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Post Partum Testing/Care

Are you pregnant again after having preeclampsia once already in a previous pregnancy? Post your thoughts/concerns here - there are others who share your feelings. This is also the home of our Bedrest Buddies Support group.

Post Partum Testing/Care

Postby MomTimesThree » Sat Jul 14, 2012 03:38 am

by MomTimesThree (570 Posts), Sat Jul 14, 2012 03:38 am

I'm wondering what I should expect/request when it comes to PP care. After our 2nd I was so glad he was here and healthy and that our BP went back down to normal I never pursued anything else and was just glad to not see doctor's offices. I was so sure everything was just a fluke anyway. Now since during our 3rd things went wonky, I'm wanting to make sure I get some answers, but I'm not even sure the questions to ask.

I'll be going in a week (2 weeks PP) for a BP check (and still monitoring at home) and then I assume from there just my 6 week PP appointment. I'm thinking I should request a 24 hour... though not sure when is best to do that since our levels were higher than normal (194) at 10 weeks, but I'm not sure what else if anything.

Thanks in advance!
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
MomTimesThree
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Re: Post Partum Testing/Care

Postby sam10 » Sat Jul 14, 2012 01:47 pm

by sam10 (1437 Posts), Sat Jul 14, 2012 01:47 pm

I was monitored for my BP, but was switched to my primary care a few weeks pp who then decided when it was time to wean me off. My OB ran some blood tests, checked on my c-section scar, but did not do a 24-hour urine collection. They did do a dip though. A few months after I saw a cardiologist to check my heart and did a thorough physical with my primary care.
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
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Re: Post Partum Testing/Care

Postby blythe » Sat Jul 14, 2012 11:15 pm

by blythe (3060 Posts), Sat Jul 14, 2012 11:15 pm

I'm not sure if there's a standard protocol, other than treating symptoms when necessary. We emphasize post-partum care so much because most women don't see their docs between leaving the hospital after birth and then their 6 week appointment. I'm glad you're being seen at 2 weeks pp! I'd just ask your doc what tests they recommend and why, and let us know, I'm interested in the differences in care.

One thing the Preeclampsia Foundation has been working on is to increase awareness that PE is a risk factor for future cardio issues. I wonder if providers are telling women with PE about that in their postpartum appointments?
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH
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Re: Post Partum Testing/Care

Postby mllewellyn » Sun Jul 15, 2012 03:03 pm

by mllewellyn (61 Posts), Sun Jul 15, 2012 03:03 pm

I have to be in a week pp and then if things are going well, a 6 week pp appointment.
Interesting that you asked about future issues after pre-e. I was never told anything except I would get it again and probably should consider not having children. I'm not kidding. I found out about the cardio/bp issues from the pre-e site and a few articles my mom forwarded to me because she knows my interest in this subject. I think all providers (primary care, OB, etc) should warn of possible issues in the future.
Mistie
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Re: Post Partum Testing/Care

Postby blythe » Sun Jul 15, 2012 10:11 pm

by blythe (3060 Posts), Sun Jul 15, 2012 10:11 pm

Hi Mistie, I'm glad you were able to find out about the cardio future risks through the PF, and I hope we can keep educating women and providers so we can take extra care of ourselves for our future health. I'm so sorry you were told to not have more children! Sometimes docs haven't seen cases as bad as some that we see around here, and are frankly scared. Have you talked with an MFM? They see bad cases more often and are more likely to be optimistic about future pregnancies, and can more accurately judge your specific risks.
Ah - just saw your other post. Welcome baby Gabriel! I assume the "don't get pregnant again" was after your last pregnancy, and I'm so glad this one went relatively well.
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH
blythe
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Re: Post Partum Testing/Care

