Did I wait too long to TTC?

Are you considering having another child after preeclampsia? Trying again after preeclampsia can be an emotional challenge. You can find support with others who share your concerns here.
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riehlism
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Re: Did I wait too long to TTC?

Postby riehlism » Thu Mar 10, 2011 06:27 pm

They typically do pathology reports on the placenta looking for microclots, which corroborates the preeclampsia dx. In preeclampsia is definitely a fight between the placenta and the mom. One of the more popular theories is that it is due to poor implantation. The code for implantation is found in Dad's sperm. Sometimes poor implantation takes place because the burrowing of the embryo is too shallow...perhaps the blood-rich lining of the endometrium is too thick or too dense for the embryo to burrow through.

It's thought that in the first trimester the blood vessels and in the umbilical cord distend and grow. In a case where preeclampsia may be present, bloodflow between mom and placenta is restricted (maybe due to poor dilation). So the placenta sends off these hormones because it's essentially "hungry for blood" thus raising mom's BP, etc. This creates a scenario of an apparent immune response--hence the baby aspirin so this doesn't start in the first place.

Baby aspirin is far too small a dosage to break down a clot, but it does keep things more fluid. A recent study published by OBGYN shows a meta-analysis of various research studies done in the past. It was promising study not just because it shows that those who take LDA have more favorable subsequent pregnancies, but it also helped to support the above theory I described in terms of its pathophysiology. Oh, and another tidbit I've shared before on this site is that preeclampsia used to be called toxemia. Tox for toxic or bad, emia for blood. But probably because of the eclamptic seizures women have they decided to call it preeclampsia instead of toxemia. All for the best since it's not 100% proven to be a pure blood disorder. Like many of us, we're fine in that department.

So while there are a slew of possible factors, the information in my previous post was stemming from that recent study. I guess we'll see what they come up with tomorrow.
Jasmin: Severe PE/HELLP and delivered at 24+6 & PCOS (29) Hubby Bubby, Frank (29)
Baby Blue stopped in to say hello and goodbye on 6/3/10
Baby Lucas was born on 10/13/11, PE and HELLP-free! Thank you baby aspirin and Lovenox
http://www.ehd.org/pregnancy-calendar.php?id=18192

Lee Ann
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Re: Did I wait too long to TTC?

Postby Lee Ann » Thu Mar 10, 2011 03:33 pm

I am on LDA to hopefully prevent my body from developing an immune respone to the fetus. No clotting concerns though. Preeclampsia is not necessarly a problem with clotting. In fact physicians have several theories about what causes preeclampsia although they still are not completely sure what that is. I think it is important to add that the single most important risk factor for developing preeclampsia in a subsequent pregnancy is a history of having it in a prior pregnancy. The earlier a woman is diagnosed with preeclampsia (before 28 wks) in a pregnancy the greater her risk (50-70%) of devloping it in a subsequent pregnancy. The percercentages help guide physicians when counseling women about their risks with another pregnancy. While it is true that no doctor can tell us for certain when we will get it again....it is important that woman should know their individual risk factors. They will be different for each individual woman. For example, a women who developed preeclampsia before 28 wks, has a BMI greater than 30, maternal age is 36, hx of chronic hypternsion and metablic syndrome would be at a very high risk of developing preeclampsia again. A woman who developed preeclampsia at 34 wks, no history of hypertension, normal BMI, and who is 28 yrs old may have a lower risk of developing preeclampsia again in another pregnancy. So, we really have to look to see how many risk factors women may have. The more risk factors for preeclampsia the higher the percentage that she may get it again. Sounds dire, but that is pretty much what the research tells us....YUCK!

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riehlism
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Re: Did I wait too long to TTC?

Postby riehlism » Wed Mar 09, 2011 08:07 pm

Please remember that when a doctor gives you the percentage happening again, it is only the percentage of you getting diagnosed with it and does not necessarily equal in severity. This is why it is often reported that in subsequent pregnancies, it is less severe as the first. While you may get preeclampsia, it may be very mild, and even closer to the end of pregnancy, which significantly decreases the severity. In that case, you got preeclampsia, which holds true to the statistic. But that statistic does not measure how "bad" it gets.

I agree with Danielsmom in that your maternal age maybe more of a concern. The tidbit you heard about how far apart pregnancies are an increasing your chance of getting it again has roots in maternal age. Results are better when you have babies close together, but that has to do with the age of the mom. Increasing maternal age, in general, increases your risk for preeclampsia. In addition, there is a theory that if you have babies close together your body remembers how to "handle the situation."

