Pre eclampsia

[Hattsmum]

I've had high blood pressure/pre eclampsia during both pregnancies - DD1 was born 4 weeks early, and DS 9 weeks early.

Has anyone suffered from this and then gone on to have a 'normal' pregnancy?? Me and hubbie are both very broody!

[Distel]

I had pre-eclampsia in my first pregnancy and then went on to have 2 further normal pregnancies. I think that it does make a big difference though if you have it in second pregnancy. It is common in first but not so much in subsiquant ones. Hope this hlps a little bit x x x.

[hub2dee]

Hi Hattsmum,

DW (primie) developed PIH at around 31 weeks, and later, as the BP went a bit mad, we saw a private consultant and subsequently had a c-s at 36 weeks due to IUGR / degraded placenta etc.

I don't think dw developed PE, but I asked the consultant and there are proposed treatments to reduce the chance of subsequent PE / bp issues in your pg - things like aspirin, Vit C, mag. sulphate etc.(IIRC - please check !) I think it might be worth asking what is the latest research and any proposed therapies which might be relevant to your next pg.

Good luck !

[Hattsmum]

Thanks, I will check what the latest research advises

[hub2dee]

You could also drop a sly e-mail to one of the consultant's secretaries if you just want a pointer to the latest research or a summary of what treatment they might propose perhaps.

Good luck.

I think the US in particular is keen on mag. sulphate therapy as a precautionary treatment for PE. Perhaps a
'PE prevention' google might yield something useful ?

[goldenoldie]

Tomy are currently doing a clinical trial on Vit C and E to reduce incidence of pre-enclampsia. To get on the trial you have to be less than 20 weeks pregnant and in a high risk group. Half the group get the real thing 1000mg Vit C and 400 Vit E, and the other half get a placebo.

[hub2dee]

Interesting, goldenoldie. Do you know if the trial is using any additional drugs / variables (say aspirin, higher / longer doses of folic acid, magnesium sulphate etc.) or just the two vits you posted ?

[goldenoldie]

As far as I know it is just the two vits - nothing else.

[goldenoldie]

This is the study (published in the Lancet in 1999) they are trying to replicate on a bigger scale to see if they get the same significant reduction in PE with it C & E.

Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial.

Chappell LC, Seed PT, Briley AL, Kelly FJ, Lee R, Hunt BJ, Parmar K, Bewley SJ, Shennan AH, Steer PJ, Poston L.

Department of Obstetrics and Gynaecology, Guy's, King's, and St Thomas' School of Medicine, St Thomas' Hospital, London, UK.

BACKGROUND: Oxidative stress has been implicated in the pathophysiology of pre-eclampsia. This randomised controlled trial investigated the effect of supplementation with vitamins C and E in women at increased risk of the disorder on plasma markers of vascular endothelial activation and placental insufficiency and the occurrence of pre-eclampsia.

METHODS: 283 women were identified as being at increased risk of pre-eclampsia by abnormal two-stage uterine-artery doppler analysis or a previous history of the disorder and were randomly assigned vitamin C (1000 mg/day) and vitamin E (400 IU/day) or placebo at 16-22 weeks' gestation. Plasma markers of endothelial activation (plasminogen-activator inhibitor 1 [PAI-1]) and placental dysfunction (PAI-2) were measured every month until delivery. Pre-eclampsia was assessed by the development of proteinuric hypertension. Analyses were done by intention to treat, and in the cohort who completed the study.

FINDINGS: Supplementation with vitamins C and E was associated with a 21% decrease in the PAI-1/PAI-2 ratio during gestation (95% CI 4-35, p=0.015). In the intention-to-treat cohort, pre-eclampsia occurred in 24 (17%) of 142 women in the placebo group and 11 (8%) of 141 in the vitamin group (adjusted odds ratio 0.39 [0.17-0.90], p=0.02). In the cohort who completed the study (81 placebo group, 79 vitamin group), the odds ratio for pre-eclampsia was 0.24 (0.08-0.70, p=0.002).

INTERPRETATION: Supplementation with vitamins C and E may be beneficial in the prevention of pre-eclampsia in women at increased risk of the disease. Multicentre trials are needed to show whether vitamin supplementation affects the occurrence of pre-eclampsia in low-risk women and to confirm our results in larger groups of high-risk women from different populations.