Overlooked aspirin prescription for pre-eclampsia

[QueenOfThePumpkins]

Hi everyone,

I'm 22 weeks pregnant with twins, and have had moderate anxiety all my life. When I got pregnant I decided that things would need to change and I was determined to be a calmer person. I am terrible for googling things and focusing on the worst case scenario, so I decided I would put my faith in the professionals and not go down any rabbit holes about the risks etc... just go with what information I am given. I've also been going for CBT.

Well the other day someone told me I should be on aspirin, as I meet two of the risk factors for pre-eclampsia (first time, multiple pregnancy). I asked my midwife and she said yes, the consultant should have prescribed me it. (It would be great if I'd actually met my consultant but that's another story!) Anyway she said she'd put a prescription in for me.

I had a call from my GP yesterday as they were confused about the prescription, and wanted to check how far along I was. They seemed quite concerned that I hadn't been prescribed it already as the benefits will be pretty minimal at this point

I've been up all night feeling tremendously guilty about all this. If something goes wrong then I will totally blame myself for not doing all my usual research, which would have pointed me towards this weeks ago when something could have been done.

I don't know how worried I need to be about it? Maybe I should ask for some extra monitoring? I know that if I had been on the aspirin then there's still no guarantee that I wouldn't get pre-eclampsia. I just feel so upset with myself and wanted to get it off my chest really. I'm now totally unconvinced that my anxiety was a bad thing

I'm surprised they gave it to you as a prescription. I was told to buy my own.

Just keep an eye out for symptoms of extreme swelling. It would happen very rapidly. Also severe headaches and spots in your vision. Your urine and blood pressure will be monitored at your regular appointments anyway, that will pick up any traces of possible protein in your urine.

I had preeclampsia with my first and it all happened very quick. I've been high risk for it with my second and now this pregnancy.

I was put on a medical trial with the nhs with my second. I was either given aspirin or a placebo tablet to take throughout and wasn't told which was which. I don't think taking aspirin is that much of a prevention otherwise they wouldn't have taken that sort of risk with the medical trial with patients who were high risk in the first place.

Hey OP I completely understand where you're coming from. I have a single pregnancy but as I have type 1 diabetes I should have been prescribed low aspirin at 12 weeks and just like you I wasn't told this until I was 22 weeks.

There's not a lot I can say to reassure you as I'm only 28 weeks now but it's not your fault, it's your first time doing this and there's no way you can expect to know everything. Thinking about what could/should of happened isn't going to help your babies now, focusing on doing all you can I.e taking the aspirin as needed etc will help. I struggled to get a prescription right away but you can just buy it over the counter and it's not expensive.

My advice would be to voice your concerns with your midwife, there's not a huge amount they can do but you'll feel better when they know how you feel and they can guide you moving forward.

Don't beat yourself up, you're doing your best and that's all anyone can ask. From what I can tell your babies are going to have an awesome mumma take care xx

Thank you both for the kind messages, and for the tips on what to look out for @nottodaysatanlucifer. I hope all went ok for you in the end, it must be a very worrying diagnosis to receive.

Wishing you both all the best in your current pregnancies too

If you’re particularly concerned you could push for a doppler scan this checks for blood flow within the placenta and can be a good indicator of pre eclampsia risk.

Given your anxiety I would try and push for an extra mw appointment to discuss or to see consultant.

I had severe pre eclampsia with my first pregnancy. I had extra monitoring for my second. Took aspirin and clexane (a drug thinner). The doppler scan picked up issues with my second and extra monitoring meant they picked up problems and delivered before I got it again.

Whatever about your anxiety, I'd be going apeshit on whoever should have prescribed it. I'm not exactly a pillar of society to be modelled so I appreciate if you wish to blame yourself instead.

It's not usually prescribed ime, it's so cheap to just buy the consultant or midwife will just say to take X dose. I was told that at booking so odd that it would be overlooked. Starting taking it up to 28 weeks still has benefits though.

Do you get extra monitoring with it being twins anyway? so your BP/urine will be checked regularly, you can keep an eye on any other symptoms and call your PAU if anything presents.

At 22 weeks with twins, you should definitely have seen a consultant by now. Have you been having extra scans?

Thanks all. Yes I've been having fortnightly scans with a fetal medicine specialist (as they are identical twins so higher risk), and blood pressure and urine have been checked every 4 weeks. Luckily I have access to a BP monitor at work so I may just check myself every couple of days and go straight in if it's ever high.

I was supposed to meet my consultant at 20 weeks @Tyjaro, but unfortunately she was called away. I ended up seeing someone who didn't seem to have much of a clue about anything

I'd definitely have bought some aspirin OTC if I'd known about it, but nobody even mentioned it. Not the midwife, or that stand-in consultant! Not very confidence inspiring is it...

I had identical twins and was seen every 2 weeks from 16 weeks. Please kick off at them and insist on seeing a consultant. Mine was great and it looked like my twins were developing ttts and only because the highly trained consultant was so good, he spotted it and then I had weekly checks. Luckily it turned out ok but it sounds like no one is really looking after you and your babies care properly.

Thanks @Tyjaro75, it's really helpful to hear from someone who has had identicals. I'm glad your TTTS scare turned out ok, it's my biggest worry.

They do seem pretty thorough with the scans, but I haven't really had much explained to me and I'm just sent home straight after. I am grateful that I get seen by the fetal medicine specialists, but nothing seems very well "tied together" and I'm worried what else might be getting missed. I expressed this to the hospital and they just swapped me to a different consultant... who I'm seeing at 28 weeks. I wouldn't even know who to approach now, I don't really have much faith in my midwife and I never see the same person twice at the hospital.

You poor thing. Have you joined Tamba? They may be able to give you advice on what to do to get the care you need.

Thanks for the suggestion @Tyjaro75, funnily enough I joined TAMBA last night

I have also read through the NICE guidelines for multiple pregnancies and to be honest it doesn't look like my care has fallen below those standards, other than the aspirin. The only thing I'm unsure of is whether my ultrasounds should have some sort of discussion-based appointment attached to them or not. The guidelines just say to offer scans every fortnight from 16 weeks and to have at least 11 antenatal appointments.

I think it's the small details that I might be missing out on, for example other people seem to know about centiles and things, which has never been explained to me. But maybe it's others getting really good service rather than me missing out!

Maybe have a chat with your midwife and get her to go over that with you. Good luck though.