~(

Our second son was born at 39 weeks gestation in Nov of 2011. No HELLP or pre-e! Took LDA starting at week 12 and went off of it at week 38!

http://findingtherainbowconnection.blogspot.com/
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Re: Preeclampsia Associated W/ Persistent Postpartum Cardiov

Postby mom41 » Sat Mar 03, 2012 12:16 am

by mom41 (20 Posts), Sat Mar 03, 2012 12:16 am

I believe pre-e is a risk factor for peripartum cardiomyopathy - form of congestive heart failure, usually temporary. It seems like pre-e accelerates/unmasks htn. I had an EKG and Echocardigram done and was able to reach almost my baseline exercise capacity by re-joining the gym after my pre-e pregnancy. I see a cardiologist for chronic htn once a year. He did not feel I needed a stress test or anything else.
son 4/2004 subchorionic hematoma but full term, healthy
1/2011 stillborn twins (IVF) due to severe IUGR/ pre-e 23+3 wks, chronic htn
Jason born 3/21/12, 35w 6 days, healthy 4 lbs 15 oz, 18 in, no pre-e but oligo/iugr, 1 week of NICU for hypoglycemia and mild RDS, doing great ! (thank you labetalol, lda, lovenox and my drs!)
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Re: Preeclampsia Associated W/ Persistent Postpartum Cardiov

Postby caryn » Sat Mar 03, 2012 04:08 pm

by caryn (10111 Posts), Sat Mar 03, 2012 04:08 pm

PE causes the heart issues, possibly because we are predisposed to develop them. The form is basically "busted left ventricle" because of the higher pressures we sustain, from what I can tell. It says At 1 year postpartum, asymptomatic left ventricular moderate-severe dysfunction/hypertrophy was significantly higher in preterm preeclampsia (56%) compared with term preeclampsia (14%) or matched controls (8%; P values <0.001). The risk of developing essential hypertension within 2 years was significantly higher in both preterm preeclamptic women and those with persistent left ventricular moderate-severe abnormal function/geometry.

So over half of us have *persistent* - which means it stuck around postpartum - left ventricular hypertrophy, which means the left ventricle had to work hard, got bigger, and created functional problems with how the heart pumps blood.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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Re: Preeclampsia Associated W/ Persistent Postpartum Cardiov

Postby jean » Sat Mar 03, 2012 10:36 pm

by jean (675 Posts), Sat Mar 03, 2012 10:36 pm

Is it still an issue if the person never develops high bp again?
Our first son was born and passed in Feb of 2010. Born at 29 weeks due to HELLP and passed due to NEC. We miss him every day. :~(

Our second son was born at 39 weeks gestation in Nov of 2011. No HELLP or pre-e! Took LDA starting at week 12 and went off of it at week 38!

http://findingtherainbowconnection.blogspot.com/
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