second pregnancy: does previous outcome matter?

[caryn]

Your peri has seen *your* records, so I would trust your peri. The Experts are giving guesses for the whole population, and don't have information from your records that might make them change their answer!

[wwyy88]

Thanks, Caryn.

I didn't know perinatologist has Specialty too!!! I just found out recently the mine wasn't specialized in lupus/autoimmune disease, which I had. Mine wasn't active though and my rheum. dr. gave me the okay to get pregnant. The result is I got hit by severe PE in the 2nd trimester and our baby boy died of placenta insufficiency. My peri thinks I had Thrombophilia, even though I wasn't tested positive before. It is so complicated. Anyway, back to your topic, my peri said I would have a 30-40% chance to get PE again in my next pregnancy --- that's much lower a chance than the study you are showing here........ Who is right?

[caryn]

Jennifer, it's worded in a confusing way.

Our Experts say that preeclampsia before week 28 means a [url="http://www.preeclampsia.org/forum/viewtopic.php?t=331"]60% chance[/url] of developing preeclampsia in another pregnancy. Usually it happens later in pregnancy and is more mild, but not always.

My best advice is always to find a doctor who specializes in these pregnancies and who can work with your other doctors. Many OBs go to extra school to become maternal-fetal medicine specialists, or MFMs, which is another term for peri (perinatologist.) If your peri isn't a specialist in these pregnancies, you might want another peri.

Welcome to the forums. I'm so sorry you had to find us because your daughter died. This disease is just brutal.

[wwyy88]

Hi Caryn,

I had a severe pre-eclampsia loss in my first pregnancy in the 26.5 weeks (2nd trimester). Does this mean I will have a higher chance of getting PE in the second? I am a bit confused.........

According t your quote, it should be either 4 times higher or not higher?

thanks,

Jennifer

[caryn]

Yes, that's it. Cases were women with PE in their second pregnancy, and some of them didn't have it in their first pregnancy. :-)

[beth11]

I am sooooo slow today :) So, a history of pre-e has a 5 times higher rish of pre-e in a second pregnancy - but a second trimester loss only as a 4 times higher risk of pre-e in the second pregnancy? Oh wait, do they mean second term loss regardless of the reason?

[caryn]

...Inter-pregnancy intervals of 6 years or more were associated with increased incidence of pre-eclampsia (19.4% vs. 14.7%). A change of partner had a protective effect while an increase in BMI increased the risk of pre-eclampsia. A history of pre-eclampsia was associated with 5 times higher risk {adjusted O.R. 5.12 (95% C.I. 4.42-6.48)} of pre-eclampsia in the second pregnancy. Compared to a term delivery, a previous second trimester pregnancy loss was associated with a 4 times higher risk {adjusted O.R. 4.22 (95% C.I. 2.54-7.03)} of pre-eclampsia in the next pregnancy. Previous very preterm and preterm births were associated with adjusted odds ratios of 2.32 (95% C.I. 1.62-3.32) and 1.62 (95% C.I. 1.46-1.72) respectively. The risk of pre-eclampsia was no higher in women with a previous history of fetal death after 20 weeks than those with a previous live birth, after adjusting for pre-eclampsia in the first pregnancy...

http://www.ncbi.nlm.nih.gov/pubmed/19394128

Boo hiss.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure".