pre eclampsia with 1st baby

[Boo100]

Has anyone else had pre eclampsia? I suffered with it and my son was delivered by emergency c-sec 3 weeks early. He's a beautiful, strapping 16 month toddler now despite his early start. I would really love another baby but am very nervous about the whole experience repeating itself. He also had bad colic and the first 3 months were a sleep deprived nightmare! The consultant said that as long as I keep the same partner - which I have!- there is no reason it should occur again.

I suppose I just wanted some encouragement and words of wisdom! Please let me know if you have had a similar experience and how you dealt with it.

Thanks!

[jersey]

Hi Boo100, snap!!!!!!!!!

I had pre eclampsia at 36 weeks and my son was induced at 38 weeks after a 2 week stay in hospital. He also had bad colic and still doesn't sleep very well. He is now 19 months.

I am pregnant again, currently 15 weeks this week and have to attend a hypertension clinic due to my pre eclampsia history although I have been told it is common with first babies as it is thought to be your body trying to reject something it sees as being alien. It isn't supposed to be very common with the 2nd child, but because I have already had it they have to monitor me this time.

Finger's crossed for this time as two weeks in hospital would be very difficult with DS.

Hope this helps.

[heavenis]

I had pre-eclampsia with first at 26wks born at 32 weeks, now a 4ft 1" 6yr old.
I didn't have any problems with pre-eclampsia in second pregnancy. (had Gestational diabetes but thats another story.)
It is more common first time round as like jersey said. Your are also more likely to have it again it you have a baby with a different partner.
You could tell your doctor before you TTC and see if they recommend anything.

[anchovies]

I also had pre-eclampsia with my first (also an em cs) but am now 35 weeks with my second and so far so good! This pregnancy has been a world away from my last, it's been a breeze!

[Cadmum]

I am now 33 weeks with number 4 and only have pre eclampsia with our first (a son) as well. My BP was slightly elevated from 30 weeks but soared by 32 weeks and that is when there was also protein in my urine. I was induced at 36 weeks because DB had stopped growing. He was 5 lbs when he was born but his head circumference was above average so he was considered IUGR but he is now a big 8 year old and you would never know to look at him that he had a rough start.

I will confess that I have worried with all subsequent pregnancies that it will happen again but so far so good! HTH

[PeachyClair]

Hiya

I have worked on telephone lines supporting people who've had this (as I had it myself). Your Consultant is right, you are at extremely low risk with the same partner. I won't say no risk as I have heard of repeated incidences, but they are extremely rare.

I had to have my BP monitored closely, and regular scans of the placental blood flow as it was placental damage that necessitated DS1's early (ish) delivery. Sam was 5lb but average length when born, he'd lost 1 lb in utero.

However, I found that it was very reassuring indeed to be monitored, and the MW were great- came out to check my BP even when i thought (and did) I had flu, as PET can be sneaky.

DS2 was a great PG and the best of my three labours. I wish you luck. there's charities out there- APEC and PETS (pre-eclampsia and toxaemia socirty) that can help if you need more info.

[janinlondon]

According to Duckitt and Harrington's paper in the BMJ last year, the risk of pre-eclampsia if a woman has had pre-eclampsia in a previous pregnancy is increased seven fold (Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ 2005 330:549-50). It is true that up till last year this had not really been recognised so some doctors may not yet be aware of the risk.

[heavenis]

When I had it with ds1 I took part in a trial called "The magpie trial" it was to see if giving the mother magnesium sulphate stop the pre-eclamspsia progressing. This was 6 years ago, and I'm not sure as to wether it was brought in or not.

[janinlondon]

Heavenis, they reported the results of the Magpie trial in the Lancet ins 2002. THis is the summary if you are interested:

Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial.

Altman D, Carroli G, Duley L, Farrell B, Moodley J, Neilson J, Smith D; Magpie Trial Collaboration Group.

BACKGROUND: Anticonvulsants are used for pre-eclampsia in the belief they prevent eclamptic convulsions, and so improve outcome. Evidence supported magnesium sulphate as the drug to evaluate. METHODS: Eligible women (n=10141) had not given birth or were 24 h or less postpartum; blood pressure of 140/90 mm Hg or more, and proteinuria of 1+ (30 mg/dL) or more; and there was clinical uncertainty about magnesium sulphate. Women were randomised in 33 countries to either magnesium sulphate (n=5071) or placebo (n=5070). Primary outcomes were eclampsia and, for women randomised before delivery, death of the baby. Follow up was until discharge from hospital after delivery. Analyses were by intention to treat. FINDINGS: Follow-up data were available for 10,110 (99.7%) women, 9992 (99%) of whom received the allocated treatment. 1201 of 4999 (24%) women given magnesium sulphate reported side-effects versus 228 of 4993 (5%) given placebo. Women allocated magnesium sulphate had a 58% lower risk of eclampsia (95% CI 40-71) than those allocated placebo (40, 0.8%, vs 96, 1.9%; 11 fewer women with eclampsia per 1000 women). Maternal mortality was also lower among women allocated magnesium sulphate (relative risk 0.55, 0.26-1.14). For women randomised before delivery, there was no clear difference in the risk of the baby dying (576, 12.7%, vs 558, 12.4%; relative risk 1.02, 99% CI 0.92-1.14). The only notable difference in maternal or neonatal morbidity was for placental abruption (relative risk 0.67, 99% CI 0.45-0.89). INTERPRETATION: Magnesium sulphate halves the risk of eclampsia, and probably reduces the risk of maternal death. There do not appear to be substantive harmful effects to mother or baby in the short term.

