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Kosta
Starting Member
US
4 Posts |
 Posted - 11/07/2009 : 05:17:37 AM
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Hello everyone -- I've just found this forum and am glad to have a place where I can ask questions. This seems like a fantastic community.
My wife was diagnosed 2 days ago with "mild preeclampsia," and it blindsided us. Thus far, we have had an uncomplicated pregnancy, save for an above average bout with morning sickness a few months ago. We had been planning on birthing with a midwife in a hospital setting, but we now realize that won't be happening.
She is 34 weeks pregnant to the day, and was given a course of steroids to mature our baby girl's lungs (two shots over the course of 2 days) in case the baby needed to be delivered sometime soon. After a 24 hour urine collection, her protein came back at 700 (I believe they meant 700 milligrams) and her blood pressure was hovering around 145/95 for our 2 day hospital stay.
While in the hospital, she had a few readings above 160/100, but those calmed down within 5 minutes for a follow up reading. I know the 160/100 readings were very high, and I wonder if that can be attributed to her stress/anxiety due to being admitted to the hospital. This is the first time in her life that she's actually been admitted and I can tell she is very nervous to be in that setting.
We have been sent home and she is on bedrest, with the plan being that we visit the high-risk clinic/OB twice per week and monitor her blood pressure and weight from home. We are told to call in if we have more than one reading above 150/105, or a weight gain of more than 5 pounds per week.
She is not having any headaches or visual disturbances, and no swelling either. Her only complaint currently is heartburn.
I realize this is a vague question, but how worried should I be?
I am, of course, very concerned for my wife and my daughter. I know this can go many different ways, but is it relatively common in cases like hers to induce at about 36 weeks, provided her symptoms don't progress rapidly? So the goal would be to keep her blood pressure down for two weeks?
Thanks so very much for reading. I'm sure you can all relate to how confusing and scary this diagnosis is. |
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Kosta
Starting Member
US
4 Posts |
Posted - 11/07/2009 : 05:20:35 AM
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| I forgot to mention that since we've come home, her blood pressure readings have averaged about 135/88 or so. This is with a home blood pressure monitor so I can't say if it's 100% accurate, but all of today's and yesterday's readings have been very close to 135/88 with no readings coming in drastically higher or lower than that. |
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jules2
Junior Member
UK
147 Posts |
Posted - 11/07/2009 : 06:09:18 AM
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You are right to be concerned because pre-eclampsia can progres very fast, even when it is still "mild", but there are also many positives here:
- your wife has got to 34 weeks, if she had to deliver now your baby daughter would in all likelihood do very well
- your baby has had steroids, that's a big help too if she has to come a bit early
- she's been diagnosed and therefore will be monitored closely.
I would say keep positive, its very likely you will all get through this scarey period totally fine, but your wife should be utterly vigilent about reporting any symptoms, like headaches, pain around the ribs or back, visual disturbances, swelling, particularly swelling in the face, because the scarey thing is how fast this disease sometimes progresses :-( And in my case all my symtpoms were very mild despite life threatening severe disease :-(
Hope this helps - keep us informed
Jules |
Mother to Alice, stillborn on 05/09/09 at 26+1 weeks
Missed miscarriage at 8 weeks, Nov 2009 |
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amandaoasis
Junior Member
US
145 Posts |
Posted - 11/07/2009 : 09:27:17 AM
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I'm sorry to hear that your wife has PE...but also glad to hear she is being monitored so closely. Like Jules said, you are in a good place at 34 weeks. The only issue I would mention is the heartburn. Is she sure what heartburn feels like? I ask because my midwife kept telling me I had heartburn (which I had never had in my life). In ended up to be liver pain due to HELLP (very severe PE). My BP was never diagnostic and I had no protein.
I am sure they did labs to check for HELLP in the hospital, but on the slim chance that they didn't, I would want to make sure.
Here's to at least 3 more weeks of baby baking! |
Mom to Bennett. 3lbs. 7 oz. 16 inches. Born 11/24/08 at 31 weeks 2 days due to HELLP.
TTC #2 November 2009 |
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Blythe
Ask the Experienced Moderator
USA
2081 Posts |
Posted - 11/07/2009 : 09:30:54 AM
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In my totally not-a-doctor opinion, it sounds like your doctors are on top of things. Right now they are balancing mom's health and keeping baby "inside" for as long as possible.
