For those who had pre-eclampsia first time round

[lizardqueenie]

Hi there

Just looking for advice & experiences from those who had pre-eclampsia with their first DC, just wondering what happened if you went on to have subsequent DCs as in what happened with monitoring you during pregnancy? Did you have any hope of getting near a birthing unit or home birth if everything was running ok 2nd time around or do you have any advice what what to do/ not do differently?

I had PE with dd1, just over a year ago. never through I'd see the day when I was thinking it would be nice to have a second baby buy broodiness has started to kick in & I am trying to think about what I can do/ know about before ttc no.2. Don't think a home birth is on the cards (particularly for DH who I'd say is still getting over what happened first time round but id really like a water-birth/ more natural birth. Thank you :)

Hi

I'm interested in the same thing, I had PE with my first, DS is 10 weeks old now and we wanted another child but i've been left with lingering blood pressure problems so I will be watching your thread with interest.

I had PE with first baby, who was then induced at 36 weeks. Had to have consultant-led care second time round (though only saw consultant's minion once in my 8 months) and weekly blood pressure checks with MW from around 4-5 months IIRC. Other than that there was no difference and I never had a sniff of PE second time around. I was told it was extremely rare to get it with a second baby - but I think the odds are increased slightly with a third?

I had it towards the end of my pg with dc1, was induced and ended up having a emcs. However with dc2 I had no problem at all, they did monitor me but it wasn't a problem at all for me luckily. I did see the consultant alot and the mw, but that was also because of the emcs and making a decision about how to give birth. I did make the decision that if the PE emerged again I would go straight for a cs but fortunately it didn't. I had a vbac although was monitored but was told this was because of the previous cs not the pe.

I wanted to let you know Totally that I had bp issues post the birth of dc1, not for long but they did linger slightly! I do generally have v low bp so when it started to get to normal bp that was high for me and during the induction it flipped so high that they barely gave me time to sign the cs consent form as dh wasn't in the room (poor bloke the only time he left to use the facilities and he discovered a group of medics running down the corridor with me! )

I had very severe fulminating (rapid onset and life-threatening) pre-eclampsia and HELLP in my first pregnancy very early on - at 25-26 weeks. My first daughter died as a result. I was in pieces for a long time (still grieve for her very much) and scared as I came so close to dying myself. I was told I was very high risk in a subsequent pregnancy - 40-50% chance of getting pre-eclampsia again (though probably later and less severely), with a 20% chance of having to deliver very early (before 28 weeks). Despite these grim statistics I went ahead and my second daughter was born very healthy and full term with no pre-eclampsia or blood pressure problems. I also had lingering high blood pressure for about 3-4 months after my train crash pregnancy, but it did resolve.

I'm just saying that every pregnancy is different and whilst you will be considered "high risk" no-one can really predict what might happen the next time. There is nothing different you can do - whether or not you will get pre-eclampsia again is largely determined at the time of conception. However, there is some evidence that low dose aspirin and folic acid / calcium supplements help (and I took all of these from 12 weeks). I was also very closely monitored with growth scans every two weeks in the second half of pregnancy and uterine artery dopplers at 23 weeks (these give you an indication of the risk of developing pre-eclampsia again).

Given my experience I would never advise anyone with a history of pre-eclampsia to have a home birth (I just became very ill very fast especially after delivery) but if your next pregnancy is ok it might still be possible to have a less medicalised birth (but I would still pick a birthing unit with a hospital unit very close by to be on the safe side). For me my only concern was having a living baby the second time and i ended up with a planned c section as my second daughter was transverse.

I know better than most how scarey this disease can be but I am so so glad I overcome my (pretty extreme fears and anxiety) to try again as my 11 month DD makes it so worthwhile. There are no guarantees in life but if you want a second DC I would not let your first pregnancy put you off - you will be much more closely monitored the second time. Good luck x

You don't say at what gestation you delivered your DD - if that was near or at term you risk of having it again is lower than a pre-term delivery.

