Pre-clampsia/eclampsia in 2nd pg - will it definitely come back?

[EddieIzzardismyhero]

Quick history, DS1 2.2yrs, DS2 10 mths. Very small age gap!

No problems with DS1 (except SPD) but when pg with DS2 I had pre-eclampsia from 34 weeks and was admitted to hospital with terrible headaches and nearly had a c-section then and there cos of foetal distress. All stabilised but I was monitored twice weekly until 38wks when baby stopped moving and I was admitted to hospital again - he was fine but my BP was through the roof, protein in urine, etc, etc so was induced.

All ok, but DS2 was v small and remains small even now (being monitored by paediatrician). But he is otherwise ok, and I'm fine too.

Dh and I had always planned on having four children but dh is now terrified of a recurrence of my problems with BP, etc. So my question is, will this happen again? Has anyone had PE in one pg and then gone on to have another baby with no problems?

Was the small age gap part of the problem (and the fact I hadn't lost all the baby weight from DS1).

I'm 38 and would be 39 when we planned to try again (if we do ).

Thank you.

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I am pretty sure, it's almost a given if you have had it before, I may be wrong but judging from ladies in my antenatal, if you have had pre-eclampsia before it seems that you get it again same with gestational diabetes.

Nope that isn't the case at all. I had it with dd and not with ds1 or ds2 and I'm pregnant with dd2 now. My consultant told me that it isn't a definite that it will come back at all.

No it isn't a certainty it will happen again.

I had probably PE with dd1 (she didn't grow v. well and was v. small at birth, which was at 37 weeks). With dd2 I was advised to take low dose aspirin from 14 weeks (I think) as there are soem studies which show this might help (and it doesn't do any harm). I had no problems with dd2 who was born the day before her due date and a normal weight.

You will be monitored closely at any rate with any subsequent pregnancy.

I had pre-eclampsia with my DS1. Eclamptic Fit, was quite poorly in ICU in a coma for a few days. DS1 was born at 31 weeks. Both fine now.

Had DS2 4/5 years later and didnt even get a sniff of high BP and he was born at 38 weeks with no problems.

It is more common in a first baby (includes baby with new partner!) But not it may not happen next time. You can have a special scan called a doppler scan around 22 weeks to determine your chances of getting it again to ensure you get the required monitering :)

I had PE with my DD, born 13 weeks ago. I was told with a further pregnancy there is a 10% chance of it happening again, but with me there is a 20% chance as I have high BP anyway. So your risk will depend on other factors like that too, but it certainly isn't guaranteed.

My consultant said if we thought of trying to conceive we could ask for a referral to discuss our options even before I was pregnant, might that be an option for you and your DH? You would just need to go to your GP and ask for a referral to the hospital, I'm sure they would see you to discuss your individual circumstances.

Thank you so much for all your replies. We have talked about going to see a consultant but didn't know how ready they would be to speak to us. It's very interesting to read the stats as I was under the impression that emmyloulou had that it was almost a given that it would come back.

Those of you who had more children after PE, were you advised to do anything different second time around (other than the aspirin) or did you just cross your fingers and hope?

Julezboo, your story is scary and is what dh is frightened of . If you had bad news at the scan could enough monitoring ensure that you and the baby were ok?

Part of me wonders whether it's just too big a risk, but the urge to have another baby is just so all-encompassing .

I have had PET on both my pregnancies. From 30 weeks on DS then from 36 weeks on DD, last time was pretty scary and don't think I would risk another pregnancy.

louii, sorry to hear that. Out of interest, why did the second time scare you more even though it came on later?

Emmylou, it certainly isn't a given. I don't know if severity of the disease, or when the onset was, has any bearing on the stats, but if you have had PE in a previous pregnancy, the chances of getting it again in a subsequent one are 10-15%. So really not that likely.

I had what might have been very mild PE from about 35 weeks (I had the hypertension, oedema, some protein right at the end, but PET bloods were fine and I showed no signs of serious PE) and my pregnancy is not being monitored obsessively this time. My MW (independent) knows I'm worried and has been keeping tabs on my BP and so on, but hasn't told me I have to see a specialist unless it's indicated. I'm fine with that.

She did suggest I eat more protein (this stems from the Brewer Diet that some women with previous PE swear by, but not as extreme) as this helps with blood vessel expansion and helps them to cope with the increase in blood volume, and therefore might help by heading off high BP at the pass. Have not been told to take asprin.

I had it in both pregnancies, from 34 weeks with ds1, from about 24 weeks with ds2 iirc (dates are a bit hazy now), and I wouldn't want to have another pregnancy because of it.

Reshape, very interesting, thank you.

MrsJohnDeere, this is what dh is worried about - but I didn't have it 1st time around so I'm wondering that even if I did get it again it would be much later? Were you induced very early with DS2 or just monitored and/or medicated?

First time round was more gradual, ended up induced at 36 weeks. BP was very high, i was horrifically swollen up.
Second time had a fab pregnancy, then very suddenly BP was up and has loads of protein in urine, my kidneys stopped working (was peeing blood) induced again.Made it to 40+2 though
Second time think it was because it was so quick, was scarier.

Been different symptoms each time and I think I have been lucky me and my babies escaped unscathed, maybe would not be so fortunate next time.

