What happens biologically during Pre-E

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lharrison
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Re : What happens biologically during Pre-E

Postby lharrison » Wed Oct 06, 2010 09:06 pm

Great thread!! I have heard some of these explanations before but never all together in such a concise and understandable way. Thanks so much for the explanation!!

This post is in response to smb's post from 2/2009 - this may be a new development in predicting PE, but I am pregnant with my 2nd and being closely monitored after emergency c-section due to PE and HELLP at 35 weeks with 1st pregnancy. At my 18 week MFM appointment they checked a uterine arterial flow on both the left and right. MFM said that the pattern of the blood flow can be an indicator for developing PE later. A normal blood flow pattern would show as a sound wave with a peak and dip. In the cases that indicate PE, the wave pattern will have an extra notch or step as the arteries are trying to relax (after the peak). As explained above (and per my MFM) this has to do with your body trying extra hard to get the blood to the baby. He advised me that if the PE pattern shows up in the uterine arterial blood flow then your chances of developing PE are at 50%. Mine did show the PE blood flow pattern but I had already been advised that my chances of getting PE again are at 50% due to my last pregnancy. So, it did not change my chances but thought it might be helpful to share.

I wonder if this could be a test done on ALL pregnant women to possibly have an earlier marker for developing PE later in the pregnancy.

atvlady
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Re : What happens biologically during Pre-E

Postby atvlady » Thu Aug 06, 2009 05:38 pm

I agree Caryn. My high risk told me that I started to develop pre-e around my 16th week, about the time when my right foot swelled up so big I couldn't even wear flip flops. But when he said that I looked at him and said I saw you twice and why didn't you tell me then! I don't know what was going through my drs minds with my pregnancy but the saddest thing is it was at the cost of our daughter, and almost my life. I am deeply saddened by this but furious on the other hand. LUCKILY I am going to see a new MFM in November. On the other hand, my HELLP came on in about 2 weeks so yes when you say that 2 weeks is from diagnosis to delivery I can say that is very true. I find myself extremley verbal now in my care now and my future pregnancies. My new ob is very confident I can have a viable baby next time. But still in my mind my odds are 50/50.

How about the role of VEGF in pre-e??? Any imput on that??
And does lowering BP by means of medication do more harm then good?

PS Caryn...could we make this post a sticky????

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caryn
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Re : What happens biologically during Pre-E

Postby caryn » Thu Aug 06, 2009 04:58 pm

PE is a freaky weird disease, and so they describe it using words like "multifactorial" and "heterogeneous". Essentially that means that there are lots of ways to be predisposed to get it, and lots of ways for the symptoms to present.

There's no known therapy or treatment for preeclampsia apart from delivery, except possibly in women with underlying thrombophilias who might benefit from blood thinners. However, the data supporting the use of blood thinners has gotten weaker with time, rather than stronger, and that may just be an artifact of our older studies.

Some women are on blood pressure meds to keep their pressures down because that is thought to lower risk to them, and to pose risks to the baby that are manageable through careful oversight. (Bp meds are associated with smaller babies, possibly because lowering the maternal pressure lowers the perfusion of the placenta somewhat. That can be watched with extra ultrasounds and dosage can be tweaked accordingly.) But blood pressure meds are not thought to affect the time of onset of preeclampsia or the rate of progression of preeclampsia.

And bedrest is known not to work, either.

So we're stuck saying that the average time from diagnosis to delivery is around two weeks, and that some women go from 0-60 in four hours, and others crawl along for months.

atvlady
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Re : What happens biologically during Pre-E

Postby atvlady » Thu Aug 06, 2009 03:54 pm

I am glad you said that Caryn. My high risk ob said there is some tests that are currently being researched as to detect preeclampsia developing in pregnancy but then he cut my water off when he said that still if preeclampsia is going to happen in pregnancy, the baby has to be delivered regardless. I am out of sorts with his response cause I have talked to other women who's pre-e was controled. I guess it depends on progression of pre-e???? I am confused by his answers and arrogancy with my last appt!!!!!

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caryn
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Re : What happens biologically during Pre-E

Postby caryn » Thu Aug 06, 2009 03:47 pm

Not yet. Tests are in development.

It's thought that all pregnant women are very close to developing preeclampsia, and that all would develop it if their pregnancies lasted long enough, so it is difficult to pick out the women who will develop preeclampsia from the population as a whole.

kvknsiva
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Re : What happens biologically during Pre-E

Postby kvknsiva » Tue Aug 04, 2009 04:04 pm

Is there any test available to tell the pre-re going start late in the pregnancy?

shadow2356
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Re : What happens biologically during Pre-E

Postby shadow2356 » Fri Jul 31, 2009 05:18 pm

This is great, thanks!

meekness
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Re : What happens biologically during Pre-E

Postby meekness » Mon Jul 27, 2009 03:11 pm

This thread is so helpful. I'm going to share it with my family, so they will understand exactly what I am facing here today.

THANK YOU!!

atvlady
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Re : What happens biologically during Pre-E

Postby atvlady » Fri Jul 24, 2009 08:01 pm

Can we make this post a sticky? I LOVE it and has helped my husband and I a TON!

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caryn
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Re : What happens biologically during Pre-E

Postby caryn » Fri Jul 24, 2009 08:01 pm

That sounds like a form of hyperreflexia to me, but I don't know.

When I had it I felt both extremely jittery, and, for lack of a better term, hypercompetent -- which might be why pregnant women with PE sometimes say that they feel "great, really energetic!" -- but I don't remember that feeling in my eyes per se.

As always, I vote for at least calling in and asking for them to check you out, since whacking you on the knee to check your reflexes is cheap and easy and a lot less of a problem than seizing over the weekend...


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