You can also request a pre-conception appointment with a consultant obstetrician (ask your GP to refer you) to discuss any specific individual risk factors you might have (e.g. obeity, diabetes, high blood pressure) and whether these can be reduced prior to conception as well as taking aspirin and other supplements.

jules I am so so very sorry about the loss of your daughter I just can't imagine how hard that must be and think you are very brave to go on and have a second child.
Thank you everyone for sharing so far. My PE was initially picked up around 34/35 weeks and I was induced at 38 weeks as DD had stopped growing. Prior to this I'd never had problems with high bp. I think post birth I was rally in denial about the bp problems and when I look back I was suffering from PND from the way I shut everyone out and stopped taking BP medication.

I think I pre-natal appointment with a consultant is a good idea, or at least a check up with the GP. I don't think myself I could have a home birth or that would be a wise choice for me but I would like the opportunity to have a less medicalised birth if that is possible although alike a previous poster, would opt for a cs if I had PE again.

Hi - I am a pre-eclampsia veteran [hmmm]. I had it in my first and second pregnancies, both times severely but fortunately, made it full term both times
(42 weeks and 38 weeks), but was induced both times due to it. I was diagnosed early the second time around (21 weeks) but
am in the rare group of women who have it 'creepingly', which is uncommon.
I am currently 7 months pregnant with my third and both consultant and I think that I will get it again.
I did discuss what would happen if I didn't get it this time around and to my surprise was told, they would let me go to 40 weeks, then discuss options.
I had two deliveries on mag sulfate, the first one, sort of traumatic. Since I had my expectations changed, the second one was just fine, since I knew what to expect, although in paper things went very similarly. So my 'advice' is to go with what's necessary and grief what wasn't possible (wanted to have home birth with both of them...), but not be upset to much. Sorry don't mean what you should do but what worked for me.

I had severe PE in my first pg leading to the premature birth (by cs) of my ds at 34 weeks. For my second pg I was offered a pre-conception appt with my consultant (who is apparently one of the world experts on PE - think I struck lucky there!) and was advised to take low dose aspirin from 12 weeks, which I did. I also had a doppler scan at 24 weeks which looks at the blood flow from the placenta and can predict how likely you are to get PE in that pregnancy. Mine put me in quite a high risk category, which meant that I had checks with the high-risk pg unit at my hospital every 2 weeks for the rest of the pg.

My consultant told me that in his opinion calcium supplements only lowered the risk of PE in women who were severely calcium deficient, so I didn't have those.

My bp stayed under 140/90 until I stopped taking the aspirin at 36 weeks (advised to stop then in case you go into labour and have a bleed). It crept up until it was hovering around the 140/90 mark, my bloods got worse, my consultant started getting twitchy and booked a cs for 40+3 - dd miraculously appeared of her own accord at 39+6. I had a VBAC in the consultant led unit, quite medicalised with CFM and a cannula but it was still wonderful .

I did want to have a homebirth with ds before the PE kicked in, and I'm sorry I missed out on that or a waterbirth etc, but there was no way in hell I would have got any of it without a massive fight on my part and having spent 4 weeks on the antenatal ward when pg with ds and seen what PE can do I would have been too scared to take the chance.

In a second pg you would probably have to keep an open mind and see what happened with regards to the PE - if you have no symptoms then hopefully there would be no reason for a more medicalised birth. I would definitely want to be close to a consultant led unit though, just in case something happened - PE can come on very quickly during labour and post-natally.

Sorry I have waffled on for ages ! Hope at least some of it was helpful - good luck

Totallykerplunked, I was on medication for my blood pressure for about 4 months after the birth of my first dc, but 5 years on it seems absolutely fine. Hope yours is the same!

Jules125
So so sorry for you, it puts the problems I had in pg into perspective, luckily I made it to 39+5 before things started to go bad (probs started 31 weeks).

Interesting to hear what happened to some of you in subsequent pg's, my mw said on my discharge visit about not having another DC, and frankley the lack of interest when I was in labour from the mw on duty would make me seriously consider if it was a good idea as I was so frightened (bp not checked for 12 hours until I hunted down and begged the mw that something was wrong - cue the mad rush as bp v high, v close to EMCS).

I think my bp problems may continue, from normal pre-pg to somewhere between 140/90 - 170/110 with hospital admission for chest pains (fortunately "just" a panic attack).