Hi,

DS1 was stillborn at 24 weeks due to severe preeclampsia. I was contacted a few months later and met up with a consultant who made a plan of care for a future pregnancy. He said the chances of it coming ack in a next pregnancy were about 1 in 4 if that helps.

My plan of care involved taking low-dose asprin as soon as I got a positive pregnancy test, from 16 weeks fortnightly midwife/antenatal at hospital appointments so they could check BP/urine (moved to weekly from 24 weeks on), scans once a month from 20 weeks including the consultant himself doing a fetal artery doppler scan at 22 weeks. Then any sign of preeclampsia they would administer the steroids and treat me accordingly.

Well, I did get it again, but this time not until 29 weeks-ish. It was managed for 2 more weeks by admitting to hospital, regular traces and checks and bed rest etc. DS was born at 31+3 by emergency c-section. He was absolutely fine though.

I then had a couple of years pass and wasn't planning any more, but found myself unexpectedly pregnant. This time I had all the above checks but not a sniff of preeclampsia at all - DD was born full term and normal size . SO it can and does happen.

Hope that helps. I think if you've had it in a previous pregnancy the chances are 1 in 4 but if you have had it twice the chances then would go up.

By the way, if you don't have a plan of care in place I would try and arrange for one before I got pregnant - it does help your case if it's all written down for everyone to adhere to.

"maybe would not be so fortunate next time" - I totally get where you're coming from louii .

strike, I'm so sorry for your loss. I think a care plan will be essential, but I still think dh will take a lot of persuading. I think it's so hard for the husbands that have to stand and watch .

Eddie, the reason I got to that eclamptic fit stage was because my midwife them days was so crap. She ignored me for 3 weeks saying I had headaches constantly and on reviewing my notes afterwards it was pretty obvious because from 28 weeks i had protein ++ in my urine. It was pretty scary and When I was pregnant with DS2 I remember DH lived the whole 9 months on edge, he was so scared I wouldnt make it.

They did monitor me though. As soon as I knew the pregnancy was sticking (had lots of mc's too) I met with consultant in a big university hospital with a big neonatal unit and planned out my care. From 24 weeks I see the midwife weekly. I have my own BP monitor at home (can buy these from Lloyds nowadays fairly cheap) and some midwives will give you the dipsticks to check for protein as well. From 28 weeks I was on 2 weeks growth scans, until I got to 34 weeks then I was there every 4 days for either a trace or growth scan.

DS2 though was born after my waters leaked from 30 weeks (totally unrelated, I also have a split uterus!) at 38 weeks a healthy 7lb 1. It was perfect. He was born by elective section because for me that was the safest option, I was afraid my BP would rise too much if I laboured. I stayed awake for it and it was a totally different calming experience compared to the emergency section done at 31 weeks with DS1.

I am 15 weeks preg again, just to add another complication in, I had suffered quite badly with hyperemesis this time round and in all honesty, its not the preeclampsia, or the leaky waters that is making my mind up that its the last, its the sickness. I cannot go through this again! I am already checking BP which has been quite low this time. And I have my care plan in place.

I think it would be worth making an appt with a consultant before you go ahead, it can help put your mind and DH's at rest. I made sure DH was with me for the main appts and he felt reassured.

Also wanted to add, DH is still panicking this time, but not as much because he was there for every step with DS2 :)

It's not a given that you get it again. But you can.

There is no hard & fast rules tbh. It is a risk that will always be there. My friend had 4 children, first 3 all fine, 4th she had PE but no one seemed to realise for some reason* She almost died from eclampsia.

*I have to say that they seem very lax here - Australia - re PE & symptoms of. On a different forum I use here, 2 women have had tell tale signs of PE, classical signs...but their drs did nothing other than the usually checks. Even sending one of the away with a BP of 110/100!!

I had PE with dd1. Not with DD2 tho. But the second pregnancy was horrible, as it did hang over my head that it could happen again, so I was constantly looking out for symptoms & worrying about the slightest headache etc.

One of the reasons I am not having any more is that I don't want to risk PE again.

Those of you who had more children after PE, were you advised to do anything different second time around (other than the aspirin) or did you just cross your fingers and hope?

Aspirin & hope. Nothing will prevent it, if it is going to happen, it will happen, unfortunately.

I did have a scare. I was on my way to my pre admission check for dd2, (section) and my car broke down. When I finally got to the hospital my bp was 110/92. A couple of days later it was 110/90. So I was sent into be checked (monitored for a few hours), but it turned out to be nothing. They wee pretty sure the first reading was stress & the second a fluke/stress of the close due date (was a week away at this point). C

Oh and (sorry, I forgot to add this) I have protein + for a few weeks in early pregnancy, and thought...here we go...(was my first symptom with dd1) but at 20 weeks I was clear.

Julezboo and different, thank you for your posts. I've not had ms at all but know friends who have and have not gone on to have more babies as it has been so awful .

I do wonder whether my high BP was initially brought on by stress - I was sole witness to a horrific car accident (and therefore had to phone for help, care for injured, etc, while heavily pg and with DS1 in the car) two weeks before first being admitted to hospital with rocketing BP which I'd not suffered before.

We're not ready yet to think about ttc, but I have a GP appt next week so may ask for a referral then as I'm guessing these things can take time?

Thank you all so much for sharing your experiences.