Thinking of trying to conceive again but scared after PE

[snowdrop]

Hi! I'm new here but glad I've found you. I can't find much in the way of support in the UK (I'm from London). I had severe PE in my 1st pregnancy, and in many ways was very lucky but I'm very scared of pregnancy, birth, PE and also my parents are very worried at the thought of me potentially being so ill again which makes me feel sort of guilty and selfish for considering it.

My story -
In my pregnancy (daughter is now 4) I started feeling unwell from about 32 weeks but this was over xmas/new year so I didn't have any appointments until 35 weeks. No one measured my bump since about 28 weeks just looked and said it was fine. I was 50% appointments at the hospital under the consultant because I have udneractive thyroid (which has always been controlled on same dose of thyroxine since about 2003) and 50% appointments with midwife near home.

When I was seen at 35 weeks at hospital I was exhausted and stressed because I felt ill and felt under pressure at work (I'm a teacher and a lot was given to me in my last 2 weeks - I was due to finish that week). My BP was v high (about 140/100) that day with +1 protein in urine so I was told I'd probably have the baby the following week. I was signed off work and started maternity leave and came into be checked every couple of days, although was left longer over the weekend as an inexperienced doctor said because my protein was trace and BP much lower on one occasion that I didn't have PE anymore. However, when I went back the BP was back up and protein +1 again so I was admitted at 36 weeks. I started feeling weirder and weirder in hospital. I felt like I was going a bit mad and very anxious and twitchy. BP not well controlled so took Labetalol. I wasn't 'ripe' for induction. I started feeling a lot worse with really twitchy feelings in my legs and spaced out at 36+5. In my notes I found out my protein was up to +2 then +3 and BP 210/110 I think before they started to induce at 37 weeks. That day I got very ill BP sky high and started throwing up violently. WHad mag sulf drip and epidural and felt so out of it and hot in my face and odd all day. Spent 24 hours in the high dependency unit. Stayed in for 6 days which drove me crazy! I fortunitately gave birth that evening and my daughter was well although small at 5lb 8oz. My BP took 6 weeks to be totally normal before I could come off the tablets but we were fine.

I've seen my consultant recently and she says I should take baby aspiriin from 7 weeks and have a placenta scan at 23 weeks. She says I don't need any blood tests/screening. I've no idea on my odds of getting it again. I'm scared of risking my life as I don't want my daughter to be without a mum. I'm scared of feeling the way I felt that day when I got so sick. Feeling bad about my parents worrying. I have asked for support if I do get pregnant as I think I'll need constant reassurance. Hopeuflly I'll get counselling.

How does nyone ever get brave enough to try again? How do you stay calm? Thanks for reading! x

[alviarin]

It's normal to be scared after having pre-eclampsia.

I decided to try for the second time- after having severe pre-e with my first- because the odds were in my favor. Odds were, I wouldn't get it again since it is more common in first pregnancies. And odds are if you do get pre-e again, it is usually later in gestation or less severe. Of course there are no guarantees though.

I can't say I wasn't nervous trying again- or that I stayed calm during my second pregnancy- but it was reassuring that I was being monitored more closely and more frequently due to my history. I bought a BP monitor to check my pressures at home, and I read up on signs and symptoms of pre-e so I knew what warning signs to look out for.

I'm also on thyroid meds. FYI, last year the American Thyroid Association published updated guidelines for the Diagnosis and Management of Thyroid Disease during Pregnancy and Postpartum.

Not sure what guidelines are in UK/NHS but The Endocrine Society published pregnancy guidelines in 2007 (co-sponsored by European Thyroid Association) that also recommend that hypothyroid women get their TSH below 2.50 mIU/L pre-conception. And they recommend repeat thyroid testing as soon as pregnancy is confirmed. Most (but not all) hypothyroid women need their thyroid dose upped by roughly 30-50% during early pregnancy.

Anyways, I hope this helps, good luck with whatever you decide.

[aajatwins]

I'm glad you've come here for support - for a lot of people, it is the best we get. These ladies understand what it is like and how it works. Few people in real life get that! Most of us that stick around after babies are here because we found such great support and friendship and want to "pass it on". So I hope you feel the love

As far as getting brave enough to try again... some people don't. For me, personally, my faith and prayer was the thing that got me through. You just make baby-step goals of 30 weeks, then 32 weeks, then 34, etc. You come here and vent and cry and relieve the stress! But you also make sure that your care-givers recognize you are more at risk and you make sure you know the signs and symptoms well so that you can better advocate for yourself. It really is huge that you will know what to look for in subsequent pregnancy. I discussed possible scenarios (which I think a lot of doctors will not do) with my doctor before I even got pregnant. It made me feel better to know that my doctor was at least prepared for possible BP issues and whatnot.

That said, it's just hard. It's so hard to not worry about what could possibly happen. A good support system goes a long way. I wish you the best in whatever you decide!

[snowdrop]

Thank you so much for your replies. I will look into the thyroid information. I didn't have my thyroxine upped during my pregnancy and so I will look at what my TSH level is as it was tested only a couple of weeks ago. Thank you both once again for the warm welcome. It's so good to know I can 'talk' to people who understand here.

[snowdrop]

Good news - my TSH is 1.5 mui/l! Good to know about that info and reassuring that my level is about right.

[caryn]

Good - it's always reassuring to know you've ruled out a potential problem.