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Abbie
Starting Member
11 Posts |
 Posted - 05/20/2006 : 5:30:28 PM
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Okay ladies, I'm sure a lot of you have researched a ton about this disorder and may help to provide me some insight into what it really means to have Pre-E. I have a minor in bio/ and took lots of chem in college... but I have no clue how this works.
What exactly is happening that makes your BP rise and your protein to enter your urine? What do these symptoms do to your body chemically/biologically? Also, what's up with the hypereflexia - how does that enter the picture?
Any little tidbit of info would be great.
Thank you all in advance.
Abbie |
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Princess Purr
Advanced Member
USA
812 Posts |
Posted - 05/20/2006 : 6:16:38 PM
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I'm not a pro or a doc, but I think with the protien your kidneys are not working properly and not breaking down protein so it passes through your urine
With blood pressure I think you vessels are restricking and not relaxing making the pressure go with.
I'm not sure what causes hypereflexia but I had that majorly. Your reflexs are in over drive. The doc would just touch my knee and my leg would move.
Hopefully someone has better answers them me! |
Val & Rich Together Since 07/04/1996, Married June 20, 2001
Our Angel Veronica Rosina, 11/25/2004 ~ 11/27/2004
Born @ 26.5 weeks (1lb 5oz, 12inches) Severe Preeclampsia (On my way to HELLP)
www.AfterTheLoss.com (Pregnancy & Infant loss items/support)
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ileana
Senior Member
USA
1145 Posts |
Posted - 05/20/2006 : 7:12:12 PM
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I'm sure that there are others that understand and can explain the process better than I do, but they might not be able to get in here during the weekend. I read these things about 3 years ago, and I'm too lazy to go get quotes from books, but here's what I remember.
Preeclampsia is a disease of the placenta. I think that there are multiple mechanisms that can cause the placenta to get diseased, and there's a whole theory on what actually goes wrong. Anyway, in the end, the diseased placenta starts influencing the other organs.
There is no specific diagnostic test for preeclampsia/diseased placenta, but the most common systems that fail when preeclampsia strikes are the endothelium (which causes the hypertension and swelling) and the kidneys (causing them to start not filtering all the protein). Other systems that may fail are: liver - elevated liver enzymes causing right upper quadrant pain and epigastric pain, blood: low plateles and/or hemolisys, central nervous system: reflexes, visual disturbances, etc. Swelling can be that bad that it affects eyes and cause THE headache.
So basically when two or more systems start failing after 20w (when the placenta is fully functional), they diagnose preeclampsia.
Thanks for the great question! I hope this answers at least part of your question! |
Ileana
Angel - Feb 2003 - 24w stillborn severe pree - less than 1lb
Robert - Dec 2005 - 36w CHTN & aged placenta, no pree - 5lbs 13oz
Please fill in the Preeclampsia Foundation membership survey:
http://www.preeclampsia.org/Survey.aspx |
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Laura
Administrator Emeritus
USA
6177 Posts |
Posted - 05/20/2006 : 8:41:38 PM
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And I can expound a little more, until we get our science chicks in here.
As Ileana describes, there's a problem with the placenta. Recent research has established that the blood vessels attaching the placenta to the uterus in preeclamptic women aren't as deep or strong as they should be.
This set up works fine for the first part of pregnancy, but often there's a point where the baby grows large enough that these puny little vessels don't supply as much blood as the baby needs. The body responds by racheting up the blood pressure. Well, hyperperfusion might work for getting more blood to the baby- but it is a bad long term strategy, as the increased blood pressure can cause organ damage (most commonly to the kidneys) but also to the placenta itself.
In an attempt to keep the organs from getting blasted by this pressure- the body then starts the vasospasm part- the blood vessels start shutting intermittently on their own-- which can cause a whole host of other problems, including further damage to the vessels and destruction of red blood cells and platelets.
Meanwhile, the vessels begin to show the strain by leaking from the pressure and vasospasm. The watery part of the blood seeps out of the veins and acumulates in the extremities, like hands and feet. The swelling can get extreme, and the extra fluid the body has to process further stresses the kidneys, that are already groaning under the increased blood pressure. If it gets extreme, the fluid doesn't get pushed out, the kidneys don't work as well, and the swelling becomes pathologic-- it can end up as pulmonary edema in the lungs, or around the heart, or the swelling can enter the cranium and compress the brain and cause strokes or hemmorages.
Yee.
