Early Onset of Pre-eclampsia

[fraulinebeck]

I posted my question on a separate forum discussion, but realized that maybe it wasn't in the correct place. I'm not real sure where to voice my questions, but I'm hoping someone can provide some sort of hope or guidance. I was 20 weeks when I went to the doctor for my 20 wk U/S visit. 3 weeks prior to that we had just found out we were having a daughter. I was so ecstatic as I had been praying so hard for a daughter. As crazy as it may seem, I have struggled for some time with feeling like I would never be able to give my husband a first, since he had a son at a young age. I believed that if God would just answer my prayer for a little girl - then I would be able to at least give him his first daughter. That 20 week visit - all my dreams and hopes were completely ripped from me. My doctor told me after the U/S that there wasn't too much to worry about that she was measuring only 18 weeks as long as she was within 2 weeks of the due date in the second trimester it was ok. However, she wanted me to have my blood pressure rechecked as it was 150/110 when I came in. Prior to this I was demonstrating no BP problems, even 3 week prior to this visit when I found out the sex of the baby. Unfortunately my BP remained elevated despite resting for some time, and came to find out that I already had 3+ protein in my urine. She sent me immediately to the hospital and told me I was in preeclampsia and would not leave the hospital until I delivered. Once at the hospital the MFM's told me that the baby had absent end diastolic blood flow that indicated she was not receiving the blood she needed to survive and that there was nothing we could do. My husband was all the way across the continent on business and fortunately I had my family close by until he could get there. I remember being scanned in the hospital with my dad holding my hand as we looked at the U/S showing my beautiful daughter and her heart seemingly beating so strong - yet knowing what they were saying and that it would mean at the end of it all she would not survive. I was later induced and she was did not survive the labor/delivery process.
I have struggled with so many questions - but my biggest concern is that the doctors told me how rare this was to develop preeclampsia this early in the second trimester and how this puts me at a much higher risk of it happening again. So now not only was I grieving the loss of my daughter but the potential to never have a child. I felt so alone b/c they kept telling me how this is so rare. I didn't develop HELLP syndrome, but I don't know if it's just because they caught it early on and I would have later. Also, of note - when I went to the doctor that day I had absolutely no symptoms associated with preeclampsia, especially for how severe they told me I was. Has anybody ever experienced this early onset of preeclampsia before and if so how does it affect later pregnancies? I feel so discouraged at times of why this had to happen, and I realize I'm no different than the millions of women who have lost their babies - I just feel like I have no one I can relate to, as everyone's symptoms seem to have happened later and they were associated with HELLP, PCOS, or some other disease process.
I should also mention, that in the midst of all this I was also found to have an elevated ANA. However, once again no symptoms of an autoimmune disease and the antibodies for APA syndrome were negative. So now I'm at a high risk because of early preeclampsia affecting me in the past and if I have an autoimmune disease that puts me in a high risk category - so does that mean I'm at a doubly high risk. My hopes and dreams of ever carrying a baby or getting dimmer and dimmer and sometimes I feel so discouraged with the grief and not knowing if I'll ever carry my husband and I's child. Has anyone ever gone through or know someone who has gone through something similar?? No pain is as great as losing a child, and unfortunately, it is through all of our pain that we unite together on this forum. I'm so sorry for the losses you other women have experienced - I hope you can find solace and peace somewhere in the midst of your pain.

[kerisue]

Fraulinebeck, I'm so so sorry about the loss of your sweet baby girl. Preeclampsia is an awful, awful disease and the loss of a child is the worst thing I can think of to have happen. I too had hoped and prayed for a girl- I felt like all my dreams were coming true on the day I found out. Though nothing can ever replace the little girl I lost, nor yours, it sounds like we're both wanting to try again some day. I've experienced some of your same concerns about having another child- the day after I gave birth my OB said "I don't recommend you have any more pregnancies" which was devastating to hear. Since then (in addition to trying to deal with the grief) I have done a ton of research here and on Pubmed and talked to no fewer than 3 MFMs about my chances for a successful future pregnancy. Yes, 20 weeks IS early, but don't count yourself out yet. Sending you healing thoughts.

