I lost my little girl on April 30, 2007 at 33 weeks gestation due to an acute placenta abruption which clotted. I have factor V leiden and was on lovenox injections once a day. In addition, I developed pre-eclampsia at delivery. I also developed pre-e in a prior pregnancy 15 months ago. I am 39 years old and do not have chronic high blood pressure, do not smoke, drink or do any recreational drugs. There is a long span of time between my first two children and my third and fourth pregnancies and a change in fathers.
After delivery this time I was placed on magnesium sulfate. I knew rather quickly that something was wrong because I could not move on my own, could hardly speak and felt like a brick was on my chest. Unfortunately, the nurse didn't listen to me nor did she catch the warning signs...no reflexes especially since I am normally very reactive, little urine output. I quickly reached toxic levels of mag in my system. My blood was finally checked and I had a level of >14 (14 was the highest lab value) where a level of 7 is normal for this type of treatment (I do not know what the measurement is). It took 2 full days for the mag level to go below 14. It turns out that I suffered from acute renal failure. Nobody can tell me what caused it though the abruption is suspected. My creatinine levels were 2.9 at the highest and I was told that I was very close to receiving dialysis. I spent a week in the hospital for high blood pressure and poor kidney function.
It is now almost 6 weeks after delivery and my creatinine level was at 1.2 last week. I am told that my filtration is low, but nothing to be concerned with and I still have protein in my urine. The nephrologist said that I wouldn't have any lingering effects from the renal failure. But at the same time he said that I should not get pregnant again. My OB said that he would not deter me from another pregnancy as long as my kidneys do not show any signs of disease. I still have a lot of emotional healing to do, but he said that a six month wait is recommended.
I have a few of questions:
Could the toxic levels of magnesium sulfate created my kidney problems are evened worsened them if they were preexisting? What are the risks of another placenta abruption? Should I be on a higher amount of lovenox because I still clotted quickly? I assume that I will develop pre-eclampsia again so can I insist on steroid injections and is there anything I can do to reduce my chances? Most importantly, with the kidney failure, as long as my kidney function returned to normal would another pregnancy be out of the question and if not what types of testing should be done during the pregnancy? There is always a risk with pregnancy, but I do not wish to risk my life unnecessarily.
Thank you for the help.