Hope this helps! |
Alicia (severe PE) 5/98 ~ Camille (htn, oligo) 4/03~ Alexander (htn, oligo) 6/07
PCOS/Chronic htn/homozygous MTHFR |
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Laura
Administrator Emeritus
USA
6177 Posts |
Posted - 05/20/2006 : 8:45:42 PM
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Also this explains why there's no 'cure' for preeclampsia. BP meds don't work- because the high blood pressure is just the reaction to the problem.
So, the 20 million dollar question is: How would you fix it, after it has already started? How do you increase the blood flow to the baby without damaging something else?
So preeclampsia is essentially the reaction to something that happened probably before you even knew you were pregnant! |
Alicia (severe PE) 5/98 ~ Camille (htn, oligo) 4/03~ Alexander (htn, oligo) 6/07
PCOS/Chronic htn/homozygous MTHFR |
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Caryn
Ask the Experienced Moderator
USA
7654 Posts |
Posted - 05/20/2006 : 9:32:07 PM
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I'm only one of the resident science chicks, so this will probably get expanded further, but here's a little more expansion on Laura...
It is looking very much these days like the problem with the initial implantation of the placenta is caused by a response to the foreign proteins of the placenta, which the immune system either a) recognizes as an invader, and attempts to reject, or b) fails to reject strongly enough (!) . All sorts of things can predispose you to this problem: an autoimmune disease, a family history of hypertension, multiples, any of the various forms of insulin resistance like diabetes or PCOS or GD, and so forth. Perhaps the reason "first baby" is a risk factor is that the immune system has to practice recognizing and responding to fetal DNA in order to handle it properly; we really don't know.
At any rate, the placenta's spiral arteries just don't get in there deeply enough, and the placenta ends up shallowly implanted and sometimes abnormally small because its normal growth has been compromised by the immune system as well. Scientists are pretty sure about this part; almost every study I've seen lately starts off with a first sentence along the lines of "Preeclampsia is characterized by poorly implanted placentae that..."
The theory goes: right around mid-pregnancy, the fetus begins to pack on weight and demand more blood across the placenta, but the placenta can't ferry it. The fetus begins to be shortchanged with respect to oxygen and nutrients (so IUGR is often associated with PE.) Our best guess at this point is that when the placenta becomes hypoxic, a protein called sFlt-1 gets expressed in its cells. (SFlt-1 stands for soluble fms-like tyrosine kinase, which is a mouthful.)
Ordinarily our bodies produce a lot of something called VEGF, for vascular endothelial growth factor. VEGF's "job" is to rattle around the blood vessels looking for leaks, and plug them -- it shepherds repair molecules into the holes blood vessels develop as they age. SFlt-1 is a VEGF antagonist, which means it binds to VEGF and makes it unable to do its job.
This loss of VEGF means the vessels become leaky (so swelling, sometimes oliguria, and cerebral edema, which explains the headache, visual disturbances, and hyperreflexia) and the kidneys aren't repaired so they can't filter properly (so you start to spill protein) and the liver starts to become toxic (so all the bad bloodwork showing liver damage -- sFlt-1 is hepatotoxic.) Edema can increase pressure on the blood vessels from the surrounding tissue. As if this weren't enough, all sorts of vasoconstrictors start to be expressed as well, tightening down the blood vessel walls and further raising pressures. That constellation of responses is pretty much the clinical definition of "multiple organ failure."
Oddly enough, sFlt-1 is present in *all* pregnancies -- it's just present early, and in phenomenally large quantities, in hypertensive pregnancies. The hypothesis here is that ordinarily placentae are only significantly hypoxic during labor contractions, and that production of sFlt-1 would help to detach the placenta from the uterine wall. So this explains the high rates of placental abruption in the population of hypertensive pregnancies.
And some people have existing hypertension, kidney or liver damage, etc -- which means their bodies are just that much more sensitive to the beginning of this cascade. When things start to go wrong, they touch off a feedback loop, and things often get much worse very quickly as one cause drives an increase in the effect of another. The average time from diagnosis to delivery is right around two weeks, and we've had the whole gamut from mild PE posters who go for months on bedrest, to women who crash into HELLP syndrome between their 2 pm OB appointment and the start of SNL.
So it's *REALLY* important to monitor your own symptoms, push for further testing, and generally keep your eyes peeled for further problems if you've gotten a positive diagnosis and you aren't already in the delivery room. Better safe than sorry.
