Pregnant again after pre-eclampsia - anyone else riding the same rollercoaster?

[ohanami]

I developed rapid, severe preeclampsia at 33 weeks in my first pregnancy, ending up with an emcs after 5 days when my heart and lungs started to struggle. Now I'm 13 weeks pregnant and suddenly absolutely petrified after my first appointment with the consultant.

If there's anyone else out there inching their way through the same journey come and say hello, it would be great to hear from anyone else in the same boat and find people who are obsessed with blood pressure, scans and cankles as I am at the moment.

Me! It came on gradually during my preg with DD2. Ended up spending a week in hospital with sky high blood pressure before being induced a few days later. I was 38 weeks so wasn't as drastic as your experience

But I'm constantly worried about my bp, my legs swelling and headaches lol. I have my first consultants appointment next week. And to top it off, I had IUGR (restricted growth) with both my DD's. I'm not really good at the whole pregnancy thing

I didn't ever develop pre-eclamsia but I was at risk of it and was monitored throughout my whole pregnancy. Weekly midwife visits, BP checks, protein in urine checks, Gestational diabetes checks, growth scans coming out my ears, and monthly trips to the consultant. I was induced at 38 weeks as they were concerned I was pre-pre-eclamptic and very old. A very relaxing experience all round

I am only 5+1 and already the appointments are filling up my diary....

Good luck!

Hi both! Sorry to hear you're both lining up all the appointments as well. It's so hard to relax just waiting to see what's round the corner But good luck! How are you both keeping so far?

I had my first consultant appointment this week and she couldn't have been less reassuring (or less interested in me). Trying to decide whether to push to see a different doctor (the one who looked after me last time was amazing) or just let it go and put it down to being the last patient on an over running clinic list.

I had high blood pressure in my first pregnancy, they did a blood test which confirmed I was going to develop preeclampsia. I only made it for another ten days after that, then DS started to show signs of distress and he was born at only 30 weeks.
I am 13 weeks along now with my second pregnancy and feeling very panicky some days. I haven't told many people about my pregnancy because quite a few asked about the risk of getting preeclampsia again, and I just can't face talking about it
I am taking low-dose aspirin which apparently reduces the risk. I cling to that whenever I feel anxious. The consultant is very positive and does his best to make me feel relaxed during visits, but of course he can't promise it's all going to go well!

Good luck to us all

I've had pre-eclampsia in both my previous pregnancies and I'm 30 weeks pg with my third. Previously it's developed in the final weeks of pregnancy so if it happens again hopefully it'll be the same, however I'm taking part in the folic acid clinical trial which should hopefully reduce the risk. Good luck to you guys and fingers crossed everything goes smoothly for you this time.

Hi i had PE with both previous pregnancies, dd born at 36 weeks and ds born at 36+6 weeks. Am 23 weeks pregnant with ds2 have so many appointments booked in at the moment. Last pregnancy i had obstetric cholestasis as well ( and a large pph), which was horrendous.

In addition to consultant appointments i have to have regular growth scans too as i had a low papp a score and both previous babies were small.

I am feeling great at the moment, my bp is high ish but stable, and i am still 2kg lighter than my booking weight, taking aspirin and will be starting bp meds at 26 weeks. I think the close monitoring is a good thing, but very frustrating waiting around as they are always running late!

I'm feeling exactly the same scrumptious, it's a great big shadow hanging over something that should be so exciting.

tatie I've not heard of the folic acid trial - do they think that could prevent pe?

Yes they believe that taking an increased dose (4mg) of folic acid throughout pregnancy reduces the risk. I'm taking part but not sure if I have the folic acid or the placebo but so far my BP has remained normal. The nurse running it at my hospital seems fairly sure that'll it'll show good results, fingers crossed!

I've been quite lucky in that it didn't develop in previous pregnancies til 38-40 weeks so I've been able to have an induction straight away but I'd love to experience going into labour naturally this time.

Insideout, could you tell me the limits for normal PAPP values? What is classed as too low?

That is interesting about folic acid reducing the risk of preeclampsia. I was told to take it throughout my whole pregnancy, but at a much lower dose, 400 microgrammes.
I was also told to make sure I get around 100 g of protein a day, and to eat enough salt because apparently women with preeclampsia have a lack of sodium. I am really struggling to do both because I am still suffering from nausea, which is very frustrating!

That's really interesting about the folic acid. I've been on a higher dose because of a family history of neural tube defects, but stopped at 12 weeks. I wonder if the gp will let me carry on my prescription?

