Postpartum preeclampsia and trying for baby #3

[cjd1975]

Hi!
Here is my story!! I am a 36 yo mother of two beautiful little girls. I had a normal pregnancy with my first delivering naturally at 41 weeks (did have marginal previa/partial placenta accreta), baby was 7.15 lbs. Was normotensive ( I run 110s-120s/70-80s)) throughout the pregnancy and had no proteinuria. I may have had a few high normal BP readings at the end but I also have a hx of elevated BP reading in a healthcare setting (white coat hypertension) and when they were rechecked they were normal. I did have lower extremity swelling after the pregnancy but was told that was normal otherwise, I felt fine, no HA, visual changes, etc. My second pregnancy was the same as the first although I did have a c-section prophylactically due to the placenta issue with the first pregnancy. Baby was 8.1lbs at 39 weeks. I had twelve hours of severe nausea and vomiting due to the spinal but my BPs were normal. On day 4 (the day I was leaving) I had an elevated reading 150s/80s. It was supposed to be rechecked but wasn't. Again, had lower extremity swelling and I guess I wasn't voiding as much as I should but I had no other symptoms. Day 5 (the day I was diagnosed with postpartum preeclampsia) I rechecked my BP at home and it was 160/90. I reported it to my OB and was told to go to L&D. I was hysterical thinking I was going to have a stroke and die! My BP did go up to 180/100, I was very anxious and crying so I am sure that didn't help the situation. I had no other symptoms other than the high BP and the fact I wasn't voiding as much I should have been. My labs were normal aside from a mildly elevated creatinine 1.6 (likely related to the dehydration) and proteinuria. Liver, platelets were all normal. I received IV labetolol 120mg, no mag and was sent home the next morning. I did end up peeing out over 2 gallons of urine in the hospital and was having readings of 130/140 when I left. I did do the 24 hour urine and did have protein (not sure what the number was). I ended up being on oral labetolol and procardia for 3 weeks and then it was gone. My proteinuria resolved pretty quick and my creatinine was back to normal within a week. I had everything repeated about 18 months later and everything is normal including my BP.

So, I am now thinking of a 3rd baby but I am nervous/scared of this happening again, developing it earlier on during the pregnancy or having it worse. I am terrified that something will happen to me and I will leave my children motherless and that maybe I should just count my blessings. My OB says if I want another one to go for it, I will be monitored and can be started on BP meds if needed. I am just so nervous but have a huge desire for a 3rd child. I may go to see the MFM in my area to get her opinion as well. Also, I may have had this after my first pregnancy and was not diagnosed as I had no symptoms other than some swelling! Crazy to think there are women out there walking around with this and not knowing it!

Has anyone had an experience with this???

[mom29]

Yes, I had post-partum pre-eclampsia in 2004 and was readmitted to the hospital for four days to get my bp back under control. It was a scary experience to be wheeled towards the cardiac care area in the ER.

After the next pregnancy in 2008, I again experienced crazy high bp's post-partum, but the OB blew it off despite my previous experience. The nurse called the house doctor to cancel my discharge when the OB didn't return the pages for almost six hours. Called the MFM as soon as I got home (as one of the nurses suggested) and he tripled my labetalol dose and I had an easier recovery that time and no readmission to the hospital.

For my current pregnancy, I bypassed going to the reg. OB and see just the MFM. He has been telling me they will be watching me very closely. I think having the right care provider can make a world of difference. Yes, I"m high risk but I'm getting excellent care so I'm not worried.

Good luck to you as you ponder your decision!

[cjd1975]

Thanks for replying! It is nice to know that you have dealt with this a couple of times with good outcomes. It is reassuring that this isn't something you developed earlier on or worse, and that is seems to be more of a postpartum issue that an be managed.