24 weeks and it looks like pre e is back

[Kksgirl]

I am new to this forum but am in need of advice/support. A brief history: when I was 19 my husband and I conceived a son. Perfect pregnancy until I suddenly went into labor and had him emergency c section at 28 weeks. Was given a reason of unknown. He held on 3 weeks before he passed. 6 years and 2 miscarriages later, I became pregnant with another son. I developed severe pre e as soon as 20 weeeks hit and stayed in the hosp with uncontrolled bp issues, massive weight gain, visual disturbances, all relative symptoms. The baby stopped growing and the magnesium was not effective so we did a 2 day round of steroids and he was delivered via c section at 24 weeks. He made it one day. Here I sit 23 weeks 6 days in the dr office. High bp since Christmas eve been on aldomet since the 27th. My protein was negative then. I'm waiting ever so patiently to get another protein check. Last week my baby girl measured perfect on the u/s. In fact she weighed more than my second born son. But I am SCARED. To make matters scarier I now live in the dominican republic. While my care has been wonderful and the facililities are kept up nicely its scary being away from the states with such issues. My other symptoms include mild swelling in the feet and ankles, though more on the right side. I think I've injured mt right foot somehow before the 24th xmas shopping. My hands and face swell slightly as well. Breathing has become a little shallow as of the last week as well. I just have this sinking feeling I'm going to see the dr and he will tell me I'm fine and I'm going to go another week panicing myself. I know something isn't right but it is progressing more slowly this time around. I can't simply go back to the states because I don't have insurance so I feel stuck. Any advice as to caring for myself would be greatly appreciated as I am an absolute mess!

[LauraBeck12]

I can not imagine all the loss that you have suffered and here you are still fighting.
It's absolutely inspiring.

I lost my son who lived for 3 days after he came at 29.5 weeks.
I can not imagine multiple loss like that.

I am not in the Dom Rep. But i am in the worst place in the entire USA to have a high risk pregnancy. Last time i had to be helicoptered out to the city that is 6 hours south of us for help.
I am very isolated by terrain. It's still no comparison but i think it's scary here too.

Losing my son taught me 2 things :
NEVER ever second guess your instincts no matter what.
and enjoy every single second no matter what may come of it or the end result is.

That is my only advice. You have been through this. So do not lose sight of what you know to be true.
But also think that even if this was a 100% normal situation/ circumstance, there is never any guarantees. Even the healthiest pregnant people are scared of the unknown. Holding on to every second of every day with this baby with gratitude will hopefully melt away some of the very justified fear.

You want this to work out well- more then you are scared. No matter what part of the world you are in, things will unfold as they will.
You are doing everything in your power. and i want you to know that i think it's inspirational how much you love and fight for your children over and over. Go you!!

Keep us updated on how you feel. I'm sorry i can be of anymore help. <3

[Kksgirl]

I cannot thank you enough for your response. I had an u/s done and she's still doing good growth wise and heart beat. We are doing a 24 hour urine on Monday as well as liver profiles and what not. Basically he's saying he understands why I'm worried but that I'm causing more harm than good....which is true. My blood pressure lowers when I calm down so I've been taking it easier. He looked at my face and hands and said he wasn't concerned because it isn't severe. Which it can't be because I haven't gained a pound in 3 weeks. I know there is swelling but how bad can it be if my weight isn't up? I KNOW its coming but I am much more hopeful that it will happen later on. Your post really made me relax and I appreciate everything. My poor hubby has been trying to calm me for weeks and here a complete stranger manages to! I know a girl here who had her baby at 32 weeks because of pre e and her daughter is happy and beautiful! So obviously there are competent doctors and facililites to handle it if it becomes severe and it is only a 2 hour drive. I just notice things like difficulty breathing and what not but these are all things that can really happen in reg pregnancies (as if I know!).

[afaiz]

Hello I'm so sorry for your losses and everything you have suffered. I don't know if there is any advice I can offer but just to relax and take it easy. Does your dr have you on aspirin or lovenox? Those 2 things seem pretty common on the boards with preeclampsia or hellp. I developed hellp & eclampsia at 24.5 weeks in jan 2012. Our baby also didn't make it she was to premature and also didn't make it.

I am not sure what's standard protocol but it does seem like your dr is watching you closely keep us posted on your health & growth of the baby.

Praying for a couple more healthy months and a full term take home baby!

[Kksgirl]

Ok so if I could get advice from anyone that would be awesome. I had labs done and got the results today. The regular urinalysis shows negative for protein......the 24 hr showed 273. BUT the reg urine test shows I may have a slight infection. The liver function tests were good.......one protein blood serum test showed 5.2 which was a little low. Anyway, I saw the results and was hopeful. However, my dr saw them and immediately jumped up and called a cardiologist.......I was in shock. I can tell pre e is not something dealt with often here in the Dominican Republic. Anyway he had me so spooked and then while he runs out of the room to talk to the cardiologist down the hall, he has the nurse take my bp......go figure it was 130/100. On top of that I have a severe cold. Anyway I monitor my bp several times a day and it does NOT get that high. Period. I told him this but he just kept on. Then I asked about why the reg urine test keeps saying negative but the 24 hr shows 273.....which is nowhere near where i started last pregnancy (6000 first test). He did another reg urine test....negative for protein. I still have swelling in the feet and ankles when on my feet all day, but that's normal. Right is swelling more as well, but there are issues with a nerve in the foot. Very SLIGHT swelling in the face when I wake up, but it goes down with plenty of water. This dr has no idea what to do. He said he may have to send me home, as though this is an option. If I could go home and have the luxury of health care in the states I'd be there. But we make too much for Medicaid and can't get or afford the healthcare I need there. I feel good other than a cold and getting the you know what scared out of me. I know pre e can come quickly but does this seem like an over exaggeration to anyone else? For now, my Aldomet has been increased from 500 2 x a day to 500 3 x a day. I have an EKG Thursday and the dr said if my bp doesn't go down they'll have to deliver in two weeks......even though I've repeatedly told him this is not the norm. As I type, it is 110/79. My norm. I am so lost right now as what to do. Any suggestions or advice would be greatly appreciated.....does anyone have anything similar?

