Third times a charm?

[Annello]

Hello all !
This is my first post, and I am hoping I can find some answers or support around my current issue
I will start with some background info I am a 33 yo mom of two beautiful children. My oldest son, who is now 13yo, was induced @ 32weeks due to severe PE and HELLP. My youngest son, who is 2yo, was born @ 29 weeks through emergency C-section again due to severe PE and HELLP. After delivery I had to have a transfusion of platelets and blood. I also suffered from acute kidney failure which resolved before thankfully before dialysis was needed. My second son was in the NICU for 6 weeks after birth.
Currently I have chronic hypertension which is being controlled by three different BP meds and I am overweight. I also have kidney disease. Despite all of this I would like to have another child. I am hoping for a normal pregnancy, a better outcome, or at the very least for things to not be worst than the last. Does anyone have any experience with having PE or HELLP in three or more pregnancies? Or any advice on what to try or do differently?

Annello

[sam10]

Welcome to the forums!

Before TTC I strongly suggest to seek consultation with a MFM/peri (maternal fetal medicine specialist) who specializes in high-risk pregnancies and everything around PE/HELLP. S/he will have enough experience to have seen cases like yours. The MFM will assess your medical background and current health status and based on that will be able to give you good information and a statistical probability of developing PE/HELLP again.

Here is a link where you can search for an MFM in your area: https://www.smfm.org/MFM%20Member%20Locator%20Page.cfm

Deciding to try again is often difficult for women like us who have been through the mill, as there is so much to consider. But since every case is different and we all come with different medical/health backgrounds, subsequent pregnancies can be very different for each one of us.

If you have any other questions, please feel free to post them here, and will try our best to answer them as best as we can. Also, If you browse these forums you will find a lot of information that you might find useful.

Good luck and let us know how it goes!

[Annello]

Thanks for the reply. After my last pregnancy the MFM advised me not to TTC again. He realized that I really wanted to TTC again in the future so he told me to consult him before this happened. I have not been to him yet in fear of what he is going to say. But I have patiently waited the two years and I don't want to wait much longer since I am 33 yo.

I guess I was looking for some stories of women who had experienced these types of complications in multiple pregnancies but decided to concieve again. I want to know what that third experience was like. I want some hope that my husband and I can continue to have beautiful healthy children, and that I can survive to see them grow up.

[sam10]

We have posters around here who have had PE in multiple pregnancies, and we have posters who start a subsequent pregnancy with chronic hypertension. Hopefully some poster with similar experience will stop by and share her experience with you.


Why has your MFM advised you not to TTC again? What was his reasoning? Perhaps you might want to consider a second opinion?

[caryn]

Welcome to the forums!

Both chronic hypertension that is requiring three medications to control and underlying kidney disease will put you at very high risk of recurrent preeclampsia and/or HELLP syndrome, simply because your baseline inflammation levels are likely to be quite high. Superimposed PE and HELLP appear on top of those underlying conditions, probably because the body cannot tolerate the additional inflammation caused by a foreign organ (the placenta.) Technically, inflammation means an elevated innate immune response to *something* - and on top of that you'd add the response to the pregnancy itself.

So the thing to do differently would be to get those conditions as well-controlled as possible before TTC. Some women see significant improvement in hypertension with weight loss or exercise or diet changes, and you'd have to see how your body responded with a personal trial. Some women have hyperfiltrating kidneys and benefit from some treatment with an ACE inhibitor (which isn't okay during pregnancy, but can improve kidney function outside pregnancy.) These are all questions for your doc, so I agree that I'd want a pre-conception consult with a maternal-fetal medicine specialist who's in the habit of managing these medically complex pregnancies.

We've had quite a few posters with kidney disease and while they usually do go on to develop preeclampsia in subsequent pregnancies, the timing of onset varies for them. That's probably caused by differences in the genetics driving the pregnancies. Every pregnancy is different.

Hope this helps, and welcome again!