[flori]

I am so sorry for the loss of your precious daughter. You are in the right place for support and answers to any questions you may have. As you know, there are many women here who have unfortunately experienced the same loss that you have and they are a plethora of knowledge. I share the same fears that you do in regards to developing pre-e again. I lost my daughter on March 16. She was my first pregnancy and the first child for both my husband and me. After I delivered my MFM quoted me a 50% likelihood of developing it again in a subsequent pregnancy but I hold on to the hope that it will be less severe and develop much later. I did not develop all symptoms associated with HELLP and I have not had a subsequent pregnancy yet so I cannot offer you any information there either. Like you, my husband and I also struggle with the possibility of never having children of our own. He worries that another pregnancy could result in losing both myself and the baby. We are not in a position for surrogacy so that is not an option either. There are several posters who are currently in a second pregnancy after a loss and I'm sure you will get to know their stories very well. There are also many posters who have already experienced a successful pregnancy after a loss. I find them an inspiration and love hearing the success stories. It seems that there are more of those than not. That being said, this is a terrible ordeal to have to suffer through and I wish you peace and healing.

Our stories share some similarities so I will share it again: At the 18w anatomy scan for my daughter the tech said that I wasn't as far along as I thought I was because Gracie was only measuring approximately 16w. I knew this was incorrect because I used OPKs to pinpoint ovulation and I knew I was 18w exactly. My other symptoms began very early as well- I was hospitalized with bp over 180/120 at just 20w4d while on vacation in Hawaii. At the appointment with my MFM the day we returned to California (21w3d), he said that Gracie was small but did not mention IUGR. I began having URQ pain that same night. I was hospitalized again but my labs came back okay but I did have a gallstone. The doctors that released me said that sometimes pregnant women have "unexplained pain" and I was released when my bp stabilized. The following Wednesday I was officially diagnosed with IUGR and told that she also had absent diastolic flow. He told me and my husband that he's seen cases of babies surviving in utero for several weeks with no negative change so it gave my husband and me hope. I was put on modified bedrest at home and scheduled weekly ultrasounds to monitor any changes.

Gracie did well for the next two appointments. However, my URQ pain continued and worsened until my husband drove me to the L&D the night I was 24w6d, which was just hours after my last positive ultrasound with my MFM. I delivered her the next day after I was diagnosed with HELLP. We did not have time to get steroid shots and ultimately her lungs failed and she died the day after she was born.

It has been nearly 12 weeks since we lost her and I still think about her all of the time, but it has gotten somewhat easier to get through each day. I hope to continue to see you on the forums as you continue your journey.

[jules2]

Fraulinebeck,

I am so sorry for the loss of your daughter. My first daughter died two just over 2 years ago now - I had early onset PE (around 25 weeks) and HELLP post-partum. I did not feel ill until near the end despite very severe disease. And my first daughter was stillborn even though I was already in hospital being closely monitored (and with normal end diastolic flow). Yes, you might have developed HELLP also if the docs had kept your pregnancy going longer - that's what happened to me - we tried to hold out as long as possible because I had (just) reached a viable gestation. Its still a very painful memory.

BUT don't think it would necessarily mean you cannot have a family. After all that horror of my first pregnancy, my second was just normal and my wonderful 5 month daughter is resting in the crib upstairs. Yes, you are definitely at higher risk - but every pregnancy is different (and in my case, totally different). Most women don't get PE so early and severe again - or as in my case not at all. And I am now 40 so had advanced maternal age against me too! There can be light at the end of the tunnel x

[jules2]

oh, and I have kidney disease so lots of high risk factors were against me too (early onset, age, chronic disease ....)

