Pre eclampsia in subsequent pregnancies...

[SunnyDays1987]

My DS was born at 36 weeks after being induced due to suspected pre eclampsia. My BP was absolutely fine all pregnancy but I started with burning chest pains just before 35 weeks and they got progressively worse until I went to hospital in the middle of the night where they found I had a raging BP and protein in my wee. They also gave me a scan and decided that DS was significantly smaller than he should have been, so to cut a long story short I was induced. I decided I could never go through that again but as DS is approaching a year old I'm starting to think more and more about a second. I asked the health visitor what would happen and she said I would be consultant led if there was a next time, but I wanted to know has anyone got experience with what would happen? And also did you have it again if you had it in your first pregnancy?

I had pre-e with and an early delivery. If you ask your GP they may be able to refer to a pre-pregnancy consultation with one of the consultants who looked after you when you had your ds. I saw one and was able to talk it through to help decide whether i want to have another again. Although be warned my consultant didn't have copies of my hospital notes, thankfully i did, so i asked him to go through them all! he was able to give me rough idea of % risk of it happening again and what would happen with my care if i decide to have another baby. I was told i would be consultant led, an early scan and once deemed viable id be put on aspirin and monitored closely with regular check ups with the consultant.
I haven't had another baby yet as to be honest I'm still a bit scared. I'm on a fb pre-e group and a large number of women seem to go ahead and have pre-e free pregnancies.

I have had it with all 4 of my pregnancies. My last 3 were all consultant led and I had to take aspirin throughout the pregnancy. The only symptoms I had was raised blood pressure after 35 weeks that wouldn't come down even with medication, traces of protein in my urine and flashing lights in my eyes. I was just induced around the 38 week mark with all of them and have had no other issues since.

BP up and down like a yo-yo in my subsequent pg, they'd give me stuff to lower my BP then it'd crash and they'd panic and need to raise it.

Tbh being consultant-led didn't bother me at all - being in that horrendous position of potential organ failure/preemie/emcs/etc. I was happy to be under a higher level of care.

Sophie Ellis-Baxter had it with her first three I believe.

First pregnancy i was in hospital from 32 weeks with high blood pressure and got protein at 38 weeks and was induced 3 days later when blood pressure bottom one was 125.
Next pregnancy exactly 2 years later i had mw appointment at 37 weeks where bp was slightly raised but dd arrived 2 days later naturally with no further symptoms.

Yes, pre-eclampsia with both of mine. My second baby was induced at 35 weeks. He was only 5lb but it was an easy birth and he was perfectly fine and breast fed well, and he's now my strapping 16 year old son.

It's a bit of a bummer but you just have to be prepared I guess.

I had Pe with my first. Bp hit 240/190 at one point. Induced at 37 weeks. Next pg was fine. Baby was two weeks late!

Next two I had high bp and admitted on and off but no protein so it was very high bp but didn't develop into Pe. I was induced early and consultant lead with the last two. It wasn't a major deal and as you can see with four I wasn't too put off.

I did know I was risking having more. But under the consultant I felt very safe with two weekly scans

1st pregnancy - pre-eclampsia, kept in hospital from 36 weeks, induced at 38 weeks.

2nd pregnancy - No problems whatsoever (3 year gap)

I was told subsequent pregnancies are much less likely to be problematic provided they are within 5 years, don't know if that's true or not.

FWIW my mum had raised BP & protein with first pregnancy (monitored but not severe enough to induce), no problems with 2nd pregnancy 2 years later and pre-eclampsia leading to emergency c-section with third pregnancy 9 years later.

I had pre-e and HELP syndrome with dd who was born by em. Section at 32 weeks as I suddenly deteriorated having been okish for the previous 2 weeks.

With DS I had a pre-pregnancy consultation, was advised of recurrence risks etc and told to take aspirin from the moment I got a positive pregnancy test. I had consultant care an lots of growth scans. He was born by El section at 39 weeks.

Both are absolutely fine.

You would be managed on a high risk protocol. Book as early as possible, get a baseline BP recorded and plan an early (before 15 weeks) consultant review. Start low dose aspirin by 12 weeks which can reduce the risk and severity of PET by improving blood flow to the developing placenta.

You would expect monthly growth scans and two weekly BP and urine checks (this could be at GP) alongside regular consultant antenatal clinic.

I have seen many women in this situation (midwife) . Most have less severe symptoms second time around especially on aspirin.