The diagnostic criteria for mild PE is two readings at least 6 hours apart of 140/90 or greater, and 300mg or more in a 24-hour urine collection. Criteria for severe disease includes things like bp readings over 160/100 (some docs diagnose severe disease with just one reading of 160 systolic or 100 diastolic, some seem to use higher thresholds), 5000mg of protein in a 24-hour collection, signs that the placenta is failing and the baby is not doing well "inside", and blood/lab values indicating liver dysfunction, red blood cell destruction, and/or lowered platelets (and a few other possible indicators that are escaping me at the moment).
The "cure" starts with delivery - but mom can still get more ill, especially in the 48-hours after delivery, and even up to 6 weeks postpartum, so watch the signs and symptoms Jules listed and are described further here - http://www.preeclampsia.org/symptoms.asp
I've been told that some of our experts (top researchers and clinicians in hypertensive pregnancies) prefer to induce at 36 weeks even with mild disease. A new study has been published that suggests that 37 weeks is preferable if the disease remains mild. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60736-4/abstract
If the disease becomes more severe, at your baby's gestational age, I assume they would deliver fairly quickly. A good question for your docs is to ask what their criteria for delivery would be for your wife and baby! "Average" time from diagnosis to delivery is 2 weeks, but that average encompasses women who stay pregnant for months and women who go from "fine" to "critically ill" within a day.
Basically, preeclampsia is very serious but for the baby's sake they want to keep her pregnant as long as possible. If the doctors prescribe bedrest, help her do her best, but the research hasn't shown much benefit to bedrest (though many of our members will swear it kept them pregnant longer). If her blood pressure gets much higher and other symptoms remain stable, her doctors *may* prescribe bp meds - but blood pressure is an indicator of the underlying disease, not the cause, so treating blood pressure would help prevent a stroke, but not affect the underlying progression of the disease. Your wife can do kick counts to monitor the baby at home - sometimes PE affects the baby before mom gets very ill. Watch your wife's signs and symptoms very closely and call your doctor / L&D with *any* concerns.
34 weeks with steroid shots is an *excellent* place to be, however. 34 weekers around here seem to have short NICU stays and generally do well.
Please do ask any more questions you have and let us know how your wife is doing. You can encourage her to join us on the boards also!
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Heather - mom to
DS #1 - 7/18/03, 37 weeks - Mild PE, 5lbs, 8oz, 4 days in NICU
DS #2 - 8/11/06, 36 1/2 weeks, 6lbs, 14oz!!! Induced for diagnostic BP. No NICU!
DD #3 - 9/10/09, high bp at 33 1/2 weeks, induced at 37 weeks, 5 pounds, 12 ounces - healthy girl!
"Thank God for the internet - otherwise my children would be raised in a med school library" |
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Blythe
Ask the Experienced Moderator
USA
2081 Posts |
Posted - 11/07/2009 : 09:38:09 AM
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| You mentioned that the previous plan was birthing with a midwife. Your wife can still plan to give birth vaginally, though I assume her risk of a c-section is higher if she needs to be induced before 37 weeks (the HYPITAT study found no increase in sections after 37 weeks). If she wants to avoid an epidural or other pain meds, it is still possible, though sometimes epidurals are used to keep mom's blood pressure out of stroke range. Induced labors can also be more difficult and epidurals are a welcome relief. At this point the goal is a healthy mom and a healthy baby, but if your wife had other hopes for her birth experience she can search my old posts for ideas (many other women here have had "natural" births but I seem to write about it the most!). |
Heather - mom to
DS #1 - 7/18/03, 37 weeks - Mild PE, 5lbs, 8oz, 4 days in NICU
DS #2 - 8/11/06, 36 1/2 weeks, 6lbs, 14oz!!! Induced for diagnostic BP. No NICU!
DD #3 - 9/10/09, high bp at 33 1/2 weeks, induced at 37 weeks, 5 pounds, 12 ounces - healthy girl!
"Thank God for the internet - otherwise my children would be raised in a med school library" |
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SaraB
Assistant Forum Administrator
USA
2698 Posts |
Posted - 11/07/2009 : 09:54:16 AM
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Hi Geoff,
You have gotten some excellent responses already, but I wanted to chime in and welcome you to the forum. Kudos to you for doing what you can to learn about your wife's condition! Feel free to look around and ask any questions - this is a wonderful place to find information and support.
As the others have said, 34 weeks is not too bad a place to be right now. I know that the thought of your little girl arriving 6 weeks early is terrifying, but you've got the steroids under your belt and your wife is being monitored closely - both bonus points for you guys right now.