[holly3372@msn.com]

I am so sorry for your loss. It has been 9 months since we lost our 1st and only baby Benjmain. I too developed very early onset preeclampsia at 25 weeks.I had no symptoms other then "something didn't seem right" all was good at every doctors visits,bp fine ( I had never had bp issues prior to this) urine protein was good etc. Ben was born 26 weeks and fought for 4 months in the NICU we lost him in august. Since then I have learned so much about pre-e. I have been to 2 MFM's @ Ob's and 2 Hematologists. I have been told that yes I am hgh risk,that yesthis could happen again. However I am also told that every pregnancy is unique and different. I also have a chance of this not happening again. I am 39 now so time is not on my side as far as waiting to much longer. This site will help you in many ways. We here understand. When you are ready I would write down all questions you have and set up whats called a preconception consultation with a Perinatologist,MFM ( maternal fetal medicine specialist) there you can make a plan for a next pregnancy. If you do not feel comfortable with this person,find another until you have found what you feel is right. It is important to find the right team of doctors to care for you. You will be high risk yes,but that doesn't mean you cannot have a child. Many women have gone on to do so,they are my inspiration and I hope to be one of them soon. Sending love and hope to you.xo

[uncskristy]

You have found the right place. There are plenty of women here who understand and have been through similar. I had severe PE with my second child last May. I had a typical OB appt at 21 weeks, 2 days when my BPs were normal and there was no protein in my urine. The next two days after that I became swollen but did not think much of it because swelling happens in normal pregnancies. At 23 weeks 6 weeks, I woke up with bleeding. I was hospitalized at a University hospital with a large MFM dept and a high level NICU for a small placenta tear and told that I would be there until delivery. They suspected that I had PE because my BP numbers were slightly in the high range but those calmed down to normal with bedrest. At 24 weeks, two days tests showed that my kidneys and liver were starting to fail so we were forced to deliver Cooper early. (Steroids given to speed up Cooper's lung development had been masking the truth the truth of what was going on with those organs until then). He was given a couple of hours to live and Cooper fought for 22. As hard as it is with losing my son, I still try to be grateful that I escaped with my life so I could be here for my oldest son. Many women do not live and had the placenta not bled, I would have waited until my next OB appt to be seen which would have been too late. I didn't reach the HELLP category, but was told recently by my MFM that I was really, really close. I had a perfect pregnancy in 2007 so we were completely unprepared for any compliations with Cooper's pregnancy and everything was good up until 21 weeks, 2 days with the Cooper. Its been hard for us to accept how quickly his disease can progress. Even my OB has mentioned that she was shocked because she had never seen it so early, severe or progress so quickly before.

After we were given a 50% chance of developing mild PEand 18-20% of early or severe PE again, we decided to try again. I am currently 17 weeks, 2 days with our third son. Blaine and I are going good but as you know we are getting close to that "PE danger zone" where anything can change in a heartbeat. The good news is that I am way more educated this time around so if the PE comes back I am not going to feel so lost and clueless. My OB office is keeping a much closer eye and my MFM and his dept are a phone call away. I know the odds are there but I am getting through by telling myself that surely the extra things we are doing this time around will at least get us far enough that Blaine can survive even if it mentions some NICU time. I love reading stories on the Pregnant forum where someone has gone on and had a pregnancy with a happy outcome. I definitely recommend stalking that forum when you are ready to try again

[kbunsey]

Hi. Welcome. And I am sorry for your loss. The first days, weeks, months are SO confusing. Medically. I can't even speak about the emotions that sometimes still sneak up on me. Confusing doesn't come close to describing that. What I can tell you is don't give up hope! I had early and severe PE and a stillborn baby. I was super sick probably from about 20-21 weeks. I was determined that I'd NEVER do "that" again. Meaning, get pregnant b/c of my first pregnancy and how awfully wrong everything went. But the MFM who probably saved my life told me "the odds are in your favor" and he said I could get high risk care and try again. I didn't believe it could be true - not until the day Kyle was born healthy and alive. Nobody can prmoise you anything but do talk to an MFM. Get several opinions. Take time to breathe and heal. Take time and be gentle with yourself.