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Re : Will It Happen Again? The Experts Weigh In

Posted: Thu May 08, 2003 11:39 am
by expert on call
If patient developes severe preeclampsia before 28 weeks, recurrence
rate in subsequent pregnancy is 60%. One third of those will be
before 28 weeks again.

If she develops severe disease at 28-36 weeks, recurrence rate is
about 40%. One third will be at same gestational age.

Preeclampsia at term, recurrence rate is at 15-20%.

Based on our studies with HELLP, recurrence rate is always <5% even
for those who develop it at <28 weeks. However, these women remain at high risk for preeclampsia.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.

Re : Will It Happen Again? The Experts Weigh In

Posted: Wed May 07, 2003 12:39 am
by expert on call
Our experience in Mississippi, published approximately 10 years ago by Chris Sullivan and our team in the American Journal of Obstetrics and Gynecology, and recently corroborated in another center (SGI abstract) with similar numbers, is that the recurrence rate for HELLP syndrome is approximately one in four to one in five. The overall recurrence rate of any form of preeclampsia including HELLP was 40% in our experience. Lower numbers were derived by Sibai while in Memphis. Recent work by others investigating patients with acute fatty liver of pregnancy and atypical preeclampsia as HELLP syndrome suggests that there may be a genetic basis to these conditions involving long chain fatty acid synthesis. Whether or not a patient develops these conditions may depend on a number of factors, especially the interaction between fetal cells and the mother's tissues. There have been no studies to investigate how to reduce the risk of recurrence, but excellent nutrition seems reasonable as well as fairly close surveillance of a subsequent pregnancy by the OBGYN or MFM (baseline CBC, liver functions, repeats later in pregnancy if there is a question). Attention to self-monitoring by the patient in the second half of pregnancy is probably a good idea with regard to notifying her physician if she begins to notice a flu-like syndrome, develop GI problems, has nausea and/or vomiting, or experiences epigastric pain. In my experience, starting steroids early in the disease progression of HELLP syndrome improves the disease state and results in better maternal and perinatal outcomes. Of course, it is true that the majority of patients that had HELLP syndrome do not have a recurrence in the next pregnancy.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.

Will It Happen Again? The Experts Weigh In

Posted: Wed May 07, 2003 12:37 am
by annegarrett
Since we had such a great success with how to measure BP---I thought we would start a series of these questions with the various answers from our Experts. We are starting with the most frequently asked question-Will it Happen Again?

Anne