Early PE

[grammy]

Hi I am a worried grammy, My daughter is at 21 weeks and already has PE and protien in her urine. This seems very very early to me. Anyone know if the Baby and her have a fighting chance at this early stage? I had PE when pregnant with her but was much farther along was at about 35 weeks. Her Dr. doesn't seem the least bit concerned. scares me.

[laura]

Wow! My goodness! Ok- there are a couple possible ways to look at your daughter's situation. First is worst case scenario- she really is developing preeclampsia and we all need to keep our fingers crossed that she can hang on as long as she can. It has happened before, and I'm hoping someone who has been able to hold off delivering long enough for baby to get to viablity will jump in here with hope for you. If they don't, it isn't because it hasn't happened, it just is that maybe they haven't seen this yet.

Second is a mixed bag- the doc may think that your daughter has an underlying issue that might be triggering hypertension and proteinuria. If she has preexisting kidney issues or hypertension, it may not be as big a concern as if she were developing the disease of preeclampsia, which usually has about two weeks between diagnosis and necessitated delivery.

At this point it might be good to ask them a few questions to clarify the situation:
Does the doc think that there is kidney disease and/or chronic hypertension triggering these lab findings?
What exactly are the lab findings? How high is the hypertension and how much proteinuria does she have?
Is she seeing a perinatologist- a high risk pregnancy specialist preferably at a teaching/research hospital?
Does the doctor think she'll make it to term? to 35 weeks? to 28 weeks?
Is she inpatient at the hospital or being managed as an outpatient? If so, how often is she being monitored?
When was her last ultrasound? Did baby's growth look ok? How about the blood flow around the placenta?

Grammy, I'm waiting with bated breath to hear how your daughter is doing. Please let us know what you find out, and if we can help with anything!

[grammy]

Thanks for answering so Quickly. She is seeing a family practice dr only. Her last ultrasound was Jan 6th, she found out about the PE on her next appt Jan 9th. she didn't tell me the specifics BP, urine count, etc.. Just that her Dr said she had PE and the protein in her urine and that it was a reacion to the baby's dad's blood.being different then hers.? I don't get that but.. and that she should come in if she has a seizure or feels really bad. otherwise he would see her in 4 weeks. I don't understand that DR at ALL. I am in Indiana and She is in ND so I don't get to go in to talk to the dr myself or anything.

[grammy]

oh and no preexisisting issues except Renauds diease that I am aware of.

[missgamecock]

I meant to answer this a few minutes ago but IMO crashed my computer at work. I am really concerned about your daughter and I am not trying to alarm you. That being said, you should not wait for your daughter to have a seizure to come. [:(!]If she has a seizure, it can be deadly for her and/or the baby. This is called Eclampsia and is very very bad. I don't know her bp or what her protein is running, but the minimum diagnosis for PE is 140/90 6 hours apart twice or a rise in baseline value 30/15. Also 300mg of protein in urine. If it were me (and I am not a dr, just someone who has been there), I would be at the very least getting her into an ob and possibly a high risk specialist (if the ob refers her for that). She needs to be followed very closely and 4 weeks in my opinion is way way too long. She needs to have basic lab work done, this would be bloodwork that would test BUN, creatine clearance, CMP, CBC w/diff, and liver panels. She also should have a 24 hr urine done because the dipstick that they use in the office is not always accurate. 24 hr is the accurate measurement. She should also be having her bp monitored. She should be be having regularly scheduled ultrasounds to check the baby's growth. She should also be having Doppler Blood Flow studies which will check the blood flow through the placenta to the baby. When she gets further along, she should be getting NST and BPP's to check the baby's well being. I am just really concerned and don't think that she should wait till it gets bad to come in. Lord knows to have a seizure. That statement sends chills up my spine. If she isn't comfortable with her dr's care, she needs to change. Trust is EVERYTHING. Please let us know what you find out. As many of us here have found out, PE can change in hours... Waiting for an update.

