Preeclampsia at 36 weeks, induction or planned caesarean at 37?

[Babyburrito0]

So today has been a bit of a whirlwind. I'm currently 36+2 and I've been consultant led in this pregnancy (2nd baby) due to pre eclampsia in my first pregnancy.

Everything has been going well until this afternoon where I had some flashing lights in my vision. Checked my blood pressure and it was high (160/105). Tried for a few hours to get it down but wasn't working so phoned the assement unit and came in to be monitored.
My blood pressure wasn't coming down enough and theyve found protein so I've been given labetalol and will have to stay in for the next day or two.

They've said that they will be looking at delivering at 37 weeks (5 days!) And the doctors will be around in the morning to discuss how I want to give birth.

I had a week long induction with my daughter at 38 weeks, she got stuck and I was prepped for a c section but they managed to get her out with forecepts.

I'm really torn on how I want to give birth this time around. I was hoping for a smooth pregnancy and to have to option to go into labour naturally but obviously that has gone out of the window.
I don't want to go through a week long induction again for it to fail and it to end up in an emergency section (especially as I have another child at home who i am desperate to be with). I'm very aware that a c section is major surgery and that recovery can be really tough.
I think right now I'm leaning towards a c section but want to hear what the doctors think would be best for baby.

Has anyone been in a similar situation and what did you decide to do?

I had preeclampsia with my first pregnancy so they induced me and I gave birth 4 days later with forceps after it all became very urgent / stressful (that’s the short version of the story). I was exhausted and really struggled after.

I was also consultant led with my second. I didn’t develop preeclampsia but I had an elective section and honestly do not regret it at all. It was calm, straightforward and very healing after my first birth. Recovery was a little harder (psychically) but so much better mentally. After 2 weeks I was up and about as normal and the pain was managed well with pain relief.

Sorry you’re going through it again - glad it’s been picked up though and you can now make a plan that’s right for you. Wishing you all the best with whatever you do decide to do.

In your shoes I would chose the section

Best wishes OP

Personally I’d go for the section

At 36 weeks plus you are in a good position and should go for c section. The recovery from the c section is not too tricky

I had pre-eclampsia with both my pregnancies.

I had a fairly smooth and quick vaginal birth with my first. I opted to have an induction again with my second.

Not quite as quick this time as I had to wait 4 days to go to delivery suite. Also less smooth as I wound up with a C-section after baby got stuck and labour stalled at 5cm.

I have zero regrets though. Attempting a vaginal birth was important to me. After my experience with my first the expectation was it would be the same, and I just got unlucky. In the event there was a third, and it was medically indicated, I would still choose induction.

If your heart is telling you C/section, then that's what you should do.

I would go straight to C-section.

I had to have an emcs due to pre eclampsia with my first. I had an elective cs with my second. The recovery was fine and it was actually a really emotionally healing experience after the trauma of the first birth.

Go for the section. I was induced twice with preeclampsia with my first at 37 weeks and nothing happened. I had to go through two days of anxiety before I strongly requested a c-section. Recovery was pretty straightforward and pain was managed with ibuprofen and paracetamol for the first week or two.

I had similar when I was having twins and opted for induction. It all went well and it was under 12 hours just with a pessary. That said I’d had another easy induction before. Ithink with your history I’d probably lean toward a C-section.

couple of thoughts (from an obs anaesthetist pov)... not all inductions are the same and quite often a second one is more straightforward than the first. They should be able to give you a pretty good idea about how 'favourable' things are looking nearer the time. They should be able to help weigh up the balance of pros and cons with a bit more info re your general health, how the baby's looking and how the PET's affecting you... sometimes it's factors other than the PET that are more important in helping you make the decision.

This was me a few years ago. I started induction and regret it as I didn't respond to the pessaries at all. Ended up having the caesarean anyway. I would definitely go for caesarean.

I had a c-section at 37+5 with my daughter, due to PE. Was the best decision. A lovely experience! My sister had a four day induction and an assisted delivery with her son, and I was not willing to go through that. I walked in to the room at 9, she was here at 9.17 and I was out by 11am the next day and fine.

No pre-eclampsia but my first birth was a 48-hour induction that ended in an emergency section, which was a real emergency.

I'm pregnant again and will be going for a planned section without a second thought.

I know people who've had great experiences with induction but I just wouldn't put myself through it again. Having a child at home I like knowing exactly when the new baby will come, and the recovery last time was nowhere near as bad as I expected so hoping that I'm lucky again.

I developed icp and started to develop HELLP in my last pregnancy. I was due to have an induction at 38weeks as long as my bile acids did shoot up in which case it would have been 35 weeks or within 24h of them increasing after 35 weeks. I was 36+2 when my blood tests started to look like hellp and I was really unwell having had 2 admissions for severe fatigue. I was due to discuss induction at 37+3 but repeated bloods were worse so I was brought in at 36+6 instead.

I discussed induction Vs c section with my consultants and we all agreed that if I could give birth vaginally through a simple induction that would be preferable to a c section but a c section would be preferable to a long drawn out induction. So we went down a gentle induction route. I had low platelets and knew that this would have meant I wouldn't have been able to have an epidural

I had a sweep at 36+6 to see if this would tip me into labour (I had been having contractions since 32 weeks). It did make them regular and stronger. If I had been healthier I would have given them longer instead I was admitted to the induction suite the next afternoon. They weren't happy with the trace which delayed the induction and then they wanted to make sure there would be a delivery room available. They put the pessetry in at 8pm and removed it at midnight as it had done the job and they didn't want me to hyper stimulate. Baby arrived at 2pm the next day.

Ahead I decided that I would accept a pessetry but wouldn't accept multiple so if I wasn't progressing after 24h I would switch to c section
I couldn't stay awake for more than an hour at a time so if I was unable to rest and sleep during labour I would switch to a c section.
I couldn't cope with a long labour so I had a 24h clock in my head. It was 18h in the ended from having the pessetry to baby arriving and 6h in the labour suite. I didn't have much left in the tank so 24h would probably have been too much. I was unable to stand up for the last 4h and needed to be a sleep or semi asleep all the time which stalled labour. I laboured best when being more upright so the midwife manoeuvred the bed so I was pretty much upright but lying on the bed. They did need to break my waters and this did send baby into distress causing a hairy 15 minutes but this was due to him having the cord tightly around his neck rather than the induction.

We explained to every staff member that I was being induced because of extreme fatigue and icp and that the priority was for me to get through labour in the best state possible and if that meant stopping the induction that is what we would do but whilst my body was responding positively we would continue down that approach. I had ward round in the delivery suite with the drs so they knew too.