Hope this helps some, and I don't mean to scare you. Unfortunately it's a scary disease. :-/ |
Science is getting us closer to finding a cause, and even a cure. The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
Caryn, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE |
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Abbie
Starting Member
11 Posts |
Posted - 05/20/2006 : 9:42:34 PM
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| Thank you all so very much!!! These are exactly the answers I was looking for. If anyone else has further insight - please feel free to chime in. I think I'm actually starting to understand the biological process... which actually makes me less fearful - now that I kind of know what is going on. |
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ScrapAng
Junior Member
USA
106 Posts |
Posted - 05/20/2006 : 10:26:35 PM
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Wow, what an extremely informative thread! Not sure I can re-explain it if someone asks me, but it makes a lot of things make sense in my own head at least! I wonder if there is any correlation with problems in early pregnancy, maybe the beginning of things not quite setting up right. Seems like I always had trouble "getting started" with a bit of bleeding, low hcg numbers, etc. Kind of makes me go hmmm... Also makes me go hmmm... that my dr. has said he doesn't think I am actually heading towards PE and is leaning more towards an autoimmune something not related to pg. Sounds like they really are more related than I thought.
Thank you for the great information. I've never seen it explained so well! |
Mom to 4 soon to be 5
12.5, 9, 5.5, 2.5 and EDD 2/14ish |
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Catherine
Director of Research Development
USA
3250 Posts |
Posted - 05/20/2006 : 10:57:29 PM
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Caryn and Laura have done an awesome job so I'll just do a little mop up here on "things" that might predispose to poor placentation.
1) Act of the Devine/Nature/Random Fate/Unpredictable Genetics. A newly fertilized egg is a completely unique pattern for a human being, and the placenta that supports it is too. Nothing is perfect so every once in a while things just might not string together as well as they could. People who experience this might just have one episode of preeclampsia during their entire reproductive career, not necessarily your first baby.
2) Women with hypertension, or with a tendency to develop this. It is simple to imagine that a newly forming placenta may struggle to establish the optimal maternal fetal connection in a system where the pressure in the circulation is high. So, if this happens to be your particular issue, it's simple to see that the best approach to trying to establish and maintain a healthy pregnancy is to have better control of your disease. This is why BP meds help some people, they ramp back the pressure which is high or tending high due to maternal factors unrelated to pregnancy. Some perinatologists also consider high cardiac output to be somewhat akin, and will treat women with this even when their BP falls within what would be normal levels.
3) Folks with thrombophilias otherwise known as blood clotting disorders. Some are well recognized with what is termed "poor pregnancy outcomes". Blood is a carefully balanced mixture of factors that promote clotting and factors that oppose it. Pregnancy kicks that balance over in order to accomodate all the new blood vessel formation, increase in blood volume etc. The formation of tiny blood clots may impair the formation of the spiral vessels etc. and lead to a less than perfect implantation event, and maybe preeclampsia down the line. For people who have recognized issues, there are therapies that can be considered, eg. blood thinners and using them during pregnancy may prevent those problems and thus reduce the risk of preeclampsia.
4) Folks with auto-immune diseases. These are diseases where the mothers immune system is, "testy". Diseases may "flare" under any situation of physical stress... hello pregnancy! On top of this.. the immune system is supposed to "turn itself down" during pregnancy so that the baby isn't considered a dangerous "non-self" signal. This process may not be optimally regulated in people with auto-immune disease. The depressing thing is that sometimes, a bout of preeclampsia may be your first warning sign that you may be developing such a condition.
5) Diabetes, PCOS, metabolic syndrome. There appears to be some association with increased risk of preeclampsia and these diseases or problems.
6) Multiples. Simple... count placentas [:p]. Realistically, 2 or more times the risk of something just not being as good as it could be.
The reason that I add this aspect of things to the discussion, is to highlight how current understanding of the disease may help with managing your risk of developing it again. It is totally worth doing what you can to rule out the predictable risk factors... It is equally worthwhile to do whatever you can to manage your hypertension, it can't hurt to follow the sensible recommendations of ACOG regarding diet and excercise in pregnancy. Once the BFP shows up.. well for now the majority of prior pre-eclampsia sufferers step onto the rollercoaster and hope for the best outcome possible. Future basic research (the whole SFlt-1 story comes from research groups interested in studying angiogenesis.. blood vessel formation.. I think one story goes that some men in a trial were taking an angiogenesis inhibitor to try and suppress tumor growth and developed symptoms that would be called preeclampsia if they'd been female, and pregnant past 20 weeks gestation[:)]) will help, translational research will bring this material out of laboratories and into OBs offices as early predictor tests, or better still, very specfic therapies that would help support the pregnancy but not hurt the fetus. Just think about how tricky it will be to come up with a good and safe approach! |
Catherine
Mom to Finn, Lucy (preeclampsia and HELLP) and Chloe.