I told a couple of friends today, and they were obviously very excited to hear the news but from their reaction they had no idea that it might not be plain sailing (I guess why would it, as far as they could see last time something went a bit wrong and dd was born a wee bit early) but it would be lovely to have someone close by who just "gets" what might be in store. It puts me off telling more people - the explanation of due date "but maybe a bit earlier, or maybe a lot earlier, or maybe not there at all" just feels really hard to repeat a lot of times

From what I was told, taking the higher dose of folic acid does no harm, it's 4mg and apparently epileptic women take 5mg routinely so I was happy to volunteer. Still taking the aspirin as well.

I think the lack of control over when/if pe happens is quite hard to deal with, what worries me is the lack of symptoms I experience with it. Thankfully us pe mums get plenty of check ups and are generally well looked after.

I had severe, early PE in my 1st pregnancy, and hellp, without symptoms at 28 weeks. DS had IUGR & spent nearly 100 days in NICU. For a long time, we could not face another pregnancy.

With DD, I was advised to take 75mg aspirin from BFP. I also read the NICE guidelines "Hypertension in Pregnancy" & from these knew my PE risk was about 30%. Apparently if you get PE again, it averages 2 weeks later than your previous pregnancy & is milder.

I had weekly BPchecks from 20 weeks, fortnightly growth & Doppler scans. I had a bit of a wobble (RFM) at 30 weeks & had daily monitoring for a bit.

I never got PE or high BP 2nd time round, but I did get reduced fluid round DD & had her at 35+6.

No more DC for me!!

Currently going through the same. Has PE with my first - my BP started to increase around 30 weeks, in hospital for 2 weeks from 31 weeks and DS1 born at 33 weeks. Luckily he was absolutely fine, but found it really stressful and took quite a while to be ok with everything.
I'm now 13 weeks with second pregnancy. All the info given to me seems quite vague! Told it will ' probably happen again' but that it will be later. Also told a 1in 4 chance of it happening. Advised to take 75mg of aspirin daily as apparently reduces PE appearing in some women. Awaiting consultant appointment.

I'm not going through this currently, but I did have this when pregnant with DS2. I took 75mg aspirin daily and developed no symptoms of pre-eclampsia whatsoever second time around, if that is any reassurance. I was told that it is far less common with second pregnancies with the same partner - DP did get a bit cheesed off and ask why everyone seemed to ask me at every appointment whether it was the same father as last time! DS2 arrived at 38 weeks, purely because I had an ELCS and that was the only date free for it.

The lack of control/prevention /treatment is (one of the things) that scare me - I felt so well in my last pregnancy until the day I went into hdu. We know so much about so many diseases now but preeclampsia is still such a mystery.

I'm hoping that the '2 weeks later and not as bad' rule applies here. A midwife said something similar after dd was born I think, though at the time I wasn't really focused on dc2! Moderate pe at nearly 36 weeks isn't too scary a prospect. It sounds like you had a rough ride with your ds sauvignon.

Hi scrumptious the PAPP-A scoring is worked out on a percentile, like baby growth etc. My consultant said basically a score under 5 is classed as low and needs close monitoring , mine was 3.4 which is not good but could have been worse! PAPP-A is associated with placental stability and the lower the score the more likely it is to have intra uterine growth retardation (IUGR) and a tiny increase in miscarriage risk.

To be totally honest i am counting down the days until 36 weeks as i wont stop worrying until baby is in my arms, which I'm pretty certain is the same for most of us 'high risk' pregnancies. ( only 12 weeks and 3 days to go!)

Thanks for your reply, the results I got are in a different unit, so unfortunately I still don't know if they're ok or not... I live in Germany and PAPP-A is not used to predict preeclampsia. I only know my levels because they use them to predict the probability of Down's disease. I will have to ask my consultant again, perhaps he can help.
I am 14 weeks now and have had some awful dreams these last couple of nights I feel so stressed already and it's only going to get worse!!

It is worrying in any pregnancy, but especially so when you have had previous problems.

just reread my previous post a PAPP-A under 0.5 is seen as low not under 5 i am so sorry if i worried anyone

I think(hope) i am coping ok because i am a medical scientist and because of my previous pregnancy issues have done a fair bit of research into PE etc.

Typically PAPP-A results are given with the unit IU/L ( international unit per litre) or SI/L (system international per litre) this is then taken and adjusted against your weight and foetal age to give a MOM ( median of medians).

Its quite frustrating but try and remember, most women with a low PAPP-A will have no issues and give birth to a healthy weight baby, conversely women with a normal PAPP-A can have IUGR . One blood test result isnt that important on its own, and I'm sure your consultant will be able to answer all your concerns x

Thanks for the info on papp a insideout. Just got my combined screening results back and papp a is 0.94 so that sounds low but obviously higher than the 0.5 you mentioned, so hopefully a good start. I think my weight is a little lower than the one they used in the calculation (was wearing jeans and about 10 layers - it was freezing that day!) - do you know if that would push the reading higher or lower?