Do keep us posted. |
Sara
Maggie, 6/9/03, 29 weeks, severe pe
Logan, 1/19/05, 32 weeks, severe pe/HELLP |
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Fiona
Forum Administrator
Canada
5816 Posts |
Posted - 11/07/2009 : 1:01:31 PM
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Hi Geoff,
you've been given great info already, which I won't repeat - although I would reiterate getting that heartburn checked out. In your shoes, I'd be inclined to go in and let them run blood work to check your wife's liver.
You might also take your home BP monitor in with you next time to calibrate it with the one at the clinic - it would be good to know it is accurate.
So yes, you are right to be concerned with a pe diagnosis. Close monitoring and prompt attention to new symptoms are the key until delivery.
Keep us posted. |
Fiona
Nate 12/8/97 - 14/8/97 26 wks - 1lb - severe pe
Jay 11/98 30 wks - 3lb 11oz - severe pe; Sacha 5/05 36 wks 3 days - 7lb 9oz - PIH
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AnneS
Grief and Loss Moderator
USA
2279 Posts |
Posted - 11/08/2009 : 07:36:51 AM
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| Hi Geoff, just wanted to say hi and welcome. You have gotten great responses, I have nothing to add, just a hello. |
Anne
DH Richard
DS Parker 7/6/03(severe pe)33wks
DS Griffin 2/17/06-2/21/06, 25 wks,IUGR and Low Amniotic Fluid
DD Clover 6/25/08 35 wks, NO PE! |
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Kosta
Starting Member
US
4 Posts |
Posted - 11/08/2009 : 11:37:32 PM
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Just a little update. We had a few very high blood pressure readings at home (161/117, 151/95) so we're back in the hospital.
Bloodwork showed a slight increase in some test which indicated to the Dr. that there is something going on with her kidneys (is this a protein test or something else?).
My wife is to be given a blood pressure medication (Labetalol) and we'll see how she does with that. The plan seems to have changed in that we'll try to get to 35 weeks (which would be next saturday) if at all possible. The optimist in me thinks maybe she'll hold steady and we can still try for 36 weeks, but we're definitely in good hands here in case we need to deliver at 35.
It's interesting, she is not showing any symptoms other than the blood pressure and protein in her urine. I.E., no swelling, no headaches, no visual disturbances... Of course, we still take this very seriously.
Thanks, everyone, for your kind replies. I'll try to provide updates whenever I can. |
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Caryn
Ask the Experienced Moderator
USA
7654 Posts |
Posted - 11/09/2009 : 12:15:20 AM
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Geoff, since she's diagnostic for preeclampsia and has had readings over 160/100, she's probably now classed as a severe case, even with no other symptoms. Symptoms are highly individual things, and lots of us had no other really obvious symptoms until after hospitalization.
This disease is renowned for being sneaky, and there are lots of case histories where the mother felt fine but was very sick indeed, which is why we developed this maternity care system where visits come closer together as the pregnancy progresses and the first thing they do is check blood pressure. :-)
A change in her bloodwork that indicated further kidney problems would likely be a change in the uric acid level.
Keep us posted as you're able; I'm glad to hear your family is getting good care. |
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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AnneS
Grief and Loss Moderator
USA
2279 Posts |
Posted - 11/09/2009 : 11:22:59 AM
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| Keep an eye on those symptoms! It sounds like you are getting good care and you and your wife are being vigilant. Don't be afraid to take her into Labor and Delivery if she starts feeling off. Good Luck, keep us posted. As an aside, my daughter was born at 35 weeks, she was just over 4 lbs and spent 2 weeks in the NICU getting bigger and learning to regulate her temp. 35 weeks is a pretty good place to be :). |
Anne
DH Richard
DS Parker 7/6/03(severe pe)33wks
DS Griffin 2/17/06-2/21/06, 25 wks,IUGR and Low Amniotic Fluid
DD Clover 6/25/08 35 wks, NO PE! |
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kdreher
Senior Member
USA
2636 Posts |
Posted - 11/09/2009 : 1:44:57 PM
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Hi Geoff,
I am sorry you and your wife are now dealing with preeclampsia. She is in the best place she can be and your baby girl has had steroids so that's great.
I've had PE twice, the first time was severe at 26 wks and the outcome was not good.
