Preeclampsia v Postpartum Preeclampsia

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Re: Preeclampsia v Postpartum Preeclampsia

Postby babycangel » Sat Nov 18, 639550 10:29 am

I have had both with my last pregnancy and I think postpartum can be worse IF a woman is not checked properly. I was lucky enough to have good care, so when my BP shot up to 208/110 my doctors reacted immediately and were on top off things. But if I had disregarded their request to continue monitoring my BP I would have been in bad shape. Almost 8 weeks PP I am still on high doses of labetalol (1700 mg/day) and once I quit breastfeeding I will be switched to an ACE inhibitor because this last run has put my numbers out of whack.

The biggest threat is prenatal preeclampsia during the 2nd trimester and early 3rd trimester as doctors have no choice but to deliver if mom's health is compromised enough.

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Re: Preeclampsia v Postpartum Preeclampsia

Postby mom29 » Sun Nov 05, 639550 8:08 pm

This is a good reason to have your own bp monitor at home.

With my most recent pregnancy, the mfm wanted me to come in 1 week, 3 weeks, and six weeks after my daughter was born.

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Re: Preeclampsia v Postpartum Preeclampsia

Postby caryn » Thu Oct 12, 639550 10:42 pm

Yes, postpartum I got diuretics for pulmonary edema, but they couldn't give them before without compromising bloodflow to the placenta. Same goes for aggressive control of maternal pressures.

The problem with postpartum PE is since it can hit after you're out of regular medical supervision and discharged with your next appointment in two weeks. Postpartum swelling is normal, no one's checking your pressures, and you've got a headache but that's from sleep deprivation right? So women can end up being admitted after they've already started seizing, well into multiple organ failure, which is why it kills them more often - simply absence of care.
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The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
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Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

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Re: Preeclampsia v Postpartum Preeclampsia

Postby blythe » Wed Sep 20, 639550 12:23 pm

I think MissingMolly is right - prenatal is worse because the doctors have to walk a thin tightrope between keeping mom safe and keeping baby safe, so premature delivery is often required and that poses a lot of risks to the baby, including the baby dying.

But either prenatal or postpartum PE can kill the mother, and some statistics I've seen (sorry don't have the references at hand) say *more mothers die postpartum*, possibly because of delays in diagnosis.

Postpartum PE is easier to *treat* if it's caught in time and diagnosed correctly, because they can use more aggressive drugs to treat mom's high blood pressure, use diuretics (which I believe can lower pulmonary edema risks? or am I just guessing on that one?), and other interventions that aren't coming to mind at the moment.

I'll echo MM - is that what you had in mind?
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: Preeclampsia v Postpartum Preeclampsia

Postby MissingMolly » Wed Sep 20, 639550 9:56 am

Prenatal preeclampsia is worse to have, no question. Because there is a risk of losing the baby. Which happened to me and many of us here. I'd much rather have developed the thing postpartum and then maybe I'd still have my baby.

I'm not sure if that addresses what you're asking, though. Are you referring to the severity of disease? In that case, it really depends on the woman and her particular body, pregnancy, and circumstance.
Mommy to Molly, who was born alive on Oct. 29, 2011 at 23+3 weeks due to severe pre-eclampsia/HELLP syndrome and passed away 3 hours later. Loved and missed every minute of every day...."If love could have saved you, you would have lived forever."

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Preeclampsia v Postpartum Preeclampsia

Postby cjd1975 » Wed Sep 20, 639550 1:41 am

Which is worse to have?? Any thoughts?

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