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missgamecock
Senior Member
USA
6058 Posts |
Posted - 05/20/2006 : 11:13:18 PM
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| Good thread guys! |
Sabrina, mom of Kirsten Scout DOB 3/27/99, 5lbs, 1oz., 36 weeks 0 days, severe PE, & Sara Grace DOB 6/28/05, 6lbs 1oz., Severe PIH, 35 weeks 5 days. #3 Peyton, lost at 13 weeks 3 days on 2/21/08
4th - Lost at 5 weeks 4/30/08.
DD #3, Caitlyn Elyse (Catie), a Rainbow Baby, DOB 1/16/09, 5lbs 7 ozs, 36 weeks, Diagnosed w/ chronic HTN, RT Uterine Artery Notching, and mild PE.
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Caryn
Ask the Experienced Moderator
USA
7654 Posts |
Posted - 05/21/2006 : 01:40:46 AM
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| Yes, there is definitely a correlation with things going wrong in early pregnancy -- we now know that a history of miscarriage raises your risk of PE, presumably because it means that your immune system isn't responding correctly to the arrival of the placenta. |
Science is getting us closer to finding a cause, and even a cure. The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
Caryn, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE |
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Kimana
New Member
USA
55 Posts |
Posted - 05/21/2006 : 5:45:50 PM
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Abbie--thanks for asking these questions...I knew I wanted to know more, but didn't know how to phrase without sounding foolish...thanks for putting the words out there!
Thanks to everyone that has provided insight. I always feel better the more I know and enjoy learning new things. I better get DH on here to read this!!! |
Kate (29)
DH: Slade (30)
Kaden Douglas Alexander born June 19, 2006 (Pre-E/PIH) (36 weeks) |
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AuntShelly
Starting Member
8 Posts |
Posted - 05/21/2006 : 11:01:45 PM
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Wow this a great question. I have learned so much from your answers. This is the kind of information that is so hard to weed out when trying to do your own research!
Thank you
Michelle |
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Maris 1/07/2006-1/30/2006
Severe Pre-E and IUGR NEC
I miss you my baby.
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Patricks Mommy
Junior Member
USA
258 Posts |
Posted - 05/22/2006 : 11:17:40 AM
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This has been a great thread! Thanks for all of the information. I just had my husband read it.
Thanks!! |
Bethany (31)
DH Brian (31)
DS Patrick born 06/12/01 at 31 wks due to severe preeclampsia; compound heterozygeous MTHFR
DS Ethan born 09/12/06 at 35 weeks; no PE!! but I got everything else under the sun
My Avon 2 Day Walk for Breast Cancer Site: http://info.avonfoundation.org/site/TR/Walk2008/WashingtonDC?px=3849184&pg=personal&fr_id=1430 |
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jillmushet
Advanced Member
928 Posts |
Posted - 05/24/2006 : 11:48:27 AM
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| Great post. I also had my husband read it. |
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hayesmama
Junior Member
151 Posts |
Posted - 05/24/2006 : 1:45:36 PM
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| Excellent posts. This is great info! I need to get dh in here to read this. May even print this for the doc (keeping all sources anonymous of course). I never had pe/pih issues until after my molar pg---interesting. |
hayesmama
One great dh
dd 12, dd 10, ds 6, dd 4 PE 36w, ds 2 PIH 37w
10/00 complete molar pregnancy
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Kim
Texas State Coordinator
USA
849 Posts |
Posted - 05/24/2006 : 6:53:10 PM
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| Thanks ladies!! I appreciate this thread! |
Kim - Hashimoto's/Graves Diseases
Mom to Ainsley 11/26/02-35 Weeks Preeclampsia/HELLP |
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countrymom2e
Junior Member
USA
131 Posts |
Posted - 05/25/2006 : 11:07:12 PM
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| Great explanations! One question - how does post-partum pre-e factor in to things? I would think that once the placenta is delivered, the body should start to recover? But what about when things worsen post-partum? |
Mel, SAHM to Ethan b. 2/3/04 - PreE at 39 wks & postpartum
& Jack b. 5/16/06 at 38 wks - PreE at 26 wks, 12 wks of bedrest! |
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Caryn
Ask the Experienced Moderator
USA
7654 Posts |
Posted - 05/26/2006 : 11:47:51 AM
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I think the theory there goes: during delivery, the placenta is quite hypoxic, because it's undergoing labor contractions that cut off its blood supply. So it dumps a bunch of sFlt-1 into your system. The only way for sFlt-1 to be removed from your system is for it to bind to VEGF, which inactivates it. So it rattles around your vascular system for a while, and your body keeps making VEGF, and eventually you've got enough VEGF to mop up all the sFlt-1, and *then* the VEGF your body's making can go to work plugging all the little holes in the vascular system.
