Advice for second pregnancy after pre eclampsia

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Elizabethx3
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Re: Advice for second pregnancy after pre eclampsia

Postby Elizabethx3 » Fri Mar 27, 2015 05:28 pm

So glad you made it through the first pregnancy ok. I had three preeclampic pregnacies and three C-sections. All three children are in their 20's and generally doing well. My first boy was two weeks late yet only weighed 5 pounds 9 1/2 oz. A nurse mentioned that my bp was high but no one used the word preeclampsia ever. We were kept in the dark. (We moved to Dayton, OH for a house.)
My second pregnancy ended at 26 weeks (6 months visit) with a baby boy weighing 1 1/2 pounds. After a quick ambulance ride to top level care, I was put on magnesium sulfate to prevent seizures. Their intent was to save me; if he survived that was good, too. He was strong and did well. He spent 3 1/2 months in the NICU (1990). He's had 8 surgeries; none life-threatening. At age 22 he learned he had Hep-C from a blood donor and was successfully treated. He's 25 now, working near full-time again and engaged to be married.
We thought we'd never have another child but within three months, we were expecting our daughter. I felt this amazing peace from God that things would be ok. The hospital saw me twice each week until late when my bp went up. Then it was three times a week. Back then it was bed rest but no medicine. When I began swelling I knew that drinking a lot of water every day would help flush it away. I drank like a fish. Good practice for breast-feeding anyway. Maybe that, the extra rest and my mother-in-law's help around the house made the difference. Despite preeclampsia again my daughter was born two weeks early by planned C-section. She was fine and weighed 7 pounds 8 1/2 oz. She was my only easy baby and breast-fed well. She also did best in school and is the only one who has graduated college.
I'll never know if the difference in the womb has been the reason for that. :)

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caryn
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Re: Advice for second pregnancy after pre eclampsia

Postby caryn » Tue Mar 10, 2015 09:52 pm

Hi, and welcome!

The thing that seems to have the biggest impact is that it is a second pregnancy - the spiral arteries that supply the uterus are remodeled by the first pregnancy and are easier for subsequent placentas to exploit. So you're really set, there!

The Brewer diet doesn't help; we've got tons of posters who tried it and got preeclampsia anyway. The best data we've got show no effect on preeclampsia rates from adding dietary protein: http://www.ncbi.nlm.nih.gov/pubmed/14583907 "Dietary advice appears effective in increasing pregnant women's energy and protein intakes but is unlikely to confer major benefits on infant or maternal health. Balanced energy/protein supplementation improves fetal growth and may reduce the risk of fetal and neonatal death. High-protein or balanced protein supplementation alone is not beneficial and may be harmful to the infant."

Baby aspirin is the current recommendation for a subset - I think you'd be in the group, because you developed preeclampsia early enough - but doesn't help everyone. The number needed to treat (NNT) is the number of women who need to use the intervention to avoid one case of preeclampsia, and if I recall correctly, the NNT with low-dose aspirin is around 20. But it's definitely recommended now: http://annals.org/article.aspx?articleid=1902275

Really, there's very little data showing any impact of lifestyle or intervention at all - but the fact that it's a subsequent pregnancy is clearly helpful. Most women, if they do develop it again, develop it later and have a more mild case. Unfortunately that's not true for everyone, but the odds are in your favor.

Have you scheduled a preconception consult with a maternal-fetal medicine specialist? Here's a link to find one in your area: http://www.smfm.org

Please keep us posted!
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

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

sazdorn
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Advice for second pregnancy after pre eclampsia

Postby sazdorn » Fri Mar 06, 2015 08:59 pm

Hi I was hoping for some advice for the second pregnancy after pre-e.

My symptoms last pregnancy began around 28 or 29 weeks. I was officially diagnosed at 31 weeks and delivered at 34 weeks after being on procardia and bedrest for 3 weeks. It didn't go away after delivery and I still had it and was on blood pressure medications for 6 weeks after delivery.

We are not pregnant yet but are starting to talk about it. Is there anything I should do for next pregnancy or does anyone have any stories to share? I have read about the brewer diet and the baby aspirin. Is there testing I should undergo for clotting disorders etc? I had read about that a lot time ago and can't find any posts recently. I moved states so will have a different doctor than the last time. I'm extremely anxious about the second pregnancy!

Any advice or stories would be really helpful!!

Thanks :)


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