Wife just diagnosed with PE, what to do?

Are you worried about your partners pregnancy? Has your partner already had preeclampsia? Do you have advice for other dads who could be going through similar experiences as yourself? Post here!
for faith
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Re : Wife just diagnosed with PE, what to do?

Postby for faith » Thu Dec 14, 2006 07:04 pm

Hi - Everyone has given you great info., please take it to heart, I definitely learned through my PE experiences to be my own advocate.

I just want to commend you for coming to the site and gathering all the info you can on the issues of HBP.

I am assuming you both are like my husband and me who knew nothing about PE before 32wks with my first son. With my first son, I was hospitalized with 150/100 BP and he was born at 36wks (he had no issues, no NICU).

Wishing you all the best, I pray that all will be perfect with your wife and daughter. You are in my thoughts.

laura
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Re : Wife just diagnosed with PE, what to do?

Postby laura » Thu Dec 14, 2006 06:11 pm

Hi Glen, we got a response from one of our doctors:

"This level of hypertension is life threatening. She has severe preeclampsia. She does not need more tests to confirm the diagnosis. Your wife should be seen in the hospital immediately. I am the Medical Director of the Midwifery at the XXXXXXXXX and am very supportive of midwifery care. By any standards, she is not a candidate for home birth.


The sooner she is at the hospital, the more likely that she might have a vaginal delivery. She needs to be on magnesium sulfate and treatment for BP. She is at risk to have a seizure or a stroke. "


I am sorry to be alarmist - but I am very concerned about your wife and your baby.

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caryn
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Re : Wife just diagnosed with PE, what to do?

Postby caryn » Thu Dec 14, 2006 01:05 pm

Hi, welcome to the forums. I want to say first off that I know exactly what a shock this is; I booked a homebirth midwife with my first and had to make the decision to transfer care to an OB at 33 weeks 6 days when my bp started spiking up really high.

Up to that point everything had been going swimmingly and I'd been counting on being normal. I left the birthing pool and my copies of Gaskin and Brewer and Kitzinger in the living room and spent a week in the hospital -- luckily I never quite had to be transfered into the ICU myself, and DS did swimmingly after a week in NICU. I was only discharged two days before he was, because they had me on a 24-hour seizure watch for some time and then on anti-seizure medication for three days following the birth while they waited for my blood pressure to drop. I got very seriously sick incredibly fast.

The main PE symptoms are really innocuous -- high bp and proteinuria -- and not everyone has the other symptoms. I threw up twice the day I transfered care, and started hallucinating from the cerebral swelling about a day after admission, but never had a headache or epigastric pain...

If your wife does have PE, it means the pregnancy has turned *very* medically complicated and that a midwife is no longer equipped to handle her delivery because she is no longer low-risk. Again, I know *exactly* how much that sucks.

Current thinking says the placenta is short of oxygen in PE, and that's causing it to produce some chemicals which enter the bloodstream and damage it (causing high bp and swelling), the liver, the kidneys, and the brain. Placental abruptions occur with high frequency in this disease because the arteries connecting the placenta to the uterus are damaged as well as often being shallowly implanted, probably because of a maternal immune system response to the invading placenta.

My hospital was very pro-breastfeeding and supplied me with a pump and made sure that all the medication they had to prescribe was compatible with breastfeeding.

Please ask any questions you've got -- I'm sorry you're in this boat.

ETA: I just realized you're in the East Valley -- so am I. I'll email you my cellphone number and the name of the doc I transfered care to and which hospital I was at, because I got great care.

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Re : Wife just diagnosed with PE, what to do?

Postby youtan » Thu Dec 14, 2006 12:46 am

I just want to repeat what the others have said - after having gone through 2 scary pregnancies - I want to encourage you to please have her seen right away. 159/90 is still very high. In my case (and I was having no other problems, not even protein) - my OB sent me straight to the hospital - they drove me immediately, with a BP of 165/92 and also placed me on anti-seizure medication. Pre-e can become VERY serious, VERY fast - and its always best to play it safe! Friday is too far away to check labs.

You know, the first symptom of high BP and preeclampsia on our list is...nothing. So, only measurements like BP, protein, and what is sometimes terms PIH labs can determine the severity of this condition.

The best thing you can do now is to be as proactive as possible - make sure everything is checked and triple checked by the doctors!

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catherine
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Re : Wife just diagnosed with PE, what to do?

