Anyone had mild pre eclampsia progress to eclamptic seizures? Warning, scary story!!

[fiveisanawfullybignumber]

Due to go back to hospital next month for an afterthoughts session, 10m after DD was born.
She was DC5, never had any major problems before apart from quick labours and GBS so needed antibiotic IV during labour.
Went in at 38weeks for induction, delivery ward was busy, so ended up staying down on waiting bay till the next morning. Mildly contracting but ok, bad headache and frustrated and bored.
Going back a few weeks, my hands had started to swell really badly, couldn't get my wedding rings on and fingers and wrists were numb and tingly often, 3 fingers in particular felt icy cold. Doc said I had carpal tunnel, clue 1!
My BP is normally very low, and goes lower when PG, I usualy end up faining & feeling dizzy near the end. Booking BP at 8w was about 95/55. During the later part of this PG it crept up to about 125/80, normal for most people but sky high for me. Clue 2!
I had a lot of chest pains and breathlessness, doc thought I was aneamic, did blood test and prescribed iron tabs. Few weeks later was retested by midwife, she said iron was now fine, stop taking tabs. Told her I still had chest pain. Clue 3?

Because I was on DC5 & never had any problems before my community midwife wasn't concerned about me at all, even though I told her I felt awful, but eventually went in for induction.
1st day they monitored baby, her heartbeat was around 175 beats per min average, they said it was on the high side but within guidelines. That was mid afternoon. I wasn't monitored again till about 10am the next morning. After 5 mins midwife came back in, took my BP and pulse then walked off to desk.
She came back and said even though they were busy upstairs, DD's heartrate was too fast, as was mine, and they were taking me up immediately to get this baby moving.
Within 20m of arriving in delivery suite I had a grand mal seizure, I remember very little from here on apart from begging for a section to get my little girl out safely.
They hooked me up to a drip with magnesium sulfate & fluids to try and prevent any more fits.
As I had to be continuously monitored I couldn't move and DD had gone from fully engaged to hiding high up in my tummy, however her heart rate had thankfully stabilised.Labour was not quick this time as was laid flat on my back with wires, cables and tubes everywhere. They wanted to speed things up so gave me syntocin drip and had my first ever epidural as was petrified of what was happening and exhausted. Poor DH was really shook up, he witnessed everything and felt completely helpless.
I was still begging for a section to get DD out safely, in fact I remeber sobbing and the consultant saying with my history it was better to try and have her naturally so I'd recover quicker.
Not long after this I had another seizure, again i rember very little untill an hour or so later when I was ready to push.
There was then a panic about what part was presenting as midwife could feel something alongside DD's head, and literaly pushed her back until someone else came to check. They thought she might have had an arm stuck up by her head. More experienced midwife said ok, let's carry on, turns out she had the cord wrapped round her neck a few times and the cord was so twisted it looked like a spiral candle, they even made DH take a photo of it, it was so unusual.
Anyway, luckily DD and I are ok, I had a brain scan the next morning and I suffered no permanent damage.

My question is, should I have had a casarean?
Has anyone else who had eclamptic seizures been left to labour for 6 hours like me?
With every fit there is a strong risk of brain damage or death to mother and/or baby. I had a history of quick labours so they let me labour with syntocin and epidural hoping to get her out that way. I'm so annoyed that they took that risk as every subsequent fit was taking a risk with our lives.
10m later I'm still struggling to come to terms with what happened, and constantly think how it could easily have been such a different outcome.

Well the short answer is I don't know,but from reading through that I am shocked that they didn't do a c-section.Have you had a de-briefing? Could you get to talk through this and find out why you were left to have a second fit and why they didn't do a c-section.I had PE too,but no fits.my mother had PE with me and they did a section PDQ as her BP was so high.It seems really peculiar to me that you were left,but I'm not a doc.hopefully someone else will have more helpful info.Sounds very frightening for you and I'm not surprised you are struggling to make sense of it.

Thanks. I think they said to Dh that my BP wasn't really high enough to have had an eclamptic seizure at first, but as all the blood tests etc came back they said it was, cos my BP is normally so low it threw them at first, but there was still a long time I was left after this info.

Eclampsia can alter your liver and renal function, as a result it can derange your clotting making a cs life threatening. Maybe your blood results affected the obstetricians decision?

Thanks Malteser, I will ask them if that was the reason why. I need to know though, still stressing me.

Five - I'm sorry you went through all of that. Must ahve been very scary for you and your DH.

Where I work I've never seen someone go through labour after having an eclmaptic fit - they've all had sections. However these women have all been earlier than 38 weeks and not favourable for induction so very different to you. I will say though that they won't do the section until the woman is stable - they can't risk a seizure on the operating table. It sounds to me like perhaps they were struggling to get you stable (it can be very difficult) so decided to carry on with the induction while trying to stabilise you. I'd have thought if you were stable enough for a section and nowhere near delivery they'd have done the section. I've certainly known people be longer than the 6 hours you were in labour for before they got a section.

I'd be asking why noone took PIH bloods when your BP went up. Yes your BP was in normal limits for most people but not for you. There are guidelines that say when your diastolic goes up by more than 15 which yours had done then pre-eclampsia should be considered. It doesn't take a minute to take the bloods. If you've got pre eclampsia your bloods would show that.

I hope you get some answers.

