Preeclampsia and HELLP in 2nd, but not 1st pregnancy

[tanechap]

My first son was born at full term with zero pregnancy complications. A few months after he turned 3 we started trying again. In January of 2011, I found out I was 8 1/2 weeks pregnant. I had taken a test in December that was negative and had continued to have what I thought was a period. I bled all the way until 15 weeks and passed massive clots the whole time. At one point, it was so large we were sure I had miscarried. I really never felt good the entire pregnancy. I lost 7lbs pretty quickly. In the start of my second trimester I did start to gain some weight back. Around 23 weeks, I started getting a cold so I went to see my OB. My BP was up a little, but not enough for concern yet. Three days later at work, I started feeling very sick. I ended up throwing up all night and had severe chest pains. The next mornging I saw my OB. My BP was up even more. He decided to do bloodwork and then sent me home to wait. He called a couple hours later and asked me to meet him at the hospital. They reran blood work and I found out that my results were worse than they had been a few hours earlier. My OB diagnosed me with Preeclampsia and HELLP (class II). I was transferred to an OB/ICU at a near by hospital. They immediately began inducing me as my bloodwork continued to get worse. A day later, my counts all stabilized as did my BP. They still were not good, but stable. The OB was stunned that I was somewhat better. I still ended up delivering at 24 weeks and 3 days. My son was 1lb 2oz. (side note, I weighed one pound less at delivery, than I did when I found out I was pregnant in January). He spent 6 months in the NICU and miraculously is home with minimal problems. My OB said it was very rare to have a first pregnancy with no complications and have a second with so many. Anyone else experienced anything similiar? I've thought about testing for underlying issues, but I don't have any symptoms of anything to be concerned about.

[caryn]

Welcome to the forums. I'm glad you've found us.

You're not the only one to get it in a second pregnancy after an uneventful first pregnancy, even if it seems rare! We have had a number of posters in a similar position. As I understand the current thinking, this is often because the placenta in your second pregnancy just had a different genetic predilection, one that compromised either/or implantation or maternal tolerance of the foreign tissue. Considering what you say about ongoing bleeding I'd wonder about initial implantation going badly and setting up later problems.

Some underlying genetic issues with placentas are clear, like a placenta that goes trisomy 13 in some lobes while leaving the embryonic cell line untouched. That's rare but obvious in pathology. Was the placenta from this pregnancy evaluated at all?

[tanechap]

I was told that my placenta was being sent off for testing but I've not heard anything back. My regular OB hasn't heard anything either. The doctors also had trouble deliverying the placenta. I passed a chunk at home after I was released. I was on Mirena before I got pregnant. I've wondered if that could've had anything to do with my problems. It had only been out two months when I conceived. Have you heard of Mirena causing issues post removal?

[caryn]

No, Mirena hasn't turned up as a problem - but not getting all of the placenta out should (theoretically) mean some symptoms continue until it is really, truly all out. There are even studies showing that women recover faster with a postpartum D&C (scraping the interior of the uterus with a curette to remove as much placental tissue as possible.)

If you search user name "Catherine" she had a rough second pregnancy after a straightforward first pregnancy. She also had a straightforward third pregnancy.

[tanechap]

Caryn,

I just wanted to update you the my placenta results are back. Although I still don't know the actual results, I am getting ready to go in for testing. I think the 3 are anticoagulant lupus, anticardiolipin antibodies, and antiphospholipid. I don't know much about them yet. What do you know about these?

[Faye89]

Hi there, I also had my first child on his due date, no complications etc and then my 2nd child (a little girl) I went to see my midwife for a check up, she sent me to hospital as I had 3+ protein in my urine and bp was high for me! I felt absolutely fine! But from then on I had flashing lights, headaches, pains in my legs ect and it turned out I had pre eclampsia. They said too that it was very rare that I didn't have it with my first and had it severe with my second, I stayed in hospital and by 33weeks she was delivered my emergency c-section weighing 3lb 4oz i started getting horrific chest pains and they said it was my internal organs that was being starved of oxygen i lost my eye sight my hearing and my face swelled up, and then on I developed HELLP syndrome and was in intensive care for 3days! I looked at your topic and saw you say about the mirena coil, I also had this and by my scan dates and period I fell pregnant the day I had it removed... Also I got my results of my placenta and my doctor told me It was covered in bloodclots! I hope this helps as I haven't spoken to any one that didn't have it the first time but did the second so it's nice to see I'm not alone! my little girl Rosie is 8months old now and perfectly healthy weighing 15lb.12oz hope you and baby are ok too, Faye xx

[Maplecat6]

I had two uncomplicated pregnancies and then Eclampsia at 27 weeks with my third. I'm now 37 weeks into my fourth pregnancy with no complications. It doesn't seem like we follow the typical patterns, but we are out there.

[featherhaze]

I am new to this site and it has been a while since anyone posted here, but this definitely applies to my experience with HELLP. I, too, had a perfectly uneventful first pregnancy (healthy full-term boy) and developed HELLP during my second pregnancy. Three years after my first child was born, pregnancy #2 was perfectly normal other than gaining a few more pounds than I would like and some edema in my feet that no one seemed very concerned about. I went in feeling perfectly fine for my 36 week exam and the nurse got a BP reading of 170/100! They had me lay on my side and 10 minutes later said it was down to 130/80. My urine was fine and continued to be. 3 days later, BP was still 130/80. The day I hit 37 weeks I woke up with epigastric pain. I checked my BP at home and it was about 145/90. I called my OB and they brought me in for a lunch-time appt. My BP was 130/84 and the on-call Dr sent me home and suggested bed rest since I only had 3 weeks left. I went home and started to feel worse after I laid down. I knew something was wrong and ended up going to the hospital around 10:00pm. The midwife ordered lab work and by midnight I knew I had HELLP and would be staying for an induction. All went well with the induction (probably faster since it was my second delivery) but by the time I delivered around 6am, my platelets were 90,000 and dropping. I was told by the midwife the the Dr probably didn't suspect HELLP since I didn't have it or PE with my first pregnancy. Thankfully I was OK, but if I didn't listen to what my body was telling me I wouldn't have been. I am disappointed that a simple blood test was not ordered by the doctor, but I guess my circumstances were fairly rare. Pretty scary stuff! Now I am debating whether or not to have a 3rd child, but I am having trouble finding stories or stats that apply to people like me who did not have HELLP in their first pregnancy. Any ideas where to find that info?

[tree]

I hope we answered some of your questions in the thread on "Ask the Experienced." Let us know if we didn't. It is really hard to find definitive information on developing PE/HELLP in a subsequent pregnancy. Our risks are all different, and the disease is pretty unique in each of us.
It sounds like you went through a pretty crazy ordeal with HELLP in your last pregnancy. It is very important to listen to your body at times like that!