Confused about pre-e risk assessment

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!
IHNIWLTM
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Re: Confused about pre-e risk assessment

Postby IHNIWLTM » Thu Oct 15, 2015 08:23 pm

Thanks for the response, saw the MFM doc this week--she said to call if my BP read 140/90 more then once. BP was 138/80 at appointment but she didn't seem concerned, I have another appt with the midwives next week so hopefully they will check for protein, have some slight swelling in my right hand, trying not to freak myself out with the worrying about when the pre-e might occur. Just taking it one day at a time and remembering to breath.

alviarin
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Re: Confused about pre-e risk assessment

Postby alviarin » Thu Oct 08, 2015 04:12 pm

If I were you I'd call and leave a message for the nurse. Something along the lines of hey I know my doc said to call if my numbers hit x, but I just wanted to let you know my pressures have been trending up. When in doubt call the doc. Depending on your symptoms they might want to see you sooner than your next appointment.

Different doctors have different pressure cut-offs, in part depending on your normal (non-pregnant) base-line pressure. For me personally, in my second pregnancy, I was supposed to call if my pressure stayed above 140/90 for a half-hour (either number). If my pressures hit 160/100 I was supposed to go to L&D for closer monitoring.

How are you doing this week?
Hypothyroid mom to
Connor (severe pre-e at 38 weeks)
Claire (dx'd with pre-e and induction at 37 weeks)
Annabelle (chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)

IHNIWLTM
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Posts: 14
Joined: Sat Aug 29, 2015 9:29 am

Re: Confused about pre-e risk assessment

Postby IHNIWLTM » Fri Oct 02, 2015 05:50 pm

So it seems my blood pressure is starting to creep up a little in the pre-hypertension numbers. Last time we discussed BP the MFM doc said to call if it reached 140/90. Do I just keep documenting it till my next appointment? I have another appointment coming up in a week.
At what BP reading do the docs normally have a plan of action? Am only 24 weeks and this is starting to make me worry.

alviarin
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Re: Confused about pre-e risk assessment

Postby alviarin » Thu Sep 17, 2015 04:13 pm

Sorry to hear the MFM thinks you are destined for pre-e, but fore-warned is fore-armed at least, so you know to stay vigilant for signs and symptoms. I would definitely ask your care providers when to start kick counts since you are high-risk. Please let us know how you get on.
Hypothyroid mom to
Connor (severe pre-e at 38 weeks)
Claire (dx'd with pre-e and induction at 37 weeks)
Annabelle (chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)

IHNIWLTM
Registered User
Posts: 14
Joined: Sat Aug 29, 2015 9:29 am

Re: Confused about pre-e risk assessment

Postby IHNIWLTM » Tue Sep 15, 2015 07:55 pm

Thanks everyone! Met with my MFM doc today, she stated that I will def. get pre-e and does not expect me to go full-term, she is hoping that nothing comes up until 35 weeks. BP is stable right now and I will keep monitoring it. Taking one day at a time and making sure I remember to breath. At my next appointment I will make sure to touch base with the midwives on what the plan of action will be if I end up with pre-e. I had wanted to switch midwife groups but the MFM doc said to wait a while longer to see how things progress so for now I am sticking with both my care providers.

sam10
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Re: Confused about pre-e risk assessment

Postby sam10 » Mon Sep 14, 2015 02:29 am

If you don't feel 100% comfortable with your current MFM, you can try to get a second opinion if this is an option for you (depending on where you live and/or your insurance). Some doctors just are not good communicators and/or have poor bedside manners even though they are great doctors otherwise. It can leave you with more questions and make you feel more anxious than necessary. I used to bring a notebook and some questions I had for the doc and each time would write everything down, because I would forget as soon as I had gotten home.
You want your medical team be all lined-up if things should go wrong, so being in the care of doctors you trust is very important. I saw an MFM exclusively for my second pregnancy, as I did not want to deal with the back and forth of too many parties involved. But everybody is different and has different preferences in that regard.
It is definitely a good idea to regularly take your BP at home and record it and then present to your doctors and midwives. You can bring your machine to your next appt. to make sure it does not deviate from your docs/midwife's machine.
Definitely get yourself acquainted with the signs and symptoms of PE and as you have mentioned ask about the protocol of your care in case you will develop PE. It is good to know at what point your doctors want you to call them and/or head to L&D immediately.

Being at risk for developing PE does not mean that you definitely will, so there is still a good chance that you just will be watched more closely. I am keeping my fingers crossed for you and baby :)
MC 3/2009 and 3/2011
H (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
M (Nov. 2012, born at 35.4 weeks) - severe PE

alviarin
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Re: Confused about pre-e risk assessment

Postby alviarin » Thu Sep 10, 2015 04:00 pm

That is a good question to ask, who will manage care if you are diagnosed with preeclampsia. Some of our posters work more with an MFM, but I mainly saw my OB and had a MFM for consultation and backup if needed.

Some midwives will refer out to an OB once you start showing symptoms of preeclampsia. It might be a good idea to ask your midwife what their guidelines are, so if worst comes to worst, you aren't shopping for an OB at the last minute.
Hypothyroid mom to
Connor (severe pre-e at 38 weeks)
Claire (dx'd with pre-e and induction at 37 weeks)
Annabelle (chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)

IHNIWLTM
Registered User
Posts: 14
Joined: Sat Aug 29, 2015 9:29 am

Re: Confused about pre-e risk assessment

Postby IHNIWLTM » Fri Sep 04, 2015 02:31 pm

I am 20 weeks and am going to start getting scans every 3 weeks after 24 weeks. Have a repeat A/S in a week because they couldn't see details of the heart very well. Every time I see the MFM she just says "oh high resistance" and asks again about taking aspirin--that is about as much feedback as I get. I got a home BP monitor and check it twice a day. I am going to ask the MFM doc what the protocol is if my BP elevates since I am also under the care of midwives. Anything else I should specifically ask her?

alviarin
Forum Moderator
Posts: 1809
Joined: Tue Apr 18, 2006 12:56 am
Location: Texas

Re: Confused about pre-e risk assessment

Postby alviarin » Thu Sep 03, 2015 10:29 pm

Sorry to hear, unfortunately I don't know how much high resistance affects risk. Do you have another appointment with the MFM set up? I would ask them how much it increases your risk. Please let us know what you find out.

That being said, I'm in the "prepare for the worst, hope for the best" camp myself. So I would make sure you know the signs of symptoms of preeclampsia: http://www.preeclampsia.org/health-info ... n-symptoms.
Something I did in my second pregnancy once my pressure readings were elevated was to invest in a home BP monitor.
Also, depending on how far along you are, you could ask your doc about starting kick counts: http://www.countthekicks.org/how-to-count-the-kicks/

How many weeks are you now? How frequent are your appointments?
Hypothyroid mom to
Connor (severe pre-e at 38 weeks)
Claire (dx'd with pre-e and induction at 37 weeks)
Annabelle (chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)

IHNIWLTM
Registered User
Posts: 14
Joined: Sat Aug 29, 2015 9:29 am

Confused about pre-e risk assessment

Postby IHNIWLTM » Sat Aug 29, 2015 02:32 pm

Hello All,
I am seeing a MFM doctor due to my age at time of delivery 35. They did a screening for risk of early onset pre-e due to family history and said I am high risk and have put me on aspirin, she also stated that my uterine doppler showed high resistance. Do I need to prepare myself for absolutely getting pre-e, is there a chance I won't?


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