I think you really caught them out tbh - they were looking at you as a 38 weeks pregnant woman with normal BP and then you turned out to be a woman with eclampsia in an emergency situation. You are absolutely right to feel shocked.
Hopefully your notes will show the decision making process and you can follow that through. The point about needing to be stable for a c section is a good one I think and worth asking about when you have your meeting. The other thing I think that it would be helpful to kno is what sort of internal discussions followed your case - have they changed their practice? Can they now assure you that a BP change like yours would be picked up on?

I've just had a very quick look at the NICE guidelines and it only talks about if BP goes abouve 140/90 to investigate.

I think perhaps where I work maybe we're unusual in that we jump in with the blood test before NICE say we have to. I don't know where our guidelines of checking PIH bloods if diastolic is raised by 15 comes from - it may be just our hospital policy. But I think its a good one.

Thanks for both your replies.
Viva, that's interesting about the 15 diastolic guidelines. I know community midwives are very busy but I actually felt like because I was on DC5 that they really weren't interested in how i was doing. I was the one they didn't have to worry about, even when I was worried myself, it was dismissed.

god poor you, glad you and the baby were ok

I only have experience of my mum's sister who had a similar experience to you. THey didn't spot the pre eclampsia and unfortunately, it went to eclampsia and she had fits.

Sadly for her, the story didn't end so well and her baby ended up on oxygen for many months and still has breathing problems today. My mum's sister suffered lasting problems with her brain and ended up dying a few years later - though the hospital refused to ever link the two, the fact that she was a 100% healthy person before the pregnancy and then suffered constant neurological problems afterwards, seemed a fairly obvious link to me.

Anyway I'm glad you're ok. The hospital said in their defence that they hadn't seen it coming and it came on incredibly quickly. It seems like a very similar situation to you. Once my aunt was fitting they also didn't do a c-section but it seems as though it was because she wasn't stable enough to do so.

I'm a midwife and have only been involved with 2 eclamptic fits, one which went to cs as soon as the mother was stabilised, but she was pre term and not in labour. The other happened on a normal low risk second time mum unexpectedly soon after a normal birth (baby was in car seat ready to go home). Both mums were alright in after treatment.

In my recent annual study day the very experienced consultant obstetrician stressed that if mum is in labour it is reasonable to continue trying for a normal birth in some situations, on account of the fact that caesareans can be more dangeous for women with abnormal blood results. Having said that many of my midwifery colleagues were surprised about this.

Hope your debriefing session helps. If it doesn't consider asking to discuss the birth with a supervisor of midwives who may be able to help you further.

Just been searching for this thread today. Am currently on an advanced obstetrics course this weekend and had a lecture on pre eclampsia today. They said in the lecture that anyone who has an eclamptic fit the preferred mode of delivery is vaginal, especially if delivery is likely to be within next 12 hours. Reduces the chance of a PPH or DIC (where you can keep bleeding internally). Its proven to be much safer, hope that helps.

That's really interesting as I work
In icu and we take post pih woman for mgso4 infusion and siezure control and pretty much unless in active labour they are emlscs deliveries.

Thanks for the last extra 2 posters, just seen them today. Have my debrief in a week or two, this has helped me work out what I want to know and understand more.

Hi there, I had eclamptic seizures in labour with my first born child.

I was in labour for 30 hours at the hospital and during that time my urine was not checked.

My blood pressure went up to 220/110 and I started fitting, the next thing I remember was ICU the next day. My son was a healthy 9lb and although he did suffer from lack of oxygen he is fine now.

For the first few months I was absolutely traumatised by what happened, nobody seemed able to explain to me why this had happened in what had been a very normal pregnancy. I had a c-section (emergency) under a general and felt that I had missed out on seeing my child born.

I had another baby 4 years later and developed pre-eclampsia earlier on, I had my DD by C-section at 38 weeks after spending my whole pregnancy on methyldopa, aspirin and labetalol. She was absolutely fine.

I am currently pregnant (10+3) with DC3 and on aspirin and methyldopa.

I have been left with permanent high blood pressure and usually take beta blockers. I am not overweight and regularly excercise so this can only be put down to the eclamptic issues.

My notes did mysteriously disappear but then I guess that was down to the negligence of the hospital in not once testing my urine during a 30 hour labour despite me saying I felt sick, had pains in my chest and a headache throughout labour.

I was pushing when the seizures happened, it was odd as I starting hitting myself in the face with the gas and air but didn't actually feel like that was wrong? everyone around me looked horrified then it was lights out.

I hope this doesn't happen again, but it is always a worry in the back of my mind.

I was 185/110 when I had my emcs for ds1 (33wks) no seizures thankfully - had to fight very very hard to be allowed to have vbac for ds2 - cs was much much safer they said. Ended up having monthly doplars and fortnightly scans and daily urine testing from 24weeks but managed it. Very distressing reading your experience and hope they give you the explanation you are after.

eatyourveg my experience was 12 years ago in January - they never have explained it.

I was going to have a VBAC with DD but the pre-eclampsia raised it's head, to be honest I was glad for the c-section as it gave me peace of mind.

I am so lucky to have not had a prem baby so far x

missed the date on this one = sorry. my experience was 21 years ago in January

I'm really hoping it's third time lucky and the pre-eclampsia leaves me alone!!