PE or not and how about Aspirin?

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!
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heather j
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Re : PE or not and how about Aspirin?

Postby heather j » Thu Sep 06, 2007 10:08 pm

Good to hear, Mark! Definitely stay on top of things as they can change quickly if they should change at all. I think upping the frequency of visits is a very good idea given the notching, etc. You may want to ask your doctor about the notching basically correcting itself. I've heard before that this can happen as well. Her bps look really good -- I hope they remain that way!

Best to you all,

markbures
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Re : PE or not and how about Aspirin?

Postby markbures » Thu Sep 06, 2007 08:25 pm

Pressure reading today was 100/60. At this point, it looks we do not yet meet either of the two main criteria: "at least 2 BP readings of 140/90 or higher..at least a few hours apart AND 300mg of protein, or more in a 24 hour urine catch." All we are really left with is the weight gain and the notches. I understand that that the notches are indicative of potential development of preeclampsia and that, given this possibility, we definitely should be taking aspirin to keep blood pressure down. We will be doing the urine test once every 15 days and checking blood pressure regularly. Going to check with the doc about moving up the frequency of consultations. Any thoughts?

onesock
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Re : PE or not and how about Aspirin?

Postby onesock » Tue Sep 04, 2007 05:00 pm

I am sorry, I just assumed that you were in the US! Best of luck to you and make sure and keep us all posted :)

markbures
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Re : PE or not and how about Aspirin?

Postby markbures » Tue Sep 04, 2007 12:14 am

Thanks for the info about the store machines. We are going to buy a blood pressure monitor ourselves for home. A friend of ours is a doctor who has volunteered to help show us how.

We don't live in the US - here 100mg is baby aspirin.

We had good news on the urine test - no protein detected! So, going to focus on monitoring blood pressure and do kick counts for now. Still waiting to hear what the original 'high' blood pressure reading was.

onesock
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Re : PE or not and how about Aspirin?

Postby onesock » Tue Sep 04, 2007 00:03 am

Hi and welcome Mark! I am curious as to the dosage of aspirin that the doctor prescribed for your wife, as it does not even come in 100mg...only 81mg (baby aspirin) 160mg and 325mg. I would double check on that. I do know that it thins the blood and have heard many women say that they discontinued using it prior to delivery to avoid bleeding issues. If you do decide to take it, it can cause a little upset tummy in some people, but at a small dosage, your wife may not have this side effect. I have been told numerous times that the bp machines at drug/grocery stores are not entirely accurate and having worked in a retail pharmacy and trying to "fix" the machine, the calibration is literally pushing a button to reset the machine. I had no idea what I was doing and we had a lot of people getting wacky readings. I would not trust them. I used a wrist monitor in my second pregnancy and if used properly, I usually got pretty good readings. I always took it to my appointments to make sure that the readings I was getting matched those at the office. Maybe the doctor has an opinion as well. Best of luck to you and keep us posted. :)

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Re : PE or not and how about Aspirin?

Postby kara » Mon Sep 03, 2007 10:01 pm

I would go with the semi automatic digital arm cuff. The wrist cuffs are notoriously inaccurate, and the manual's are difficult to use unless you have formal training. The semi automatic can be used by your wife, by herself if she needs to as well.

How's she feeling?

markbures
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Re : PE or not and how about Aspirin?

Postby markbures » Mon Sep 03, 2007 12:04 am

Thanks! We are looking into buying a blood pressure monitor and have found a few models:
* Traditional manual/analogic used on the arm
* Semi-automatic digital used on the arm (you pump it up, but it deflates automatically)
* Digital used on the wrist

Any suggestions on which might be the best / most reliable? We have no medical training - so if we go manual or semi, we will need to figure out how to use them.

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heather j
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Re : PE or not and how about Aspirin?

Postby heather j » Sun Sep 02, 2007 11:35 pm

Do you have a fire station or the like nearby? If you can't monitor it at home, a location such as that would likely get you a more accurate reading (drugstore monitors can be off, though I imagine the cuff that the pharmacy attendent used was accurate). Also, I would call the OB and ask the nurse to pull her chart and give you the bp that initiated this in the first place. It would be useful for you to see what s/he is considering high. I'm not sure how accessible it is for you to purchase an at-home digital monitor, but here in the states they are very reasonably priced.

The notching is (very!)basically an indication of how blood is flowing in relation to the placenta. PE decreases the blood flow to the placenta and this restriction is what is referred to as "notching." FWIW it is VERY good that you're OB is looking for this as there are many who do not. Doctors will look for notching around 20 weeks or so, and if it present...it could point in the direction of impending PE. Sometimes, it resolves and corrects itself, though. I'm not sure what the implications of seeing it at 28 weeks is, though; it sounds like your doctor is handling all this very well.

As for the aspirin, I was on 81 mg for my second pregnancy and discontinued it at 34 weeks for the reasons that Caryn listed above.

As Fiona mentioned, too, I would inquire about steroid shots for babe's lungs.

Hope you can get some answers and lots more growing time. If you can get your wife to rest on her left side, it can improve blood flow as well. Hang in there!

markbures
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Re : PE or not and how about Aspirin?

Postby markbures » Sun Sep 02, 2007 05:18 pm

Went to try to get blood pressure taken today (Sunday). One pharmacy had a machine that does this - it returned 113/70 this morning but with a high rate of 111 beats per minute. This afternoon, we found an attendant at another pharmacy who used a digital monitor on her wrist and returned 100/60. Her normal (pre-pregnancy) pressure was pretty good - in the range of 110/70 to 120/80.

So, don't know how trustworthy these readings are. Going to try to find a better way starting tomorrow. If they are correct, then we have a few things yet to understand:
* What the doctor meant by high in the first place (will follow up)
* The true meaning of the 'notches(?)' (doing my best to translate 'incisura' - we don't live in the US) found in the maternal uterine arteries in the Doppler Fluxmetry (this is what contributed to the original diagnosis - the umbilical and cerebral fetal arteries tested fine by the way)

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caryn
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Re : PE or not and how about Aspirin?

Postby caryn » Sun Sep 02, 2007 00:07 am

Mark,

September 19 is quite a ways off, so I would like to encourage you and your wife to take her pressures two or three times a day, and log them. That way you'll be alerted to upwards trends and spikes if they appear.

Here's a link to a Pubmed abstract, recent research on aspirin: http://tinyurl.com/39lem9

You'll notice it says Antiplatelet agents had no significant effect on the risk of death of the fetus or baby, having a small for gestational age infant, or bleeding events for either the women or their babies. The hope is that it will inhibit prostaglandins, and thereby reduce clotting. Preeclamptics are usually tipped too far along towards the clotting side of the spectrum, and antiplatelet agents can improve blood flow to the placenta in some cases, pushing delivery back and shortening NICU stays.

A lot of docs do want the aspirin discontinued a few days before delivery, to cut down on the odds of postpartum issues (hemorrhage, PDAs that are slow to close) and I would expect your care providers to discuss that with you as delivery approaches, which hopefully won't be for some time.

Keep us posted, and welcome to the forums.


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