Help? How to spot HELLP coming?

This section is for discussions with other women who have probably been through the same signs/symptoms that you may be experiencing. Please note, we cannot offer medical advice and encourage members to discuss their concerns with their doctors. New members, come on in and introduce yourself!
momo
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Re: Help? How to spot HELLP coming?

Postby momo » Tue Sep 17, 639563 1:00 pm

Thanks so much - I'll read through the PRECOG guidelines. It's also really nice to know that recurrence of HELLP is not very likely.

As for blood pressure I think I'm going to have to find a way of getting that checked more often. As a high risk pregnancy I fall between the hospital and the midwives at my local surgery for care and both think the other will take charge of the routine stuff! I'll try and get that sorted this week one way or the other.

Thanks again for all your support and advice - it's really helpful to talk with people who know what they're doing.

tree
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Re: Help? How to spot HELLP coming?

Postby tree » Tue Sep 17, 639563 6:43 am

It seems that almost everyone here walks a very fine line between paranoia and watchful waiting in pregnancies after PE. It is a difficult balance.
I am glad you know how to work the NHS system and live near a hospital with a good NICU. I hope you don't need it, but it is always nice to have just in case.

Your BPs appear labile, and it is common for blood pressure to swing pretty wildly (and quickly) before it stays high. It is possible that there was a problem with the measuring equipment or operator error, but you might want to check that more often than every couple of weeks. Can you call the midwife or stop in at a clinic just for a BP check periodically? One high blood pressure reading is not a cause for panic, but I would want to monitor it more frequently. FWIW, I believe that the recurrence rate for HELLP is fairly low. However, women who have had HELLP are more likely than the average Mom to develop some sort of gestational hypertension in subsequent pregnancies, even with the same father.

The NHS follows the "PRECOG" guidelines for diagnosing and managing PE. They are available here:
http://www.apec.org.uk/precog.html

It might be helpful to read through them a bit and ask your midwife and consultant if they are following them. You can search the forums for 'PRECOG" and come up with a lot of posters and info from the UK.
Daughter born April 2009 at 35 weeks due to Class 1 HELLP

momo
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Re: Help? How to spot HELLP coming?

Postby momo » Mon Sep 16, 639563 2:45 pm

Thanks - I think I need to tread that fine line between looking out for possible difficulties without being too paranoid! Ho hum...

Yes, I am in the UK and though the NHS is often great (and luckily I happen to live round the corner from a hospital that has a great NICU unit!) it is often a case of having to know a fair bit to act as a reasonable advocate for yourself.

So far, protein is good when they last tested (dip test) and BP is a bit hit and miss 140/95 followed by 120/85 but am unsure quite how much this reflects my blood pressure or the measuring equipment. They don't want to see me for a few weeks so am hoping nothing horrible kicks off yet. Guess it's all a case of wait and see...

Thanks for your help.

tree
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Re: Help? How to spot HELLP coming?

Postby tree » Fri Sep 06, 639563 9:47 am

Hi Momo,
Welcome to the forums! This recent discussion on doppler scans might be reassuring for you. It is apparently pretty common to have an abnormal scan a 20 weeks and then see normal (or better) results later. High resistance and/or notching are good reasons to watch for symptoms carefully, but neither is a guarantee that you will get PE.
http://www.preeclampsia.org/forum/viewt ... er#p349017

It is also relatively common to develop HELLP or PE without any noticeable warning symptoms until you get extremely sick. We have a few posters who felt fine despite having one or both conditions. I had HELLP without high blood pressure also, but I felt absolutely terrible for a while. If I get pregnant again, I would be watching for any signs of unusual nausea, fatigue, swelling, abdominal pain, bruising, terrible headaches, or anything else that just doesn't seem normal. I am not sure that monitoring my BP regularly would be beneficial since it didn't really go up (and still only 135/85) until I was admitted. It can't hurt if you want to do it in a non-obsessive way. I would ask for a 24 hour urine test and PIH labs if I felt bad or thought something might be going on. As you know, HELLP can come on quickly. Have good lab results a few weeks ago does not mean that they will stay good. I will keep my fingers crossed that yours do!

Have you had any signs of elevated blood pressure or protein yet?

Are you in the UK? We have some regular posters who are familiar with the NHS and the treatment guidelines for PE that will be able to provide some additional information on how to effectively ask for care in the UK.
Daughter born April 2009 at 35 weeks due to Class 1 HELLP

momo
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Joined: Sun May 13, 2012 11:34 am

Re: Help? How to spot HELLP coming?

Postby momo » Fri Sep 06, 639563 5:15 am

I'm week 23 at the moment and had some bloods done in week 20 and nothing had gone awry then. Just trying to come up with a plan to cope and try to spot any symptoms that might come my way this time...
Thanks for replying

Shannonlynn
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Re: Help? How to spot HELLP coming?

Postby Shannonlynn » Fri Sep 06, 639563 1:55 am

I'm sorry you're having trouble with your pregnancy. I had pe and hellp with my first. have you had any blood work done? A CBC would be good: platelet count, liver enzymes, and white and red blood cell counts. Those would give you some idea where things are. Have you done a 24 hour urine lately? How far along are you? Take it easy and try to relax. Shannon
Shannonlynn-mommy to Frederick Otto "Fritzy"
born May 6, 2011, became an angel one hour later
Severe PE at 24 weeks to the day
Gavin Walden born 8-4-12,lovenox, folgard, lda, prenatals. PE and HELLP free.

momo
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Posts: 9
Joined: Sun May 13, 2012 11:34 am

Help? How to spot HELLP coming?

Postby momo » Thu Sep 05, 639563 11:58 pm

HI, I’ve just joined the forum after reading some of the posts and finding such useful links to medical journals…
In my first pregnancy everything was going well except for some leg swelling. After a 24 hour urine check for protein the consultant said that I was free to go home and that they would monitor the growth of the baby. I just had to see the nurse in fetal medicine to check the baby’s heart beat and then I could go. The aforementioned nurse said that there was no way I could go home (despite the baby being fine) and argued with the consultant and admitted me to the ward (luckily!). By the next morning the doctors came running over to see if I’d had my breakfast because I needed an emergency caesarean (at 31 weeks) which had to be done under a general anaesthetic because my platelets were too low for a spinal anaesthetic. I had developed apparently developed HELLP syndrome but never really experienced any of the symptoms I have since read up about. All is now fine and my baby girl is a happy healthy 10 year old. :D
My second pregnancy (9 months later) was fine from start to finish but now – (8 years later) my third pregnancy is beginning to show signs of trouble…
The consultant this time said that I couldn’t have a doppler scan to check for trouble because the baby was to the same father as the first two and so there was very little risk of pre-eclampsia or HELLP again.. Luckily I was saved by the same lovely lady in fetal medicine who checked me in anyway when I had my anomaly scan. It appears that my blood flow in my uterine arteries has high resistance (way off the scale of 2.14 on the right, and just off the scale of 1.23 on the left) and notching. I gather from reading around theses aren’t great results – but any light thrown on this would be great!
Also, they don’t want to see me for another few weeks and I’m rather scared after the first time with pretty much no symptoms how I will spot it coming this time. Any ideas? I’m thinking of hiring a blood pressure monitor (although I didn’t actually have trouble with blood pressure the first time around until after the delivery) and buying some urine dip sticks to monitor the protein. I’m not sure there’s much else I can do other than hope but any suggestions would be gratefully received…
Sorry for such a long post.


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