What happens biologically during Pre-E

[MaggieLu1]

Amazing stuff has been shared here. I am wondering if anyone can expand on preeclampsia post partum? I had difficult to control blood pressure for three months following the delivery of my little girl. And the fact that the disease is not ''cured'' with delivery really worries me...as I am expecting again It just seems so uncontrollable and unforeseeable.

[blythe]

Hi MaggieLu1, welcome! We just had a quick technical discussion about post-partum PE on this thread -
http://www.preeclampsia.org/forum/viewt ... 12&t=41617
Congratulations on your new pregnancy!

[wels0069]

So if I wanted to have another baby and risk our lives could I request a blood test that tells the levels of this anti-agent that does not allow the repair of leaky vessels in the 1st trimester?
Maybe with that information me and my dr. could plan for a rocky road.
Let me know.

[caryn]

This test is in development in the US. A similar one (not as accurate as what will be needed to meet regulatory requirements here) is available now in Europe.

Since you've already had PE, your care providers will already be on high alert, so I'm not certain that this test has a whole lot of value for women with a history. There's no treatment yet, and what this test does is alert you to the likelihood of complications. But you're already alert!

[alexis]

This is very difficult to study, but it's an ongoing, very intriguing, area of research. One thing that I find fascinating about it is that some chronics have babies who are *big* for gestational age, which might suggest that even though the placenta is shallowly implanted it's developing a decent blood supply anyway, or might suggest that implantation is deep enough to grow a big baby but at the same time the maternal immune response to it is creating hypoxia and triggering the same downstream effects that a shallow implantation would cause. There are multiple pathways operating here, multiple placental strategies for maximising bloodflow, so you could simultaneously have shallow implantation and then other strategies that compensated somewhat for that shallow implantation, like upregulation of maternal respiration rate and heart rate and appetite (so the little blood that does make it 'round to perfuse the placenta is still packed with supplies. (I think this is a useful way to explain tachycardia and breathlessness in some PE patients.)

Ok - this intrigues me.

Baby #1 - 8lbs1oz at 37 weeks. I had fewer growth scans, but I remember she was measuring a week ahead at 12 and 20 weeks (and I'm sure about my dates)
Baby #2 - EFW over 1 lb at 20 weeks; I forgot to ask percentiles, but I think I saw something on-screen about 95th percentile. Currently 22 weeks, so outcome is open. On Toprol this pregnancy but not with #1.

Everyone (my providers included) seems concerned about IUGR and blood flow to the fetus. But I wonder: If my history is that I manage to both have superimposed PE and grow a very nicely sized baby in the past, how should I apply that to my current pregnancy? Does it have any relevance at all?

[caryn]

I think IUGR is something they'll watch for simply because the correlation between PE and IUGR is known to be very strong, likely due to the shallow implantation. They're watching for horses, not zebras, and so they'll watch for IUGR.

But yeah, superimposed preeclamptics with bigger babies - ie a lot of us chronics - are probably pulling off some other set of problems that just look similar. Oscar was almost 5 pounds at 34 weeks, and in a normal pregnancy, would have doubled his weight between 34 weeks and delivery. So a 10-pound firstborn. I *really really suspect* that the maternal-fetal conflict issue in my case was simply that my body tried to modulate bloodflow downward from a normal (or perhaps deeper than normal) implantation and the placenta fought back, triggering the whole PE spiral. (My husband and I are both bossy sorts, by the way.)

[smz1789]

So glad I found this post... I learned more about what pre-e really is in this single thread, then I've ever heard in a doctors office, or read in a pregnancy book!
Thank you for sharing this insight ladies!

[momof4as]

I was told that they are studying a link between the genetics with the Father that could be contibuting to pe in the mother... any news on this? I makes sense since I had two children without PE and both kids with my husband I've had PE with.

[caryn]

Joy, yes, lots! Try this link:
http://www.preeclampsia.org/forum/viewt ... 12&t=43563

[Sara35]

Thank you so much. I am pretty scared at the moment. Am 36+2 and have been watched non stop since 32 weeks as protein in urine with raised BP which slowly raised enough to 160/103 last week that they put me on labetolol...200mg twice a day which brought bp down to 120/77 average. Today went in and it was 139/90 so am having an extra dose of labetolol. Have been told to come back in for monitoring and then if all well, they will give me a sweep at 37+2 (a week today). I am just a little nervous because the last 4-5 weeks have been a haze as been checked so often and am constantly linking every pain and strain to PE, feel like a hypochondriac.