So depending on how much got released, it takes some time for your body to begin to repair itself, and it can even experience further damage from the lack of repair postpartum.
Did that make any sense? [:D] |
Science is getting us closer to finding a cause, and even a cure. The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
Caryn, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE |
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deerhart
Missouri State Coordinator
USA
3587 Posts |
Posted - 05/27/2006 : 1:21:42 PM
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Oh yes there is a strong corrolation between miscarriages and other problems, especially blood clots. In fact, most doctors you talk to will know the connection between blood clotting disorders and multiple miscarriages but not between it and PE (since a lot of woman with them end up with the miscarraiges instead of PE because they don't get that far along).
Having multiple miscarriages is enough reason to run a full set of blood work on both clotting and autoimmune issues.
As for post partem PE, well delivery isn't the only cure, time is as well. You could have clots in places other then the placenta (blood clots), there may be residual eneimes left over that your body is attacking (auto immune), hormones can still be out of whack (this can affect everything from clotting, autoimmune to toher conditions like PCOS, diabetes etc..).
Not only do you have to deliver, but you also have to have time pass for whatever is cuasing the PE in the first place to start to correct itself. For some it takes a matter of minutes, others it can take weeks and for some of us it can takes months or years for our bodies to come back to normal. |
Erin
Missouri State Coordinator
Mommy to Alex (7) and Mason (5)
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misscoleyp
Junior Member
USA
378 Posts |
Posted - 11/25/2006 : 3:47:38 PM
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| Can this thread get stickied and updated with any updates from current research? This thread would be great for those wanting a deeper understanding. |
Nicole (26)
1st Trimester M/C 1-17-04
^l^ Cooper Walker 12-28-05 www.myspace.com/cooperstank
TTC #3 Since April 2007 w/ PCOS |
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LisainNJ
Advanced Member
595 Posts |
Posted - 11/26/2006 : 1:25:36 PM
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| I've been wondering, if the placenta is hypoxic, would boosting the mother's oxygen level help? Maybe the placenta could settle down some and stop producing so much s-Flt1? At least in some cases? |
LisainNJ
wife to Joseph
ds born 1988 (Asperger's syndrome), dd born 1991, ds born 1996, dd born 2002
and my babies in heaven Elizabeth miscarried 2000 d. 13 weeks, Therese miscarried 2001 d. 10 weeks, Francesca Marie, stillborn 9/1/2006, 20 weeks, PE/HELLP |
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ozierja
Advanced Member
USA
538 Posts |
Posted - 11/27/2006 : 11:59:04 AM
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| I think maybe a s-Flt1 inhibitor would be great thing to try to produce. There might be more adverse effects with too much oxygen. One of the premises behind retinopathy of prematurity research is that ROP develops because of the varying levels of oxygen, not just the hypoxic state. So when the sats of the preemie go down, the O2 gets turned up and when the sats are high, the O2 gets lowered. What ends up happening is that once the preemie is off O2 then the retinal vessels that grow but they are the leaky ones and not properly formed. |
Julie O
Kelly Ann born 27.5 wks on 10/19/04; 2lbs 1oz; severe HELLP/PIH
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LisainNJ
Advanced Member
595 Posts |
Posted - 11/27/2006 : 8:43:18 PM
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I would settle for my baby being blind and alive, sigh...
But researchers seem to be looking at hypoxia-reoxygenation as a cause of preeclampsia - apparently more damaging than simple hypoxia. And carbon monoxide (smokers have less risk) seems to limit the cellular damage caused by hypoxia-reoxygenation.
