2nd preg if you had pre eclampsia first time, what precautions will be taken?

[Gemzooks]

My Ukrainian friend (non-Mumsnetter so far) is 38, had severe pre eclampsia in her 1st preg.

What special checks will they do and what should she ask for? Any tips much appreciated!

[Gemzooks]

bump? Anyone?

[madmarriedNika]

Is she over here or in Ukraine?

Over here medics are supposed to follow PRECOG guidelines which recommend the type and level of care for those at risk of developing PE- see:
pesupport.friendhood.net/health-guidelines-nice-precog-f2/ (which by the way is posted on PE a forum I found very helpful)

Having had PE previously she is unfortunately at a slightly higher than "normal" risk of developing it again.
Depending on her history she might be suitable for low-dose aspirin (75mg) therapy- which is usually started in the first trimester and taken daily until around 35 weeks. It has had quite a lot of success in preventing PE or at least delaying onset & moderating the severity.

She should also receive "early specialist input" in any pregnancy- in other words should be seen at hospital by an obstetric consultant before 20 weeks- ideally before 12 weeks- as only obstetricians can prescribe aspirin and advise her on this. Hopefully she would also then receive more monitoring- particularly BP & protein in urine checks, growth scans etc- again depending on her history.

If she's in the UK she can go to her GP and ask for a pre-conception consultation with an obstetrician who specialises in PE. The charity APEC (Action on Pre-Eclampsia) have a list of medical experts in the UK who will see ladies with a PE history for free- she can call APEC's helpline to find out more (see: www.apec.org.uk/helpandsupport.htm)

Hope that helps

[Gemzooks]

thanks Nika!

She's in Holland, as am I. they take a very casual approach to pregnancy and childbirth, all natural, home births etc, and they just don't take this kind of thing seriously. Will pass on the info. thanks again!

[ajm200]

I'm in the UK

I had PE last time and it was suggested that I should be under consultant care this time. Have never seen a consultant this pregnancy and no-one seems that bothered.

Saying that, I'm at 35 weeks and showing no signs whatsoever whereas I was swollen with high bp and occasional protein in my urine by 32 weeks last time.

[LiegeAndLief]

I was going to say all that, but Nika beat me to it!

One other thing I will apparently be offered in 2nd pg (had severe PE in 1st) is a uterine doppler at 24 weeks. This looks at blood flow to (from?) the placenta and can be helpful in predicting whether you will develop PE again.

Really recommend trying to get a pre-conception consultation if she isn't already pg, mine was very helpful - if she is pg then push to see a consultant ob as soon as possible.