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Postpartum Preclampsia In 2 Pregnancies

April 25, 2022 By Michelle Conti-Giambruno

Postpartum Preclampsia In 2 Pregnancies

During my first pregnancy with my son in 2017, I did not think much about risks. It wasn’t until the end of my pregnancy that I began to swell, rapidly gain weight, and had protein in my urine and high blood pressure during my doctor’s visit. My OB at the time wrote off many of these symptoms as ‘normal’ for the end of pregnancy. I even had expressed that I had pain in my upper right abdomen that was nagging– she told me it was probably the baby in my rib cage. At my 39 week appointment my pressure was high and would not go down…so she sent us to the hospital. They started off with a 24-hour urine collection to detect protein. But since I was nearly full term and my pressure was not coming down, the doctors decided to induce. After a long 36-hour induction process my son was born via emergency c-section. My son was healthy and we were relieved. But I had the worst headache of my life and the pressure was not dropping. They discharged me but they did send me a visiting home nurse to check on my pressure. A few days later, my pressure was around 160/90 and my OB told me to go to the ER. I had no idea what to expect. I was filled with fear, worry, and uncertainty. My pressure did continue to rise to dangerous levels and I was admitted to the CCU for my magnesium drip. I stayed there for 24 hours and it was the most frightening place. Other patients were critical and coding. Luckily my mother stayed by my side the entire time, my husband at home with our baby. I then stayed on the maternity floor for 3 more nights and I was finally discharged on 2 different medications to manage the pressure. After that, I went to my primary care doctor, slowly weaned off the meds, but the experience truly changed me. I was fearful of another pregnancy. We waited 3 years before we found a new OB and consulted a high risk practice. I was informed that there was a higher risk of recurrence with my second pregnancy so I would be closely monitored. In 2021, we became pregnant with our second son and again we were filled with worry. From the beginning my pressure was closely monitored, my doctor had me do a 24-hour urine collection earlier on than usual, and prescribed daily baby aspirin to reduce the risk of preeclampsia. We simply crossed our fingers and hoped for the best knowing my doctors were very knowledgeable. This time around I was scheduled for a c-section at 39 weeks, but at close to 38 weeks my pressure was climbing slowly and a repeat 24-hour urine collection revealed very high protein levels. My doctor pushed up my c-section for that week, hopeful that we could get ahead of preeclampsia. After my c-section, I had a post-partum hemorrhage and needed a blood transfusion. I had no idea that preeclampsia increases the risk of post-partum hemorrhage. That experience was a rollercoaster as my blood pressure went from high to low (due to the loss of blood) and back up again. Once discharged, I advocated with my nurse and doctor to start blood pressure medication. Unfortunately, it was too little too late. I knew what was to come and I was dreading it, but I also knew it was for the best. Another magnesium drip, 4 days in the hospital, 2 medications later and I was finally discharged. As I write this, I am 2 months postpartum and I am still on one of my blood pressure medications. Before I had my babies, I had no idea that preeclampsia could occur after birth. I feel it is critical for women to know about the risks of hypertension, preeclampsia, and post-partum preeclampsia. I am so thankful to my doctors for discharging me both times with the visiting home nurses, who helped me recognize my symptoms (headache, fatigue). My home blood pressure cuff was key to helping me monitor for myself. Self-advocacy and self-care are crucial!! While we are so focused on our new little ones, II believe it’s also important for new moms to rest and take care of themselves.