Ask her to call her dr TODAY and get in and get some answers. Added the link for signs and symptoms - you can even send this to her by email and have her bring it into her dr and go over it with him.
http://www.preeclampsia.org/symptoms.asp

[grammy]

She is comfortable with him. I am not!! She also has endemitriosis and the placenta is attached on her cervix I forgot these things in the earlier posting. What are NST and Bpp? I can't do anything much from here, being we are almost 1000 miles apart and I hate to get her upset. She already thinks i am trying to meddle or something. oh and she has a sinus infection and can't have any meds she is allergic to penicillin.

[thw75]

Ditto to all of the above advice. If you and she are communicating correctly then she needs to be seen by a high risk OB and also needs to be seen weekly, at least. Please email her a link to this website. There is no such thing as too cautious when it comes to Preeclampsia. And bloodtype has nothing to do with it (maybe she is referring to another condition??). A baby born prior to 24 weeks has no chance of survival, and its dicey up to about 32 weeks -- if she does have preeclampsia the odds of her making it that far are pretty grim. She needs to know what she is dealing with for sure, and get her specific medical test results and info. Better a meddling Grammy than a grieving Grammy.

[missgamecock]

NST is a nonstress test - they put two belts on to monitor baby, one for heartbeat, one for contractions. Usually starts around 30-32 weeks. BPP is a Biophysical profile - checks movements, practice breathing, etc, checks for baby's well being. Much better to be meddling than grieving. She needs to know this. Then she has the additional risk of the placenta on the cervix, forget the ob, she needs a high risk specialist! Please by all means get her upset. So many have said if I had only known..... We know that is why we are being so insistent. Please talk to her right away and tell her she needs to be seen by an ob and get a definite on what is going on. I know you are 1000 miles apart but there are things that you can do. Talk with her, convince her, send her the link to this site. Heck have her email me through my profile. But she needs to get on top of this. So many drs even obs lack the understanding of this disease. To put it in perspective for you. They decided to do an emergency induction (couldn't do a csection because blood wasn't clotting right and they were afraid I would seize). My dh left around 9pm on Friday night. At 12 am Saturday morning I was very ill. I was FINE three hours before. He came in at 6am on Saturday and was shocked by what he saw. When he left the night before, I had 1 iv in. He came in the next morning, I looked like the michelin man, had bruises up and down my arms so bad that I looked like a drug addict (they had to take blood out of my hands and feet for the next two days), had every hook filled on the one iv, plus they had inserted another iv and all of those hooks were filled. So I had two ivs in, one in each arm. The second one was for the mag sulfate. I had a nurse sitting in my room physically watching me to make sure that I didn't have a seizure. I was hooked up to EKG machine for vitals, bp monitor, and the belts for baby's heartbeat and contractions. I looked AWFUL. This was in a space of hours and I am darn lucky that I was in a hospital much to the insistence of military drs. My ob was totally blowing me off and did not watch me the way she should have. So please do what you need to do to convince her that this is very serious.....

[laura]

21 weeks is a little early for a BPP and NST. It doesn't necessarily become helpful until 28 weeks.

One thing has me really concerned; we're not docs here, but the most current research on the subject indicates that preeclampsia is not a reaction to the father's blood. There is an immunological component to it, but it isn't that simple.

What state is your daughter in? Maybe she can get a second opinion. I work the forum here, but I also do regular support for the PF. Would you like me to call your daughter? I can call or email her, just drop me a line at laura@preeclampsia.org

In the meantime, as Sabrina was saying, she should have the information she needs to stay safe. You can ask her to watch for signs that things are deteriorating. In preeclampsia, sometimes it can get badly very quickly.

You gotta watch for a couple of different things, in a couple of areas:

signs of nervous system compromise- and that would be headaches that won't go away, visual disturbances like flashing lights etc.
Signs of organ damage- cola colored urine, upper right sided or shoulder pain, etc.

The stuff mentioned on the symptoms page. Those are go straight to the ER, do not pass go symptoms. My guess is that she isn't quite there yet, so if you start talking about emergencies, she'll wonder what the heck you're talking about and perhaps get a tad defensive.

Hang in there!

[grammy]

wow sounds like I got by very very easy with mine 24 yrs ago. I had to pretty much stay lying down on my left side and drink lots of water. and limit salt intake. That got me through with this daughter from Jan 21st to Feb 28th. She was induced only 10 days early from my due date.