Did I wait too long to TTC?

[Lee Ann]

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!

[riehlism]

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.