Postby mllewellyn » Tue Jul 17, 2012 08:43 am

by mllewellyn (61 Posts), Tue Jul 17, 2012 08:43 am

Heather, I was actually told not to get pregnant after my 1st. I dind't listen and actually spoke to several doctors about the future pregnancies. I never got an affirmative answer in either direction. My 2nd and 3rd (only live births) were with a different father than #1. My MFM told me that it would make a difference. It did with #2 but not so much with #3. I didn't develop HELLP with my 2nd and 3rd though so that is a plus. Since I am 39.5 years old, I went ahead with tubal during my emergency c-section. I am too old. :)
Mistie
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Re: Post Partum Testing/Care

Postby MomTimesThree » Tue Jul 17, 2012 06:36 pm

by MomTimesThree (570 Posts), Tue Jul 17, 2012 06:36 pm

I had my appointment today. My BP is still totally labile, though I do think it's getting a lil' more normal... About a week PP it was dropping so low mid morning I was getting dizzy so (with Dr approval) dropped to just a lunch dose instead of AM/PM dosages. Now my morning is creeping back up so my doctor said she trusts my judgement for when to take two doses and when to just keep a lunch dose. I'm up for a midnight-ish feed anyway.

As far as testing follow up goes, I will go back to our provider who watched over us our last week at the "big" hospital at 6 weeks PP to review the placenta pathology reports and monitor BP, then I will see my regular "local" OB at 8 weeks PP and see where we stand BP wise, I'll also do a 24 hour since our levels started high to begin with. From there we'll decide if she wants to send me off to my PCP, nephrologist or both. Because I also had GD, I'll also do a blood test (forget which one... A1 Ace something?), I think at 12 weeks PP.

In the meantime she reminded me to continue to monitor BP and symptoms and that things could take a full 6 weeks to get back to normal, if they are going to. After my 2nd things went back to normal like magic... this time, not so much. That and the abrpution during delivery seals the deal for me that my body is very done having kiddos.
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
MomTimesThree
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Re: Post Partum Testing/Care

Postby blythe » Wed Jul 18, 2012 11:24 pm

by blythe (3060 Posts), Wed Jul 18, 2012 11:24 pm

Lauren, really good hearing everything your doctors are doing for you PP, thanks for sharing! We've had quite a few moms who have rebounded fine after the first few kids and the "last" has put their bodies over the edge a bit. Maybe it's just that we're also getting older, but it does seem that repeated PE takes its toll on us. There are researchers working on the long term effects, we'll keep posting as the studies come out!

And Mistie, if you're curious, search Caryn's posts on paternity, she's collected a lot of great information
http://www.preeclampsia.org/forum/viewt ... 28&t=26469
I am also 39, and while objectively I know I'm not, wow do I feel old ;-).
Heather, mom to
#1 7-18-03 - 5#8oz 37 weeks PE/PIH
#2 8-11-06 - 6#14oz 37 weeks PE/PIH
#3 9-10-09 - 5#10oz 37 weeks PE/PIH
blythe
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Re: Post Partum Testing/Care

Postby sam10 » Thu Jul 19, 2012 07:27 pm

by sam10 (1437 Posts), Thu Jul 19, 2012 07:27 pm

For what it's worth mentioning, after this pregnancy I will also get my eyes checked with an opthamologist. During my last eye exam just a few weeks back, they found that my retinal blood vessels appeared to be as if I had high blood pressure (retinopathy) or diabetes, which I don't. I just wonder if it could be a left over from my last PE pregnancy where I had high-blood pressure.
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
sam10
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Location: Boston, MA

Re: Post Partum Testing/Care

Postby MomTimesThree » Thu Jul 19, 2012 07:32 pm

by MomTimesThree (570 Posts), Thu Jul 19, 2012 07:32 pm

That's really interesting... I didn't think to follow up about that. My husband actually had a random bout of high blood pressure not too long ago (maybe I'm contagious!) and had some eye issues at the same time- and sure enough he had some bleeding from one of the nerves I think? Something with the retina.

I'm sure I'm due for an eye exam and might follow up with that as well. I'm very much wanting to cover all my bases and go forward with life with either a clean bill of health or at least knowing what to watch out for.
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
MomTimesThree
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Posts: 570
Joined: Sat Feb 11, 2012 08:54 pm

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