Needing Some Guidance

[zaras_mummy]

Hi I am new to the board but wish I had found this site many years ago. I am 38 and pregnant with number 6 I have 4 living children and a beautiful angel lost at 24wks due to severe pe I started having seizures and developed Hellp very quickly. My first 2 children I developed mild pe I remarried and were so excited when I fell pregnant then devastated when we lost our little girl. The 2 pregnancies that followed I was induced at 34wks and 31wks due to severe pe. My last pregnancy things went bad very quickly they booked me in for a induction at 29wks and 3 days to allow steroids to be given but on the day I was meant to be induced the head ob at the hospital cancelled it because I didn't quite meet the criteria not for pe but for a early induction. About 4 days later she stopped moving the did a ultrasound my s/d ratio was over the 95th percentile but they still didn't want to induce but 3 days later another ultrasound revealed that she had suffered a stroke in-utero and was induced that afternoon. I never thought we would have anymore but surprisingly found myself pregnant when our youngest was 14mths and I am now 23wks pregnant.

Thing have been going really well until the last 1.5wks my bp has been around 120/70. I woke up one morning with a severe headache I took my bp and it was 159/106 so I went straight to the hospital I was monitored and put on labetalol 100mg 3x a day. Thing settled for a couple of days my bp ranged between 145/85 to 160/95 during those few days. Then again I woke up with a extreme headache took my bp and it was 179/120 once again straight up to the hospital when I arrived about 1hr taking my bp tablet it was 160/110 and slowly fell through out the day to 150/95 after they increased my meds to 300mg 3x a day. They admitted me ran blood tests which were fairly normal my creatitine levels were high, low hb and low white blood cell count but nothing that indicated hellp yet. They had me do a 24hr urine which came back at 5300 which shocked me the highest my protein had ever gotten was around 3500 when I lost my daughter. The drs have told me outright they don't believe it is pe yet but are monitoring things. My baseline protein levels when I did a 24hr at 10wks was around 250. I am on fortnightly appointments with my OB and call in if I feel things are not right but I am struggling to understand how they are going to monitor things when my protein and bp are already so high. I don't think I have pe yet either I know that horrible feeling of just knowing when things change but I am concerned. He thinks the high protein is previous kidney damage from my previous pe pregnancies and I should not be concerned but I am. Any advice would be greatly appreciated. How high do protein levels need to be before they become concerned I was followed by a kidney specialist after my last pregnancy but my protein levels returned to normal pretty quickly and my kidney function was normal. Thanks.

[trish]

So sorry for your losses, PE is an awful, awful thing. As to this pregnancy, I am not a Dr. but I would think 5,300 for protein is already something to be very concerned about based on your baseline 24 numbers. I mean if your baseline had been 5,000 then it wouldn't be a concern but it's MUCH higher than that! How many weeks are you now?

It sounds to me like you are already diagnostic for PE (140/90 and 300 protein) and likely already to severe PE which I believe is 160/100 and 5,000 protein. If it was me I would call my Dr. and ask specifically if they consider you to have PE and if not why not? And I'd ask what is the next step or at what point would they plan to deliver/have you go to L&D etc.

Please update when you know more. I'll be worrying about you!! Take care.

[zaras_mummy]

Thank Trish for your response. I guess that is what I need to work out with my OB on what he is going to class as PE. I know diagnostically I meet the criteria but I feel really good at the moment except for the horrible headaches I keep on having. I only have very mild swelling but i have never been a big sweller it normally hits me after i give birth within 12-24hrs i double in size and it lasts for weeks. I had another trip to the hospital my bp is getting a bit out of hand so they are looking at putting me on different bp tablets as well as the labetalol. They did a spot urine test which came back at just over 600 they said that is equivalent to over 6000 for a 24hr. I asked about being referred to my kidney specialist again buy they don't think I need to see one. I am worried about the possible damage being done to my kidneys now I remember my old specialist saying that once protein teaches a certain level it can damage the kidneys. I was out shopping today and started getting some fuzzy vision I had a headache but I think that was more the lights in the shops. I have a growth scan in less that a week I will be 24wks when it is done. I also have a short cervix and have tested positive for positive antibodies I am rh negative and we think the antibodies developed after having amnio done at 15wks so our baby is being monitored closely. Thank you once again.

[caryn]

How are you today? I'm worried about you.