[heavenis]

Thanks for that. They did a follow up with ds1 when he was 2 to see if he had any difficulties etc, and I did a taped interview with a mid wife from Liverpool Womens hospital. I still don't know if I had the placebo or not. I just wondered if other women have benefited from me and others taking part.

[Mercy]

I was borderline pre-eclampsia with first pregnancy - high BP, flashing lights, small-for-dates baby but no puffiness or protein in urine. It eventually subsided with no treatment and dd was born 4 days early.

With 3rd pregnancy BP etc normal all the way through - until immediately after I gave birth. BP rocketed and I felt truly awful. I was told I had a form of pre-eclampsia which on rare occasions can happen post-birth. Apparently very little research has been done on it occuring this way round!

Good luck - you should be monitored more closely next time due to your experience

[usandbump]

Hi all, I too am worrying about this. This is my first pregnancy, both my mum and sister have suffered with pre-eclampsia. Does anyone know what the chances are of me suffering with it too? Don't think my mum suffered too badly but my sister was in hospital for a month before being induced at 35 weeks.

[Cadmum]

I was also given Magnesium Sulfate... Hmmm... Can't believe that I nearly forgot about that whole nightmare. The Dr. explained that I might feel slightly hot but I actually felt as though I was on fire!! It did bring down my BP sufficiently that the induction was held off for a further 6 days.

Interestingly, my mother was also pre-eclamptic but with her third pregnancy (my brother) and the first two pregnancies were also with the same man (to the best of my knowledge as we look alike! )

[janinlondon]

usandbump here are some stats for you.

from Duckitt, BMJ (see earlier post)

Family history of pre-eclampsia
A family history of pre-eclampsia nearly triples the risk of pre-eclampsia (2.90, 1.70 to 4.93) (two cohort studies [27][28]).


From reference 27 (Arngrimsson et al, 1990). This is their summary:

Br J Obstet Gynaecol. 1990 Sep;97(9):762-9.

Genetic and familial predisposition to eclampsia and pre-eclampsia in a defined population.

Arngrimsson R, Bjornsson S, Geirsson RT, Bjornsson H, Walker JJ, Snaedal G.

Department of Obstetrics and Gynecology, National University Hospital, Reykjavik, Iceland.

Familial predisposition and patterns of genetic inheritance of eclampsia and pre-eclampsia were investigated through three or four generations in 94 families from the homogenous island population of Iceland. The families descended from index women delivered in the years 1931-47 and who had either eclampsia (n = 38) or severe pre-eclampsia (n = 69). Inheritance was followed both through sons and daughters. The prevalence of pre-eclampsia and eclampsia in daughters was significantly higher (23%) than that in daughters-in-law (10%). No difference was noted in the prevalence of these diseases by whether the daughter was born of an eclamptic or pre-eclamptic mother or whether she was a first or later born daughter. There was a non-significantly higher occurrence of pre-eclampsia among grand-daughters than in grand-daughters-in-law. No difference was seen by whether grand-daughters descended through sons or daughters. With increasing numbers of affected daughters or grand-daughters the probability rose of finding more affected women in a family. Hypotheses of single recessive and dominant gene inheritance were compared and maximum likelihood estimates for gene frequency obtained. For a single recessive gene model this was 0.31 reflecting a population prevalence of 9.6%, whereas a dominant model with incomplete penetrance gave 0.14 at 48% gene penetrance, corresponding to a population prevalence of 0.9% homozygous expression of severe disease and 11% heterozygous expression of milder disease. Either genetic model could fit the data.

[Boo100]

Thank you very much for all your thoughts. It's making me nervous just reading them! But encouraged too as a lot of you had no probs the 2nd time. I think I will go to my GP to see what, if any monitoring will happen. I still really want another baby. But it was truly horrible before. I was so worried about myself that my head could hardly hold worry for my baby. I still have massive guilt about that. Thank you all.

[usandbump]

Thanks janinlondon, I'll just have to go with it and see what happens. Thank you for the info