Anyone had pre-eclampsia/HELLP syndrome in a second pregnancy?

[LaDiDaDi]

I'm going to see my GP next week to ask for a referral to Obs to discuss my risks of this happening again. At the time I was quoted 10% for a second pregnancy but everything I've read since suggests that the risks are more like 25%.

I thought that I'd conduct my own highly unscientific research here on mumsnet whilst waiting to see the consultant.

I had severe pre-eclampsia at 37 weeks with DS. I am now 8 weeks pregnant again and have been told I will be having consultant led care this time round, even though you are not so likely to get it in a second pregnancy, or as severely. I will have scans at 12, 20, 28 and 35 weeks, and I am taking low dose asprin. So, hopefully I will stay healthy this time! It will be interesting to see how many people did get it a second time. I am just keeping everything crossed.

I had it in my first pregnancy, was induced at 36 weeks. Second pregnancy I didn't get it at all. I did get migraines with flashing lights, zig zags etc which made me think I was getting it again and resulted in dh driving me to the hospital while I was crying hysterically, but I was fine.

Depends on the severity and time of on-set, your consultant should be able to give you a better idea. I had severe pre-eclampsia starting at 29 weeks, had ds at 34 weeks, my consultant gave me a 20% chance of getting it again in a second pg (as long as it was with the same father - different father = higher chance of repeat recurrence!) If you do get it in a second pg it is likely that it will start later and be less severe.

I had PE in both my pregnancies. First time it was severe- HELLP syndrome- DS born at 30 weeks. Told I had about a 20% risk of reoccurrence in subsequent pregnancies (if same father). Second time PE was much milder and later onset (which is usually the case in second cases- though not always)- BP started creeping around 32 weeks, admitted at 35 weeks, DD born 36 weeks- but they didn't let it become full-blown, just waiting until a "safe" gestation to deliver DD and reduce risk of my becoming very ill again. Second time I was under excellent consultant care, and on low-dose aspirin from 6 weeks- both of which I attribute to the comparative success of my second pregnancy.

Risk of reoccurrence of PE depends on how early you developed it before, how severely plus any other risk factors (e.g., high BMI, existing hypertension, family history, autoimmune or blood clotting issues etc.).

There has been some recent research on actual rates of reoccurrence- see: second most recent post on blog

I find it hard that they can't explain why PE has struck twice for me, as I do not have any known predisposing factor- but as my consultant says in 20 years they'll know a lot more, and there are probably blood clotting issues that they can't yet identify- esp. as it seems the aspirin (which thins the blood) helped me.

Good luck x

PS. I found this PE support forum very helpful in case you might be interested:pesupport.friendhood.net/index.htm

Thanks,

I had dd at 32 weeks after developing proteinuria at 30 weeks but being otherwise fine until I was suddenly very unwell on the day that she was delivered with full blown HELLP and a bp of over 170 systolic.

I've got no risk factors as far as I can tell with no pre-existng hypertension and a BMI of around 18. Second pregnancy will definitely be with same partner.

LaDiDaDi- after you had PE with your DD did they do any further blood tests to check out rarer autoimmune or blood clotting probs (e.g. Factor V Leiden)? If not it is likely the obs you see for pre-conception advice will do these, as if you are shown to have any clotting issues (that shouldn't affect you in everyday life, only when pregnant) they may look into using heparin in addition to aspirin during a subsequent pregnancy.

Hope you have a constructive appt with your Obs when you get one. Subsequent pregnancies after HELLP can be fraught with anxiety but I fund if there was a good care/management plan in place it made me a bit more confident- knowing they'd hopefully pick up anything going awry before it got out of control and hopefully minimise risk to both mother & baby. I had lots of growth & doppler scans post 20 weeks gestation, from 25 weeks did daily urine dips and weekly or more BP checks... But like you with DC#1 PE developed very fast with unusual first symptoms (my BP was the last thing to go awry)- which made me nervous.

Good luck.

No further blood tests once I'd recovered. I will mention this at the appointment.

I'm just sooo happy to have persuaded dp to ttc again that I really want the obs to be able to say that because of my lack of risk factors my chances are good even though I was so ill last time.

Had appt today. Doc basically said that my risk of recurrence was around 20% and it might be at around 32 weeks or slightly earlier.

They advised taking 75mg aspirin daily from the moment that I got a positive pregnancy test. They would do umbilical artey dopplers at 20 weeks and if they showed any problems with placental function then I would increase the aspirin to 150mg, if everything looked fine then I would just continue the 75mg until I got to 36 weeks.

Glad you got some answers from your appt. Really hope all goes well the next time round!

Thanks. Will be stocking up on aspirin asap.

I've just started another thread about this, as my consultant told me to start taking aspirin at 11+6 - hopefully will manage a poll!

The one I saw today was very clear that for the aspirinto help it should be around at the time of placentation so start taking it as soon as the test is positive.

HI there
Not sure if any of you have any more news since your last chats?

I felt fine all through my first pregnancy. Had a routine check at 34+4 and was rushed in to hospital in ambulance. My midwife couldn't get my blood pressure it was soo high and 6+ protein in urine. 3 hours later I had an emergency c-section and a baby weighing just short of 4lb. I spent 3 days in high dependency unit and was said to have been an hour away from full blown eclampsia and seisures. All worked out well in the end!
Just found out i'm 5 weeks pregnant. Again I was told 10% chance of reoccurence but after looking into it it's at least 20-25% because of severity.
Are you guys in America or UK, just wondered if aspirin advice is different here. I'm in UK.
Thanks
Katie

Hi Klolav,

Have you been offered an early (ie preferably before 12 weeks) appt with an obs consultant? If not go and ask your gp for a referral asap. They should be able to advise you on your individual risk, whether to take aspirin and when and any other monitoring will be done, eg uterine doppler at 24 weeks. Good luck!

Am in UK btw.

hi i also had hellp syndrome i had my little girl a year ago! i like yourselves had the same issues! however my little girl was small, she hadnt grown for 5 weeks did anyone eles suffer with this??

Induced due to PE at 36 weeks with dd1.

Dd2 pregnancy = some protein (trace) for a few weeks around the 20 week mark, but it went of it's won accord.

BP behaved. Did have one scare, bp was 140/90...but I checked out OK & cons said that he was happy for me to be induced there & then or wait for a week for my normal appt. The high BP could have been stress.

Just be aware that although you may be OK, it may hang over you, as it did me. I could never relax with preg #2 as I was worried at every little symptom....in hind sight it may have been better not to keep googling PE!

I had HELLP syndrome at 38 weeks with DS1 was given a GA and immediate CS, pretty nasty and felt pretty weak for weeks afterwards, happily DS1 was smallish (6lb2) but fine. I had DD1 20 months later and 10 days late in a birthing pool. Bliss!!

DC1 I had nothing,

DC2 induced at 38 weeks - PE diagnosed at about 36 weeks

DC3 induced at 35 weeks - PE diagnosed at 32ish weeks - much more severe

I can't remember what sort of odds I was quoted for it recurring in the 3rd pregnancy but they certainly weren't surprised at all - although they were surprised that it was worse -not sure why though