Postby catherine » Thu Dec 14, 2006 12:37 am

I can answer this one as all of mine have been born at just about 35 weeks. If dealing with a healthy baby coming from a healthy mom you have a reasonable expectation of the baby doing really well. In the case of two of mine, they were "take homes". They had no reason not to be with me while in the hospital, although my youngest needed a little observation time for low blood sugar at delivery (born in the middle of the night after a long day not intended to involve birth). They were on the small side (5 lbs) which is the normal size for this gestation, and needed no support for breathing or eating. My middle child had a rougher start, probably directly caused by the preeclampsia, and consequently needed ventilator support and lung surfactant and some other medical interventions during her first few days of life. After that, she took off running. Developmentally you are pretty much right there. Sometimes there may be inital problems with eating, remembering to breath, and maintaining body temperature but they are usually rapidly resolved.

Umn, I hate to sound like a nag, but while the monitoring of BP may be reassuring to you, the liver enzymes and platelet count (which are very important) cannot be evaluated without the laboratory tests (blood draw). For that alone you should consider going to L&D, just her BP and the gestational age of the pregnancy will prompt these from the staff there. The information from this kind of test can have very important ramifications, not everyone "feels" the pain associated with incipient liver failure, and lowered platelets could put your wife at risk for hemorrage. I'm sure that your wife is very concerned about the baby and perhaps a little bit about "compromising" with respect to her delivery plans. I know I would be if I were in her situation, I just thought I had a little bit of food poisioning when I went to the hospital.... but sometimes the unexpected and unplanned for happens.

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Re : Wife just diagnosed with PE, what to do?

Postby deerhart » Thu Dec 14, 2006 12:35 am

most of the development done (according to the books) is weight gain and lungs.

My youngest was born at 36 weeks exactly. He spent 4 days in the special care until (3 on o2 24 hours off) and was released. He was on O2 because his lungs were in transition still (mature but still wet)He's had little to no problems since (hernia repair that was all).

If your child's lungs are mature, they are less likely to spend significant time in the NICU, baring other problems (low birth weight etc..). My son was 6lbs 12oz at 36 weeks (his big brother who I was sick with much longer was 5lbs 10oz, but had only grown an estimated 1lb the last 4 weeks I was pregnant which was 2-4 lbs too few)


ozierja
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Re : Wife just diagnosed with PE, what to do?

Postby ozierja » Thu Dec 14, 2006 12:34 am

By now, mostly just growing and gaining weight is what is happening. This resource was great for me as to what to expect: http://www.pregnancyguideonline.com/
Of course everyone is different but in general, this is kind of how it goes week-by-week.

tooleyg
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Re : Wife just diagnosed with PE, what to do?

Postby tooleyg » Thu Dec 14, 2006 12:25 am

Thank you for all of your responses. Her BP was tested again today and it is lower at 159/90. Still not in a good range. She has not experienced any of the effects typically associated with such a high BP, not to say nothing is wrong. We are montering the BP and other symptoms. The urine test and other BPs will be taken to confirm the PE.

Another question I have, is what would be expected with a 35 week baby? Would she need to be in the NICU for sometime? All tests up to this point suggest she is growing correctly and is healthy. How much development happens in the last 5 weeks?

ozierja
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Re : Wife just diagnosed with PE, what to do?

Postby ozierja » Thu Dec 14, 2006 12:15 am

One good thing is that 35 weeks is a good place to be if you do have to deliver!

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catherine
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Re : Wife just diagnosed with PE, what to do?

Postby catherine » Thu Dec 14, 2006 12:12 am

I really have to agree with Fiona, I went to the hospital at 35 weeks and 4 days with some symptoms of right upper quadrant pain and a big headache. My BP in L&D triage was 176/116. I delivered my baby 6 hours later and then went on to experience several very unpleasant complications associated with severe preeclampsia. Your wife's BP ALONE is at a very high level (the definiton of severe preeclampsia includes proteinuria with BPs at 160/110 or higher). I think you need to give serious consideration to going into L&D and having her current condition quantitatively evaluated. It would be very important to know if her BP is in that range right now, how much protein is she spilling (usually have to do a collection and then assay), whether or not the elevated blood pressures are negatively impacting her health or that of your baby. Usually, that might involve a blood draw for her to check her platelets and liver enzymes, and possibly an NST or BPP to check on the baby. None of these tests are too unpleasantly invasive and all could provide the assurance you need.

Happily, my daughter and I came away from my preeclampsia and HELLP experience unscarred. She had a little bit of a rough start and was in NICU for a couple of days, but after that she has done well, we even managed to establish an excellent nursing relationship that lasted 16-17 months.

Please don't wait until Friday. It can't do any damage to check your wife's condition today, and it might just save you from some problems down the line.


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