[zaras_mummy]

Thanks Caryn for your concern. I am struggling at the moment my bp is steady but high between 150/160/95-100. I am having the worst headaches which hit when I am asleep and are waking me up. My swelling is very bad during the middle of the night also worse than what it is during the day but not to bad when i wake up again in the morning this is one of the first pregnancies I have had swelling even with my history. My dr doesn't think it is that bad but for me it is he also does not want to add any more bp medication yet as he thinks if we do it won't give us much room to move later in the pregnancy if needed. I asked him about when he would class it as PE and all he could say was he would let me know when he thought it was PE.

I have been having pain under my rib cage which I find very scary I went to see my OB and he thinks it is more kidney based a possible infection so I am waiting for blood test and urine results he also ran the usual PIH bloods just to check my liver function again. I have a scan in 2 days which will be good to see how our little girl is doing. I will be 24wks when it is done she is a very quiet baby I only felt her move for the first time at 22wks and only feel her move on the odd occasion every couple days so it will be good to see if she is ok. I find my OB very frustrating but where I live I am a public patient and he has been assigned to me I don't really get to choose but I have been told he is good at what he does and will definitely intervene if he thinks it is needed he is also the head OB at the hospital. I am just hoping that he starts taking things a bit more seriously soon.

[trish]

Well I'm glad they are running labs again & that you have an u/s in 2 days. But those pressures plus headaches that wake you up are scaring me! Once mine got that high with my first (& I started having some URQ pain) I was already right at 37 weeks so my OB went ahead and induced. With my 3rd, while I was on BP meds, and my pressures were that high my OB just said I guess we need to up your meds again. Did he give you a "call in" number? Like if you BP is over X then call him? I would ask about that as your BP's are starting to get to what a lot of people's "call in" numbers usually are.

Take care and let us know how the u/s goes! (((HUGS)))

[zaras_mummy]

Hi everyone I have been trying to get back to update but my son who is almost 16 and lives with his father severed 2 tendons in his hand and has has major surgery to repair the damage. I have had to fly up to be with him but he finally came out of hospital today. My scan went better than I thought it would appear our little girl is sliding down the percentile charts but mainly because her abdominal circumference dropped from the 60th to 20th percentile which is a bit of a concern but once again it is still within normal range so my OB is not concerned. My big concern at the moment is the amount of swelling I have. As I mentioned previously I am not a sweller it normally hits me after I deliver and lasts for weeks but I currently have so much swelling. It goes up past my knees I can feel the tightness up the back of my legs and you can't tell where my feet end and my ankles start. If I press on my legs the indent can last for about 10 minutes none of my shoes fit anymore. My hands are very tight constantly it hurts to bend them I did fly a few days ago but it was only a 1hr flight which I have done before while pregnant and never had this happen. I have no idea what my bp is I was in such a hurry to pack to see my son I forgot my bp monitor. The head aches are still there same as the pain in my ribs but it comes and goes my OB said my bloods last week were still fairly normal and there was no sign of a kidney infection like he thought. I am home in 4 more days I can't wait to get back I am so uncomfortable with all this swelling.

[zaras_mummy]

Hi everyone I just thought I would give you a update. I am in hospital 12hrs from home and things are going a bit crazy. I went to the dr with my son yesterday and asked them to check my bp and it was 182/114 so they sent me straight to hospital. My spot urine protein came back at almost 900 so eqivilant to almost 9000 for a 24hr I am half way through a 24hr now to get a true reading they said I have 4+ pitted edema it is very severe. I haven't been told what my blood tests are yet but they are being done every 2hrs. I am only 24wks and 5 days so I am really scared I don't have anyone around me because I am so far from home just my ex husband and he is no comfort to me. My husband is trying to organise someone to look after the kids but it is hard because our youngest had the stroke and takes extra care. They gave me steroids last night and due for more later today. I just want to go home but I have been told it is to dangerous for me to travel until they get a clearer picture or can try and stablize me. They are debating starting a mag drip I hope they don't I hate the stuff. This is all bringing back so many memories of when we lost our little girl I am terrified.

[blythe]

I'm so sorry to hear you're having such a rough experience - so many scary things at once, for you and the rest of your family! I hope your body holds on long enough for that second round of steroids. Thoughts and prayers with you!!

[rosemary]

I am so sorry that you are having issues, especially being so far from home. Do you have any other family members or a friend who might be able to come to be with you? I know it's easy for me to say, but the important thing is, you are getting good care. My thoughts and prayers are with you. Please keep in touch with us and let us know how you are doing, okay?