In short, while you don't like what your MFMs have said...in the end no one knows if it will happen again. There are women on this site who have had worse outcomes with each pregnancy, while most have improved outcomes.

My MFM told me there's no way to know for sure until you get there.

The LDA is fine. It's actually something that a lot of doctors endorse for general health. Since preeclampsia is related to blood clotting, the LDA keeps your blood more fluid. ***I've qualified this statement in another post since it may have caused a bit of confusion*** :D

Sorry, but it's a tough decision. Good luck.
Last edited by riehlism on Thu Mar 10, 2011 07:24 pm, edited 2 times in total.
Jasmin: Severe PE/HELLP and delivered at 24+6 & PCOS (29) Hubby Bubby, Frank (29)
Baby Blue stopped in to say hello and goodbye on 6/3/10
Baby Lucas was born on 10/13/11, PE and HELLP-free! Thank you baby aspirin and Lovenox
http://www.ehd.org/pregnancy-calendar.php?id=18192

Lee Ann
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Re: Did I wait too long to TTC?

Postby Lee Ann » Wed Mar 09, 2011 04:58 pm

Hi Anne,

My advice and remember it is only my advice, would be to start trying now if you want a baby. Unfortunately, as we get older the possibility of conceiving gets more difficult. I am 36 and my doctor just told me that my egg quality was not the greatest and that it will be difficult for me to become pregnant without any help (fertility drugs or invitro). Of course this has upset me, I did become pregnant within my first year of trying with my first child and unfortunately developed severe preeclmapsia at almost 24 wks. My daughter lived for almost 3 months and passed because of an infection of her bowel that is so common in premie babies. I only waited 7 months before trying again and after trying for almost a year with no success, I went to the doctor and I was told my egg quality was not the greatest. I am devasted and we are thinking of invitro, but I am afraid that invitor will make my risks even greater! So, if you plan on trying start now. My risk of getting preeclampsia again are 50-70% because I had it so early in my pregnancy. You are at risk because you have had it before so talk with your doctor about your concerns. Only you will know if the decision is right for you.

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bordergurl72
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Re: Did I wait too long to TTC?

Postby bordergurl72 » Wed Jan 26, 2011 03:40 pm

claricemaala wrote:By the way you had mentioned that there is a correlation pf pre e episode in relation to the timing of next pregnany. I am wondering if you have the article to support this? I have been looking for it or did your doctor mentioned it to you?
Thanks in advance


i actually read it on here somewhere, but I can't remember the exact place...but it said something like waiting over 5 years in between pregnancies can increase the risk, because I suppose if we do it before then, our bodies are still in the "pg mode" or something like that and it makes it easier for our body to remember what to do. Don't quote me on it at all, that is just what I took away from it.
Anne, 39
DH, 47
Daughter born March 2005 at 38 weeks at only 4 1/2 lbs. by emergency c-section. Severe PE, HELLP & IUGR.
36 weeks of carefree PG, then it all went downhill and had an excruciating 2 weeks of pain and brushing off by Dr's until being properly diagnosed and delivered at 38 weeks. Since then have been diagnosed with celiac (2009) and Hashimoto's (2011).
Terrified to TTC, but really want to TTC.

christina89
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Re: Did I wait too long to TTC?

Postby christina89 » Tue Jan 25, 2011 08:31 pm

I to am so scared, I thought I would have time to think or something after we started TTC. But the very first time we tried I got pregnant, I am now 6 weeks scared outta my mind. I had early onset delivered at 23 weeks. I have never been told anything about the space in between pregnancys. I am 7 months post partum and like i said 6 weeks pregnant so we waited 6 months is this a good thing or a bad this for me, it is also with the same man ( mylove :) ) My MFM said she wouldnt give me a % for it returning what do you guys think..... im so terrified :(

claricemaala
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Re: Did I wait too long to TTC?