So giving the mother oxygen unless done very very gradually might be a bad idea. |
LisainNJ
wife to Joseph
ds born 1988 (Asperger's syndrome), dd born 1991, ds born 1996, dd born 2002
and my babies in heaven Elizabeth miscarried 2000 d. 13 weeks, Therese miscarried 2001 d. 10 weeks, Francesca Marie, stillborn 9/1/2006, 20 weeks, PE/HELLP |
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ozierja
Advanced Member
USA
538 Posts |
Posted - 11/28/2006 : 08:50:21 AM
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| I really wish there was more research out there about this condition and treatments for it. Being around research in my job I can't understand why there is so much more research on diseases that are less common and certainly less damaging (at least potentially). I work at a major medical center/university in the top 20 of US research funding and not one study done here is for PE or PIH or HELLP. |
Julie O
Kelly Ann born 27.5 wks on 10/19/04; 2lbs 1oz; severe HELLP/PIH
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AmbersJourney
Junior Member
US
359 Posts |
Posted - 02/23/2009 : 3:17:58 PM
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| Wow- this says it all! Great, detailed information!! |
11/06 Aiden @32WKS Hyperemesis and Severe Pre Eclampsia
11/07 Katerina @ 36WKS PIH Mild Pre Eclampsia; Labetalol and Heparin.
Due Date: 5/11/09 Heparin
EDD now: 4/20/09 Labetalol |
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smb
Starting Member
NZ
9 Posts |
Posted - 02/24/2009 : 02:49:41 AM
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| this question is pretty obvious - can they scan the placenta to see if it has implanted properly? Forewarned is forearmed as they say |
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Jacinta
Starting Member
Australia
10 Posts |
Posted - 02/24/2009 : 04:09:44 AM
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| Hey, not so obvious! I asked the same thing of my MFM and the answer I got is that the spiral arteries are too small and numerous to appear on an ultrasound. Caryn is referring to them in her post above. The only way the doctor told me she would be able to examine them is on an autopsy of the placenta, obviously postpartum. |
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chippery
Starting Member
US
8 Posts |
Posted - 05/14/2009 : 10:55:49 AM
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First of all, THANK YOU for actually explaining PE, it's the best simplified description I've seen yet.
I was trying to research my own two pregnancies and fell into this site...luckily. :)
The first pregnancy, was finally a success after finding out my thyroid was off. Soon after starting and adjusting my dose, I got pregnant. I bled the entire first trimester. It stopped right around the 13 week mark. All was fine until around 26 weeks, when my BP started to rise - quickly. I was on two different BP medications, and it was still creeping up to 160/100+ on a daily basis. Protien in the urin was around 1 until the very end when it hit 3+. They did a c-section at 37 weeks. My son came out at 5 pounds 6 ounces(5 percentile). 18 1/2 inches (25 percentile). His blood sugar was low, had to go on oxygen and was in the incubator (fishtank as the family called it) for approx. 4 days. He's now 10 months old. His weight has increased to the 10th percentile, 17 pounds and his height is now average. :)
I found out I was pegnant again 4 months after having the last one. This scared the daylights out of me, after everything we'd just been through. Sure enough - at the confirmation appointment with my regular doctor, my blood pressure was 160/?. I've always had normal BP my entire life. He immediatly put me on pressure meds. I'm now 25 weeks and am starting to get the typical BP headaches. The pressure isn't as high now, being in the second trimester, but w/ the meds it's starting to reach 141/95.
However there was no bleeding w/ this one in the first trimester. So I'm trying to see what the chances of the PE are, if I'm just having the BP signs this time. My doctors already told me to expect it - and be happy if it passes me by. I just wish this wasn't such a mystery condition. |
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Caryn
Ask the Experienced Moderator
USA
7654 Posts |
Posted - 05/14/2009 : 7:39:20 PM
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Katie, welcome to the forums!
If you develop hypertension prior to twenty weeks gestation, they'll usually call that unmasked chronic hypertension. The idea is that the stress of pregnancy on your body reveals your genetic tendency to become a chronic. Chronic hypertensives have a 25% chance of developing superimposed preeclampsia in any given pregnancy.
However, you developed symptoms pretty early in your pregnancy last time, and that probably makes your risk closer to 40-60%. Here's a link to our Experts talking about recurrence rates.
Are you being seen by a high-risk team? |
Science is getting us closer to finding a cause, and even a cure. The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
Caryn, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE |
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chippery
Starting Member
US
8 Posts |
Posted - 05/19/2009 : 4:47:08 PM
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Thanks for the quick reply Caryn.
They've labeled me as High Risk from the start pretty much. I only see the Doctors anyways as we are already planning a second c-section. (Since the last one was just 10 months ago.)