I also took aspirin with all my subsiqent pregnancies.

I had PE with first pregnancy - hospitalised at 35 weeks and DS1 born at 36 weeks exactly. No problems with two subsequent pregnancies.

I had severe pre-ec with emcs at 33 weeks for ds1 so was consultant led the second time around. They gave me a doplar every 4 weeks until 28 weeks and then every 2 weeks. I was also on low dose aspirin. ds2 was 2 weeks late so they booked me in for a cs which I had wanted to avoid but fortunately my waters broke on the morning of the op. BP was fine and so pg3 was back to midwife led.

I had PE with my first pregnancy. Hospitalised at 33 weeks and DS born by CS at 34+6 weeks. No problems at all with my second (6.5 years later though if that makes any difference), DS2 born at 39+6 weeks.

I knew I was at increased risk of PE with DS (now 3yo) because:

1. My mother had it with me (doubles your risk & if your MiL had it when she had your partner then that also increase your risk by a margin - or so I was told),
2. I used to suffer with migraines,
3. I have an auto immune thyroid condition

and

1. my Papp A score was low when they did the Down's syndrome test (if low risk of Down's means there is a small increased risk of PE).

I was fine all the way through. However at 40weeks I was suffering with depressive symptoms and a migraine. GP locum told me I was fine (no protein in urine). However 3 days later, with no change to my BP i suddenly had PE. Induced the next day at 40+4. I hated induction. Plus all the drugs and other issues made bf hard. Eventually sorted that. However as a result we have not yet had another as I found the whole thing traumatic.... Altho I have just found out i am pg. slightly panicking tbh. GP told me not to take aspirin yet until I have seen the gynae and confirmed all is well. (Something about bleeding...) So. Am following this thread with interest! My mother had 4 kids and had PE with each of us. In order we were born at: 34w, 32w, 36w and 34w via CS. She has type 1 diabetes though and spent ages in hospital before having me, less with the others. I certainly didn't see snow or feel like I was ill. To the extent there is a part of me that really wonders if I had PE! My mum was seeing snow in August and was slightly delirious. I feel sorry for my dad. Watching it happen and wondering if she & the baby would survive. My husband found it quite traumatic watching my BP sky rocket on the machine and my pulse & baby's pulse were indistinguishable!

Best of luck with your research OP but I understand for some people having PE in a 1st pg does not increase it for a 2nd. I have no idea if I will be one of them tho!

Thanks for all your replies. It's reassuring to hear that some people didn't have it in subsequent pregnancies. My biggest concern would be that I wouldn't have an extra monitoring and would just be left to get on with it. Is that really not going to happen then?

Have a look at the NICE guidelines. If they say you should be consultant led with increased monitoring it'll be difficult for them to refuse this.

I had pe with my first, high bp and protein, I was monitored and given bp tablets until 36 wks then induced. With my second I was told it was unlikely to happen again but I was still given aspirin from 12 wks and consultant led. Now am having my third, am on aspirin but as the second pg was fine am not consultant led.

I'll have a look thanks.

For those of you who had fine pregnancies afterwards, did you notice any difference in the pregnant in general? I really hated it the first time round and had terrible insomnia all the way through, I don't know if it was related or just unlucky?!

Both my pregnancies were similar up to the PE stage. I had a bit more morning sickness with the second one (dd)
Like Mindfulbear my mother had it with me but not as early. I wonder if I had it now if i would be given bp tablets and not in hospital for so long.

Ikeameatballs that's really good to read that your second got to 39wks. I was admitted at 30wks with pre-e and icp and delivered by emcs at 31wks. :)

those of you who took aspirin in subsequent pg - when did you start taking it?

& does anyone have the link to the NICE guidelines?

I was prescribed asprin from 12 weeks for ds2. Nausea just the same second time around , lasting until 5 months ish. No insomnia at all.

Hardly any symptoms on first pregnancy (until the pre-eclampsia), just mild morning sickness around 12-16 weeks.

Second pregnancy had much more morning sickness, feeling faint and other normal pregnancy complaints throughout, but no pre-eclampsia.

Hi. I had preclamseaia with the first. For the second I was consulted led, put in aspirin at 12 wks and had more scan and more mw apps. For the third (currently of), it a normal pg, I think am only on aspirin because I pushed the mw for a prescription. I was told
During the second pg it was highly unlikely I'd develop preclamseaia again.