You are a husband and father to be, so being worried is natural. Today's modern medicine is awesome. Last November 19 my son arrived at 32 weeks, he weighed 2lbs 10 oz. We kenw from 26 wks on that he had IUGR (intra uterine growth restriction) and our plan was to make it to 36 wks. I ended up in the hospital after 6 wks of bedrest at 32 wks due to my high bp. I was put on magnesium sulfate (which your wife may end up on..it's a life saver) and given 1 round of steroids. The plan then was to make it to Friday (this was on a Tuesay). I, like your wife, showed no symptoms other than high bp and protein in urine...the next morning I had a slight seizure when I got up to use the restroom and within the hour was in surgery for a c/s.
I am not telling this to scare you, just to show you how fast things can move. Michael came out very small but screaming, after 6 wks in the NICU he came home. I suspect your daughter will be more than twice his size. Today his is 10 days shy of his first birthday and is a happy, healthy, 16 lb boy :)
Please keep us updated. I personally HATE preeclampsia and wish no other mom/dad had to go through this. I will keep you in my prayers. |
Kristine-
Mommy to Michael Jon born Nov 19, 2008, 2lbs 10 ounces, 15 inches at 32 weeks 4 days - (preeclampsia and +1 protein, slight seizure, emergency c/s, IUGR)
Mommy to Tyler 3/9/95 to 3/23/95 (15 oz, 26 wks severe pe/HELLP)
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my3tatertots
New Member
US
50 Posts |
Posted - 11/11/2009 : 10:41:19 AM
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| I too had planned to have a midwife for my last birth. Unfortunately PE blew my plans out of the water. My daughter was born at 35 weeks and had a short NICU stay but was/is extremely healthy and happy. Best wishes and let us know how things turn out! |
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Kosta
Starting Member
US
4 Posts |
Posted - 11/14/2009 : 4:26:22 PM
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Well, our latest round of labs has shown nothing has progressed, and there are only 'trace' amounts of protein in her urine, so we're lucky. Her blood pressure is averaging around 120/85 now that she's on meds, so that, too, is fabulous. Today is 35 weeks for her.
Our doctor says she will induce at 36 weeks. I have a question for the experts here:
If our labs and blood pressure remain as they are (i.e. below the diagnostic for even mild pre-eclampsia), is there even a medical necessity to induce right at 36 weeks? Should we make any attempt at all to hold out to 37 weeks? Doctor says she thinks there is nothing to be gained by waiting past 36 weeks. The dilemma is my wife would like to have as little intervention as possible, so is hoping to wait as long as possible.
Would love everyone's thoughts on this. I have my concerns about waiting past 36 weeks (esp. with the Thanksgiving holiday coming up), but I also want to see to it that my wife has the best possible birth experience she can, given the circumstances. |
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Fiona
Forum Administrator
Canada
5816 Posts |
Posted - 11/14/2009 : 5:00:54 PM
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Hi Geoff,
I'm very glad to hear your wife is stable right now. I understand that things appear very positive right now, but I think I can address your concerns regarding a 36 week delivery.
First of all, once you are diagnosed with pe, you don't get undiagnosed until delivery. Let me elaborate:
Your wife's BP is currently beneath diagnostic criteria, but don't forget she is on meds. That's what's keeping her BP down - the underlying disease hasn't gone away, one of the symptoms is being properly managed.
Ditto for the proteinurea: it is often the case that bedrest has an effect on the amount of protein being spilled by the kidneys - again, her symptoms are being properly managed, they haven't gone away.
Preeclampsia can progress very quickly and your doctor is managing your wife with caution - which is exactly what we like to see around here. The average time from a dx of pe to delivery is two weeks. Once you get close to term, the doctor is balancing how much advantage to the baby to keep inside the womb, compared to how sick the mother may become by so doing.
If delivery is pushed later, everything may be fine, of course, but there is the risk that your wife's condition will deteriorate and subsequently the interventions at delivery would be greater.
Being relatively well at delivery makes a huge difference in a woman's post-partum recovery. Likely at 36 weeks, the baby will need very little in the way of help.
I know it is hard to reconcile the dream of a natural birth with a delivery due to complications, but healthy mom/healthy baby is the priority now.
I would recommend voicing your concerns to the doctor and ask them to explain fully their reasoning - it might make you both feel better about the decision. |
Fiona
Nate 12/8/97 - 14/8/97 26 wks - 1lb - severe pe
Jay 11/98 30 wks - 3lb 11oz - severe pe; Sacha 5/05 36 wks 3 days - 7lb 9oz - PIH
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Concerned Husband -- How Concerned Should I Be?