They just started doing the Fetal Imaging today, and I'll be doing those every two weeks. The baby was at the 62% today - so on track so far. BP jumped to 150/92 this last week or so, and they've doubled my BP medication. They've told me to expect bed rest around my 30 week mark again. Everything is repeating the first pregnancy, down to the WEEK. |
Edited by - chippery on 05/31/2009 10:49:45 AM |
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sckitzo
Junior Member
USA
333 Posts |
Posted - 05/20/2009 : 11:42:38 AM
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| Can anyone tell me if Hyeremsis (rare condition in pregnancy that causes extreme Morning (all day) sickness, weight loss) and PE have any connection. I had Hyperemsis in both prenancies and Severe PE, in both pregnancies. This caused extreme stress on my body in the first trimester, and was wondering if it could have had any effect on the plecenta, or implantation. I have not had any miscarriages, or bleeding, I have been tested for everything under the sun, and have no blood clotting, Autoimune issues. I have no diabiates (gestational or otherwise), or BP issues. Besides history of PE (me only not in the family) I do not have any pe risk factors. Just wondering if there has been any research linking Hyperemsis with PE? |
Amber Bell
Brianna Charm Bell - 1/23/05, 33 weeks, 3Pds 3ounces 14 1/2 inches, Severe PE
John Thomas Chance Bell 9/21/06 - 10/18/06, 23 weeks, 1pd 6ounces, Died of Hydroceplus, and IVH Grade 3, Born 16 1/2 weeks earily from Severe Eclampsia, and Hellp Syndrome. |
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Caryn
Ask the Experienced Moderator
USA
7654 Posts |
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dbronson
New Member
US
86 Posts |
Posted - 05/31/2009 : 9:49:23 PM
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| Wow! I feel so smart now. You ladies rock. |
Tanner-7 38 weeks Severe Pre-E
Kellan-4 Term NO PE!!
Baby Boy Love sleeping 19 wks 6-04-08
Casey Daniel-5-25-09 37wks 5days Pre-E Again! Grrr
www.daniellebronson.com |
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chippery
Starting Member
US
8 Posts |
Posted - 07/23/2009 : 11:48:48 PM
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Caryn, I completely didn't see your question. Sorry for the late response. The dose I'm on now is Labetalol(sp?) 300mg/3xdaily. The pressures swing so much that we don't want to raise the dose, or it could hit too low. It is creeping at a steady pace, however it's more the bottom number that's creeping than the top. Right now I'm averaging 130/90 on the meds, so I can't complain.
I do have a question for ya'll though. I'm not getting the trademark pounding headaches that I was getting earlier in the pregnancy. But I have been getting the head pressure, behind the eyes, back to the upper ears for many weeks. I've never seen flashes of light or the other things that are mentioned on here. However over the last couple of days, I'm getting a "jumpy" feeling in my eyes - kind of like if you are looking at too many things for too long that your eyes get overworked. It doesn't hurt, but I noticed it during driving yesterday for sure. Would you wait to talk to the doctor on Monday about it, or give the on-call dr. a ring? (Or could this just be normal pregnancy,which I try not to assume w/ PE)
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Caryn
Ask the Experienced Moderator
USA
7654 Posts |
Posted - 07/24/2009 : 8:01:34 PM
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That sounds like a form of hyperreflexia to me, but I don't know.
When I had it I felt both extremely jittery, and, for lack of a better term, hypercompetent -- which might be why pregnant women with PE sometimes say that they feel "great, really energetic!" -- but I don't remember that feeling in my eyes per se.
As always, I vote for at least calling in and asking for them to check you out, since whacking you on the knee to check your reflexes is cheap and easy and a lot less of a problem than seizing over the weekend... |
Science is getting us closer to finding a cause, and even a cure. The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
Caryn, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE |
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atvlady
Junior Member
US
332 Posts |
Posted - 07/24/2009 : 8:01:34 PM
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| Can we make this post a sticky? I LOVE it and has helped my husband and I a TON! |
Delissa(36) Hubby(43)
#1 Rissa-Janelle "Darren" King born 6-6-09 10:33 p.m. passed 6-6-09 11:53 p.m. Twenty weeks one day gestational, 192 grams (6.8 ounces), 9 inches long. Severe HELLP, severe Pre-e and severe PIH.
#2 TTC as of October, 24 2009. HELLP, pre-e and all your ugly buddies, STAY AWAY!
Learn from the past, build for the future. |
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meekness
Starting Member
US
42 Posts |
Posted - 07/27/2009 : 3:11:57 PM
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This thread is so helpful. I'm going to share it with my family, so they will understand exactly what I am facing here today.
