MFM/ PERI**update**

[cmccaffrey]

Hey Ladies,
My husband and I have a preconception appointment with a Perinatologist/MFM this coming Monday and I was wondering what I should expect? Also, are there any questions I should make sure and ask? I saw this same perinatologist in my last pregnancy, but it was under completely different pretenses and nothing was wrong at that point in our pregnancy, so we didn't have any questions to ask really.

I would really appreciate any help/suggestions.
<3

**UPDATE**
So I met with the Peri this morning. I brought all of my medical records and my list of topics/questions. The Peri looked at my file and immediately saw several red flags from my last pregnancy and was shocked at how no one thought to ask for a consult sooner. Anyways, the past is in the past and he said that he felt more than comfortable with us trying again (he even said something about us possibly trying earlier than we had thought), but that we should wait until I finish coumadin and my hematologists finishes my blood panel. Once we get pregnant, he wants me start lovenox twice a day and wants to see me every two weeks for blood pressure monitoring and doppler blood flow scans. It was a positive consultation, but needless to say I was an emotional mess. It's not like it changes anything, we would be looking into all of this even if our son had lived because we have always wanted a few children. I just feel like I am making plans to replace Mason and it sucks... What I wouldn't give to have him in my arms.

[sam10]

When I had my first preconception visit with my MFM I put together a list of comments/questions, which I printed and brought along. Also brought pen and notebook to make notes. I tend to forget details quickly:-)

So here is what I put together (roughly):
- my case of PE: I summarized what I knew about my case of PE the last time around and asked the MFM if there is anything he would want to add (e.g, how severe was my case, any further insights etc.)
- underlying disorders (if you have not been tested, this is a good time to ask about): blood clotting disorders, Vit D etc.
-sport (I am active and wanted to know how much I could/should be doing)
-nutrition (I asked if he recommended any changes in diet)
-weight (if you have weight concerns, you can ask if you should loose or gain some)
-supplements and medication(I discussed which ones to take and when to start)- prenatals, fish oil, LDA, Calcium, Vit D, and medication I need to take
- I asked if anxiety meds were ok during pregnancy
- I specifically discussed how my care would look like during a subsequent pregnancy (what tests, whom I would be seeing (ob and MFM or only MFM) etc.
- my chances of developing PE again based on my test results from underlying disorders and my personal health and Constitution, and my history of PE
-discussed my previous c-section and what it means for future deliveries
-discussed how long to wait before seeing a RE in case I would not get pregnant in my own. Also if fertility treatments were ok.
-discussed latest research re: PE and the European approach of adding extra salt to the diet and testing that is only available in Europe at the moment (I love him for the fact that I can discuss with him)
-discussed the influence of stress during pregnancy (this was related to my somewhat stressful work environment).

I also brought my husband.

Good luck and let us know how it goes!

[cmccaffrey]

Julija,
thank you so much for the VERY thorough list of topics/questions... I just copied it and will retype it to fit me. I am really excited and nervous. I am worried that he is going to tell me something like... "you can never have children so just go home and forget about it" or something like that. I know it's crazy, but those are the weird thoughts I have racing through my brain at 3am every night.

Thanks again!

[sarahkm]

Julija,

Thank you for your list of topics/questions. We are again visiting a MFM physician at the end of this month. Our son was stillborn Dec. 2006 at 38 weeks due to placental abruption and severe HELLP syndrome. I had been advised not to attempt another pregnancy mostly because of my abnormal kidney function. My kidneys are still not completely back to normal but my Creatinine is below 2.0. I'm still on a low dose of antihypertensives. We have been waiting to adopt for 2 years and decided to at least talk with the doctors again about another pregnancy.
Did you experience any long-term issues from your PE and HELLP? Thanks! Sarah

[sam10]

@Sarah: I am so sorry for your loss! I don't seem to have any long term health effects thus far. There is still the risk of cardiovascular problems later on in life (after experiencing PE). I was off my BP meds 3 weeks postpartum.

@cmccaffey: I had fears my doctor would say something like that, but due to the fact that I am healthy and have no underlying issues other than MTHFR, my doctor gave me the green light to try again (I had to wait for a while, b/c of my classical c-section). He of course could not tell me whether I would have PE again, but put my risk factor in the 25-30% category.