So confused- what tests?

[egearns]

Hello everyone,

I have a 16 month old daughter who was born at 32 weeks due to my preeclampsia. I would say that, overall, my doctors are/were very good with recognizing and managing my symptoms. I'm very confused about what I should be doing before TTC this summer. I had some tests done (only because I asked) and I had a vitamin d deficiency but nothing else show up. If you don't mind, what tests did you do before trying again? My doctor told me to have my vit d checked again in 6 months and just "take care." She said that I should call her as soon as I get a positive test to establish baselines and THEN meet with a doctor specializing in mfm. It seems as though the stories I read involve people having a lot more testing and seeing specialists first, Please share your experiences- I am making myself absolutely crazy here. I have to know that I did everything I could before getting pregnant again. I am fairly certain that my doctor will order whatever makes me feel most at ease.

Thank you in advance!

[caryn]

Welcome!

There is no standard workup, which is why you're seeing so many conflicting reports. There are a handful of underlying disorders that are more common in preeclampsia, but in most cases treating them is not thought to improve pregnancy outcomes - just (just!) to improve your underlying health. There's also one disorder that should quite clearly be treated to improve the odds of a successful subsequent pregnancy, which is APS (or antiphospholipid syndrome.)

Most commonly docs will test for chronic hypertension (the most common underlying condition), diabetes, PCOS (or polycystic ovarian syndrome), APS, and thrombophilias. Chronic hypertensives will often be managed in subsequent pregnancies with blood pressure drugs that are known to be safe in pregnancy; this doesn't reduce risk of preeclampsia but does make really high maternal pressures less likely, which lowers your risk of stroke. Most thrombophilias aren't thought to contribute to PE risk but are correlated with it, and some docs will use heparin or Lovenox in patients with particular thrombophilias but not all. PCOS and diabetes can be brought under control before pregnancy and managed aggressively in pregnancy, much like chronic hypertension.

But most women who develop this syndrome don't have anything that's obviously treatable outside of pregnancy - because most of the time, it's a placental issue that is not caused by these conditions. It's just that women who have these conditions or who will develop them as they age are also more likely to get preeclampsia.