THANK YOU!! |
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shadow2356
Junior Member
US
165 Posts |
Posted - 07/31/2009 : 5:18:56 PM
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| This is great, thanks! |
MaryEllen
DD Julianna 3lbs 8 oz, born 1-8-08 at 34 weeks due to severe PE and class 1 HELLP |
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kvknsiva
Starting Member
US
11 Posts |
Posted - 08/04/2009 : 4:04:42 PM
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Is there any test available to tell the pre-re going start late in the pregnancy?
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Caryn
Ask the Experienced Moderator
USA
7654 Posts |
Posted - 08/06/2009 : 3:47:16 PM
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Not yet. Tests are in development.
It's thought that all pregnant women are very close to developing preeclampsia, and that all would develop it if their pregnancies lasted long enough, so it is difficult to pick out the women who will develop preeclampsia from the population as a whole. |
Science is getting us closer to finding a cause, and even a cure. The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
Caryn, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE |
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atvlady
Junior Member
US
332 Posts |
Posted - 08/06/2009 : 3:54:45 PM
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| I am glad you said that Caryn. My high risk ob said there is some tests that are currently being researched as to detect preeclampsia developing in pregnancy but then he cut my water off when he said that still if preeclampsia is going to happen in pregnancy, the baby has to be delivered regardless. I am out of sorts with his response cause I have talked to other women who's pre-e was controled. I guess it depends on progression of pre-e???? I am confused by his answers and arrogancy with my last appt!!!!! |
Delissa(36) Hubby(43)
#1 Rissa-Janelle "Darren" King born 6-6-09 10:33 p.m. passed 6-6-09 11:53 p.m. Twenty weeks one day gestational, 192 grams (6.8 ounces), 9 inches long. Severe HELLP, severe Pre-e and severe PIH.
#2 TTC as of October, 24 2009. HELLP, pre-e and all your ugly buddies, STAY AWAY!
Learn from the past, build for the future. |
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Caryn
Ask the Experienced Moderator
USA
7654 Posts |
Posted - 08/06/2009 : 4:58:18 PM
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PE is a freaky weird disease, and so they describe it using words like "multifactorial" and "heterogeneous". Essentially that means that there are lots of ways to be predisposed to get it, and lots of ways for the symptoms to present.
There's no known therapy or treatment for preeclampsia apart from delivery, except possibly in women with underlying thrombophilias who might benefit from blood thinners. However, the data supporting the use of blood thinners has gotten weaker with time, rather than stronger, and that may just be an artifact of our older studies.
Some women are on blood pressure meds to keep their pressures down because that is thought to lower risk to them, and to pose risks to the baby that are manageable through careful oversight. (Bp meds are associated with smaller babies, possibly because lowering the maternal pressure lowers the perfusion of the placenta somewhat. That can be watched with extra ultrasounds and dosage can be tweaked accordingly.) But blood pressure meds are not thought to affect the time of onset of preeclampsia or the rate of progression of preeclampsia.
And bedrest is known not to work, either.
So we're stuck saying that the average time from diagnosis to delivery is around two weeks, and that some women go from 0-60 in four hours, and others crawl along for months. |
Science is getting us closer to finding a cause, and even a cure. The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
Caryn, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE |
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atvlady
Junior Member
US
332 Posts |
Posted - 08/06/2009 : 5:38:47 PM
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I agree Caryn. My high risk told me that I started to develop pre-e around my 16th week, about the time when my right foot swelled up so big I couldn't even wear flip flops. But when he said that I looked at him and said I saw you twice and why didn't you tell me then! I don't know what was going through my drs minds with my pregnancy but the saddest thing is it was at the cost of our daughter, and almost my life. I am deeply saddened by this but furious on the other hand. LUCKILY I am going to see a new MFM in November. On the other hand, my HELLP came on in about 2 weeks so yes when you say that 2 weeks is from diagnosis to delivery I can say that is very true. I find myself extremley verbal now in my care now and my future pregnancies. My new ob is very confident I can have a viable baby next time. But still in my mind my odds are 50/50.
How about the role of VEGF in pre-e??? Any imput on that??
And does lowering BP by means of medication do more harm then good?
PS Caryn...could we make this post a sticky???? |
Delissa(36) Hubby(43)
#1 Rissa-Janelle "Darren" King born 6-6-09 10:33 p.m. passed 6-6-09 11:53 p.m. Twenty weeks one day gestational, 192 grams (6.8 ounces), 9 inches long. Severe HELLP, severe Pre-e and severe PIH.
#2 TTC as of October, 24 2009. HELLP, pre-e and all your ugly buddies, STAY AWAY!
Learn from the past, build for the future. |
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What happens biologically during Pre-E
