Locked FAQ Members Login

2nd preg w/ history of PE, heart failure

Do you have a burning question you just have to ask our Medical Board Experts about hypertensive pregnancies? Please email your question to expert@preeclampsia.org Keep in mind, however, that we won't be able to answer every question and our docs can't offer medical advice and won't be able to comment on specific medical cases.

2nd preg w/ history of PE, heart failure

Postby expert@preeclampsia.org » Mon Apr 26, 2010 02:59 pm

by expert@preeclampsia.org (322 Posts), Mon Apr 26, 2010 02:59 pm

3 years ago I had a great pregnancy. At 39 weeks I was induced due to size of baby and favorable cervix. I labored 18 hrs and pushed for 3. During labor and delivery my bp was extremly high. Around 205/130's...the nurses and my doc didn't seem concerned. After I was extremely swollen head to toe. so swollen my eyes were crossed! I don't remember having my vitals checked while in the hospital I was so in and out of it and we were sent home the usual 48 hrs after. I remained swollen and I felt terrible.

The 3rd night home I felt like I couldn't breath. I was still so swollen and had a horrible headache. My husband, an emt had me call my ob the next morning and she told me to go straight to the er. My bp was sky high and I was started on LASIK. They ran test after test and I stayed in the hospital on the cardiac unit for 3days. They stabalized my bp and I lost 41lbs of fluid. I was sent home with bp meds, iron, and potassium.

At my 6 week check up with my cardio doc I was cleared and able to stop my meds. They said I had developed preeclampsia and it caused me to have congestive heart failure. I have been normal and healthy since bp running about 110/60's. I am a runner and very healthy otherwise.

I am currently pregnant with #2. the beginning was great I felt good. Around 12 weeks I began to feel bad. Like a hangover....headache, dizzy, vision trouble, tired. My husband checked my bp and it was 138/85. A couple of days later I had an appt with my ob for my 12 week checkup. My bp that day was 138/88. My ob wasn't concerned, she said it was just 1st trimester issues and prescribed me migrane med. I had an allergic reaction to that and was back in office the next day, bp up again. A different ob was concerned and told me to watch it at home. If it got above 140/90 to call. 2 days later it got up to 149/95 and they had me back in for 24hr urine and blood work. It came back normal and a few weeks later the day before my 16 wk check up my vision went dark on me and I fell while at work. My bp was 149/99. The next day at my appt my bp was still up and my ob was very concerned. She called my cardiologist and they put me on labetlol 100mg 2x day. I was still not feeling good and had tried several meds for my headache which none have helped. I have had numerous tests ran all are normal.

I saw a maternal fetal doc and he found my platelet level is very high and ran bloodwork for genetic testing which was all normal. He put me on baby asprin and fish oil daily hoping it might help me feel better with no results...they were both leary about calling me preeclamptic because this has started so early. My urine has been up and down at each doc appt for protien...it's been traces and 1+ and none. I go back in to my ob in a few days for my 24 week check up. And I don't know when I will see my mfm again.

Could this be preeclampsia developing slowly???? Is the way I'm feeling a sign of pree??? I feel like I need some idea of what is going on. The past week or so I have developed nausea and can't eat a lot. I'm worried that this is pree and am curious as to what may come down the road. Working is hard, I'm on my feet all day and feel out of it. I'm worried it may not be safe. My bp is stable with the exception of it rising while busy working it goes up to around 130/80's.

Should I be concerned??? Thanks so much for any info!!
expert@preeclampsia.org
Registered User
 
Posts: 322
Joined: Wed Mar 29, 2006 02:46 am

Re : 2nd preg w/ history of PE, heart failure

Postby expert@preeclampsia.org » Mon Apr 26, 2010 03:00 pm

by expert@preeclampsia.org (322 Posts), Mon Apr 26, 2010 03:00 pm

This patient relates a story which appears to represent severe preeclampsia manifested by postpartum pulmonary edema. Patients with this degree of swelling are best managed with lasix immediately postpartum and for 5-10 days thereafter so that pulmonary edema rarely develops. Blood pressure control to prevent systolic hypertension (keep it below 160) was advised in 2005 after a series of patients with severe preeclampsia suffered strokes when this level was exceeded in association with headaches and other symptoms of an affected central nervous system. Rarely a story such as this patient's represents a postpartum cardiomyopathy, but most likely it was severe preeclampsia manifested by cardiopulmonary compromise.

This patient appears to be in the hands of a maternal-fetal medicine subspecialist and an OBGYN specialist who are sensitive to this patient's risk of recurrence of preeclampsia. Early onset of mild hypertensive readings as described can be either pregnancy plus mild chronic hypertension versus slowly developing recurrent preeclampsia. Both need close monitoring and care by experienced physicians.

Encourage the patient to keep her appointments and work with them for a successful pregnancy outcome. It would seem to me from what the patient says that she may be a candidate for a job change to get something less stressful with more time for rest.
expert@preeclampsia.org
Registered User
 
Posts: 322
Joined: Wed Mar 29, 2006 02:46 am


Return to Ask the Experts

Who is online

Users browsing this forum: No registered users and 4 guests