Afraid It's Happening Again

[afraidpre2ndtime]

I'm pregnant with baby #2. We plan to have this be our last pregnancy because it's just so tough on my body. This is going to be long, but I wanted to give a quick as possible back story for my pregnancy with my daughter:

I started seeing symptoms of preeclampsia around week 32. I had enormous swelling in my legs, my hands,, my feet and beginning to swell in my face. Then, I started seeing spots and flashing lights in my vision. My blood pressure, though, stayed normal at 120/80, so the docs didn't find any reason to watch me any closer than normal.

I was already a high risk pregnancy due to pre-existing type 1 diabetes (insulin dependent since age 14), but I knew the warning symptoms of preeclampsia that I listed above were signs that my brain was swelling. The docs sent me home despite my concerns and said to watch for a migraine.

By the time week 35 came around, I was so badly swollen that I physically couldn't bend my knees to walk up stairs. My shins skin was splitting because the skin was stretched too tight. I couldn't close my hands into a fist because it was too badly swollen. My face was DOUBLE the size it typically is. I literally needed help walking because I couldn't bend my legs from the swelling.

The docs still told me to wait for a migraine because my blood pressure wasn't elevated yet. So, at 37 weeks, I went i with a migraine. They admitted me and my blood pressure was 256/114. I had never in my life been over 120/80, sometimes even 110/60.

My concern today is that I'm pregnant with baby #2 and I'm feeling swelling in my ankles already. I'm 16 weeks pregnant. My belly is really swollen and I look like I'm 6 months pregnant instead of the 4 months along that I am. I drink water constantly throughout the day and hardly any pee comes out. A few days ago, I blacked out completely while driving, which ended in a car accident, which gave me a concusion that lasted for twelve hours.

I know all of these things are symptoms of pre E. But, the high risk team let me get so far out of control last pregnancy that I don't know what to think about how far out of control they'll let me go again. Also, being so young in the pregnancy, I would really want to keep the babies in there for much much longer.
I avoid salts, drink tons and tons of water (I'd guess at least a gallon per day), get mild exercise, eat NO processed foods (extremely strict on my diet, everything is homemade) and am barely hungry- yet I've gained about 10-15 lbs already. I seriously don't know what to do. I feel like I'm doing everything right and being so careful, but I just don't feel like something is right with this pregnancy. The docs say the baby is healthy so far. I have a full anatomy scan in three weeks.

Does anyone have experience? I'm worried.

[alviarin]

Sorry to hear you have been having a rough time, but welcome to the forums.

It is normal to be worried about a second pregnancy after preeclampsia, but it is extremely rare to get pre-e before 20 weeks gestation. Also, it is more common during second pregnancies for pre-e to strike later in gestation or less severely (or not at all).

In your shoes I'd be more worried about my diabetes being well controlled than pre-eclampsia at this point. How are the doctors managing your condition during pregnancy? (ie have you had to up your insulin?) What did they say about the fainting episode and fluid retention (swollen ankles and decreased urine output)?

Has anyone checked your urine for protein lately? Sometimes women with a history of pre-eclampsia are given a 24 hour urine collection test pre-pregnancy or during early pregnancy to establish a baseline.

[sam10]

A second pregnancy after PE is no walk in the park and many things that our bodies do during pregnancy makes our alarms go off. I am currently 18 weeks pregnant and by the evening my belly triples in size; it can fluctuate widely. I was very concerned about that (I retained a lot of fluid in my previous pregnancy), and my MFM told me that hormones can do that Also, a second pregnancy comes with larger bellies, so I hear from other experienced moms.
The earliest onset of is around 20 weeks, so it is very unlikely that what you are experiencing is PE, but you definitely want to talk to your doctor about your fluid intake and output, so they can take a closer look, and do a proteine check. I agree that at this point I would also make sure that your diabetes is being managed well.

[jenh]

I hesitate to write this because it could be completely the wrong advice for you, but I'll share in case it helps. What stood out to me is that you're avoiding salt. I don't know much about diabetes diets or if you have salt-sensitive hypertension outside of pregnancy, so you may have very good reason to avoid salt. But if you're avoiding salt because you think it will prevent PE, the research I've seen says it really doesn't help.

When I was pregnant with my first and second, I had excessive swelling early on. The only advice anyone gave me was to drink more water, but I was already drinking 1.5+ gallons of water a day. I was horribly thirsty and not peeing much. Finally, a friend who is a doctor (but not my doctor) mentioned that perhaps I was drinking myself into an electrolyte imbalance. He suggested I add some salt in, specifically drinking Gatorade but I don't know if that's an option for you with diabetes. I got some that day, and spent the next several hours in the bathroom. The fluid just poured off. From then on, I didn't restrict salt on my food and continued to drink a little Gatorade every day. My swelling stayed under control until PE struck again a few months later and I ballooned up again.

As I said, this could be the completely wrong advice for you, but it may be something to discuss with your doctor. Too much salt is bad, but we do need a little.