Postby claricemaala » Tue Jan 25, 2011 02:00 pm

Hi Bordergurl,

I waited 4.5 to 5 years before my second one and pre eclampsia came back same time at 27 weeks. My first was born at 33 1/2 weeks and he is now 5.5 yrs old and well and no complication from being born early. Same is true I was scared to try and I was also so busy at work.
So I tried last year but same episode occurred (but unlike you I did not hook up with good OB/MFM before the second preg). I was hospitalized for pre e and given my history (pre e at 27 weeks, abruptio placenta ) I was bedbound in the hospital. They decided to C sect me after learning that my son oxygenation was destaurating. He was born healthy though small. About to be discharge after two weeks and then he developed NEC (Unrelated to pre e but unfortunate gut infection for premature babies). He died on 2/1/2010. And it is coming around soon.
Since my son's death I have been wanting to TTC. I have seen a cardiologist, MFM, and ny OB and they all gave me thumbs up to TTC now JAn 2011. I have not tried because I am scared and also want to be finacially rock steady for he said I will be on disability very early (end if firts tri or early second tri) .
I am scared for the chances of pre e is high for a third. But he now has me on LDA, prenatal, calcium and my blood pressure meds. (Since this last pregnancy I have been diagnosed with chronic hypertension) .
I also have the panic because I will be 38 by October so he wants me to be preggo before 38.
I also want to try again later (if possible).
By the way you had mentioned that there is a correlation pf pre e episode in relation to the timing of next pregnany. I am wondering if you have the article to support this? I have been looking for it or did your doctor mentioned it to you?
Thanks in advance
Mom to 6 year old. Born at 33 1/2 weeks after preeclampsia and abruptio placenta.
Angel boy -Michael- born 2/1/2010 at 31 weeks. Had pre eclampsia and hospital bedrest at 27 weeks. Died due to NEC. Forever loved and missed
Rainbow baby due Feb 2012. Hoping for a looooonnnnnnngggg uneventful pregnancy.

lizard
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Re: Did I wait too long to TTC?

Postby lizard » Tue Jan 25, 2011 10:39 am

i think we are all scared. how could we not be? but a lot of us try again and have great outcomes. the fear doesn't go away but can be managed in my opinion. i was soooooo terrified to get pregnant again and go through what we did. but here i am at 36wks and PE free. my 3.5 year old is doing great as well and i couldn't be happier. it has been a lonnnnnnnnng road emotionally but well worth it. i personally did a lot of things on my own i think contributed to my health both emotionally and physically this time around. I am on LDA, go to acupunture and do YOGA all the time. it has been awesome for me. there is just no real knowing what will happen, that is what is so scary. good luck and i say go for it!

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bordergurl72
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Re: Did I wait too long to TTC?

Postby bordergurl72 » Mon Jan 24, 2011 05:12 pm

I spoke to my mom, she made to after 50 before starting menopause, so I hope that is a good sign for me, should we try.
Anne, 39
DH, 47
Daughter born March 2005 at 38 weeks at only 4 1/2 lbs. by emergency c-section. Severe PE, HELLP & IUGR.
36 weeks of carefree PG, then it all went downhill and had an excruciating 2 weeks of pain and brushing off by Dr's until being properly diagnosed and delivered at 38 weeks. Since then have been diagnosed with celiac (2009) and Hashimoto's (2011).
Terrified to TTC, but really want to TTC.

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danielsmom
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Re: Did I wait too long to TTC?

Postby danielsmom » Mon Jan 24, 2011 10:17 am

There are risks, you're aware of that... the best thing for you to do is to get the best info you can and then make an informed decision. I know you're probably tired of getting that standard issue response, not the warm & fuzzy one we want.

But I'll weigh in with this: based on your pre-e/HELLP risks, I'd go for it. You had a late onset, almost at full term (36 weeks some consider) before you saw symptoms, and with closer monitoring mixed with the fact that your risks are lower than the first time, I'd feel pretty good about it.

I'd be more concerned about maternal age risks though. At 39, risk for Down Syndrome is 1 in 202, and they say to generally half that for other chromosomal abnormalities, so 1 in 101, but I'm not sure how accurate that is. Again... those are good odds, just riskier than a 30 year old. I've also read that it's not necessarily about how old you are, it's how close to menopause you are. Did your mother have early menopause?

What does your partner think?
Miscarriage Feb 05 & Dec 07
Daniel born Feb 09 at 27w5d, 1 lb 1 oz/12 inches (severe IUGR) due to Severe Pre-E & HELLP. Now tall for age and no complications.
Diagnosed with MTHFR
Cornual Ectopic miscarriage Mar 11
Natalie born 6-5-12 at full term, 7 lb 11 oz & 21.5 inches, progesterone 2-8 weeks (for suspected luteal phase defect), lovenox 6-29 weeks, lda 0-36 weeks, folic.


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