[afaiz]

Hi I'm sorry your going through this is there any way you could get a consult with another Mfm? Maybe it would help you feel more comfortable, I'm not sure but your urine/protein level doesn't seem bad or even alarming? It might just be the blood pressure? Have you tried bed rest? Or maybe you can convince him to put you on hospital bed rest in the 2 weeks time instead of delivering? I know it's scary but hang in there I really hope things turn around for you... How is the baby growing? Could you try to get an appt with a nephrologist that could evaluate your levels and discuss with your dr?


Good luck

[Kksgirl]

I found a new dr Monday that shuttles back and forth from where I live to the capital 2 hrs away (btw the hospital he shuttles to and from has the only nicu on the island!). He is AMAZING. He didn't get much time with me Monday as I literally just walked in to meet him. He still did a quick u/s for heartbeat and weighs me, bp (which was perfect). My blood pressure before finding him an hr earlier was 150/110. He literally put me at ease immediately. His wife delivered prematurely due to pre e, so he is extremely informed and emotional which I need. He doesn't seem as alarmed as the initial dr either. I go back tomorrow to do a thorough exam, u/s, and labs. He said we will know where to go from there, but that we are putting the cart before the horse talking about delivering that quickly. Especially when as you said my numbers are not alarming, and my symptoms seem to be improving since I left the stress of the previous dr. My husband and I know we found the right dr. He did say with my sudden onset pre e history that we will be starting steroid injections next week, so he understands my previous situation with developing it so severely so rapidly. My bp has been controlled all week and I've taken it easy as my amniotic fluid is a little low. So no swelling all week, no bp issues though I am on 1500 mg aldomet and 120 mg procardia. But it's working and it's not maxed out! I will update my appt results tomorrow. As far as the growing, she has been measuring perfect but my last normal u/s was 22 weeks. When he did the quick u/s Monday he measured her head and I saw it said 23 w 5 d. I was 25 w 2 d. But I know her position changed from transverse to breech and it was extremely fast. He didn't even mention that and doesn't know I saw it. I think he wants to see all my records and get a better u/s before scaring me, if there even is anything going on. At 22 weeks my placenta was still a grade 0, so I have high hopes it was just a bad measurement. Her estimated weight at 22 weeks was 1.2 lbs. I truly believe I'm going to hang on longer than a few weeks....of course pre eclampsia may decide otherwise for me. I just know how bad off I was last time and we held it off 4 weeks. I'm faithful with such few symptoms this will progress more slowly. I have to have that faith or I'd be a mad woman!

[Kksgirl]

Well, I had a seemingly good visit. We have to wait until Tuesday for more labwork and Wednesday for an ultrasound, as there is a Christian holiday weekend going on here. The dr looked at my lab results that had my last dr telling me we will deliver within two weeks a week ago and said there may be a sign preeclampsia can come, but it is not here!!!!! I think I knew that, but hearing that from a dr made me feel like a million bucks . He prescribed me an antibiotic for a UTI. He also questioned why I didn't have a baseline protein....good question but until I got high bp, I avoided all preeclampsia related sites to do the appropriate research to know, and unfortunately I don't think my last dr knew. So there is a SLIM chance the 273 is close to my baseline or the infection raised it. My uric acid was 4.7, which he says they don't like it to get to 5. Other than that my numbers seemed fine to him. He is starting the steroid injections next week though to make sure her lungs mature in the event anything rapidly progresses. I never thought I could face pre e with hope after our experiences, but I have it! The dr actually said he's HOPING for 35 weeks (9w 1 d away), but said assuming dates with pre e is impossible. Things are definitely not as bad as I initially thought! It feels great to have hope again and enjoy the little things like feeling her kick.

[Rubbie78]

Hope pre-e stays away. Glad your hope returned. Hoping for a healthy baby and Momma!

[Kksgirl]

I'm glad hope has reappeared as well....it has helped me tremendously! My labs have somehow gotten better. Uric acid went from 4.8 to 3.8. Platelets went up from 161000 to 183000. No protein trace in urinalysis. Everything seems like it just temporarily it better in that retrospect. My fasting glucose was 63 and the glucose test then was 153. He's having me modify my diet again....no biggie. The amniotic fluid has increased to healthy levels, and everything is measuring right on target of 26 weeks 4 days. Except the head is 25 weeks. But that is not too concerning. My placenta is a grade 2, which I'm not happy about but my blood pressure has been a roller coaster so it's to be expected. My dr is pleased but still started the steroid round being that I have a history of rapid onset of severe pre e. something that I'm really worried about is the umbilical cord is wrapped around her neck once. The dr said we will keep an eye on it, but is that all I can do? She is breech and he's hoping she stays that way, but what if she doesn't? I'm thrilled with the other news, but I know this cant be good.