Planning a PG and have ?s on advice from Peri

Are you pregnant again after having preeclampsia once already in a previous pregnancy? Post your thoughts/concerns here - there are others who share your feelings. This is also the home of our Bedrest Buddies Support group.

Planning a PG and have ?s on advice from Peri

Postby maxs mom » Tue Dec 30, 2003 09:37 pm

Hi all!
I just saw my Peri today. He became my Peri because I delivered my son at 25 week due to severe Pre-e on 1/20/03. Thankfully, Max is doing great today, a little small at 15+ lbs, but he was only 1 lb 3 ozs when born, so I am sure he will catch up eventually.

Anyway, the reason I saw the Peri is he said to be sure to come to him before we started to plan our next PG. After meeting with him I had a few questions for all of you. But first let me tell you all about how I had to go to the lab and give 13 vials of blood for tests he wanted to run to make sure there is no underlying cause of the pre-e. Honestly, it was no big deal to me to have the blood taken (I donate to preemies now because I am CMV negative) but I think even the lab tech was surprised she had to draw 13 vials. [:D]Anyway, I am glad to have these tests done, and feel pretty confident nothing will show up (just a gut feeling). During my consult, I was asking my Peri all kinds of questions about things I have read that people are doing to avoid pre-e second time around (e.g. aspirin, high calcium, brewers diet, etc) and he said that no reputable studies have showed any of these things helping. He actually referred me to this site to get data on the studies. But my question to all of you is, you all seem to be having good experiences with the measures you are taking. Is it worth it? I am really torn about what to do. Do I got to the extreme and do everything possible so I can feel like I am making a difference. I can't stand the thought of the brewers diet, I hate milk (lactose intolerant) What are all of your thoughts? I would also love to hear from people that actually did something preventive and still got pre-e anyway, I think that might help me make a decision on what to do.

Well, we won't be trying for #2 until late July. The Peri told me I had a classic C-Section when Max was born. I think because #1 he was breached (head tucked under by my rib) and #2 they wanted to get him out fast (3 or 4 minutes from incession to birth, wow) So, he absolutely wants me to wait 18 months until next PG, no problem though.

Thanks for listening to me!

Kara
Mom to Max, 25 weeker, 1/20/03
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Re : Planning a PG and have ?s on advice from Peri

Postby julie f » Tue Dec 30, 2003 11:13 pm

Kara,

I'm so glad your little boy is doing well![:)]

We had consults with 2 different peris and here's the short version [;)] of what they've told us: They didn't cite any concrete evidence of diet, aspirin or vitamin therapy actually working to prevent/delay preeclampsia. However, in some women they feel there is reason to believe that certain things may help... So, for my specific case (I tested negative for any pre-dispositions to preeclampsia) they recommended extra calcium and a low dose aspirin therapy. I've read numerous things about the potential benefits of adding extra Vitamin C & E and asked my doctors and they said while they don't see the necessity, it will not hurt. So, what we've decided on is prenatals, extra Vit C & E, extra calcium and a low dose aspirin. I've also started a regular exercise program that I plan to continue as long as I'm able while pregnant.

I guess I'm kind of from the extreme mindset and want to do everything that might help - as long as I know it won't hurt. I'm not a fan of the Brewer diet though and just plan on eating a regular balanced diet as I did last pregnancy.

I know it's hard to figure out what the bestthings to do are, especially when there are so many conflicting opinions between the doctors themselves. I would just really encourage you to keep good communication with your doctor to reach the agreement on what's best for your specific situation. Good luck to you!

Julie
Zachary James, 7/22/03-7/27/03, born at 26 weeks due to severe pe
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Re : Planning a PG and have ?s on advice from Peri

Postby laura » Wed Dec 31, 2003 11:38 am

Hi Kara,
I do agree with Julie's take- I think that the general understanding is that especially severe preeclampsia and preterm preeclampsia is (are?[:I] grammar crisis!) usually associated with some sort of triggering underlying disorder. And I think that the triggers and/or causes may and probably are very different for each woman- so it stands to reason that no one regimen will help all. Your peri sounds outstanding- (recommending this site being not the least of his virtues[:D]) Testing is good. Moderation is good.

The thing I think about, though, when I think about the 'certainty' of testing for underlying disorders is that some of the diseases that are associated with PE can be subclinical- or not detectible for years- before they emerge. My husband's aunt inexplicably had really small preterm and term babies- at the time for reasons unknown. Eventually, she went on to develop severe autoimmune disease that eventually rendered her disabled and probably contributed to her tiny babes. My point- obscured as it is- is not that we're all going to develop debilitating disease- rather, that sometimes it's hard to pinpoint your trigger.

And the problem with universal regimens to prevent PE are that depending on your trigger, you may do more harm than good. Women whose PE pregnancies are complicated by low platelets probably won't benefit from aspirin. Women with "quiescent" kidney disease (as our experts like to say) could be harmed by the amount of protein in the Brewer diet. It took me personally two pregnancies to discover that the hypertension I develop in pregnancy is probably underlying chronic hypertension that I get to look forward to in the future. [xx(]

In any event, Kara, GOOD for you- you're doing good work for your children- born and future- just by educating yourself about this crazy disease. Best wishes to you- and your tiny one!

Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/
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