| My wife had pre-eclampsia with aour second child. Yes, it is a
potentially very serious complication of pregnancy, but needn't be if
you follow your doctor's advice and get lots of rest!
My wife had to lay down on her left side any time she wasn't doing
anything else. She had no noticeable symptoms (noticeable to us, that
is). Her doctor made the diagnosis based on an elevated blood pressure
that lowered when on her left side. she only showed protein in the
urine wonce or twice, not at every checkup. She only worked one
marathon day per week, and had to stop frequently to rest. Her doctor
advised quitting work at 34 weeks, which she did. We had a 21 month
old at home at the time, so rest was still difficult. During her 40th
week, she suddenly gained great quantities of weight (I think it was 12
pounds, when she'd only gained 8 lbs up to that point!) and swelled up
like a ballon, esp. ankles, feet, and hands. At theat week's checkup,
the doctor took her BP at (if memory serves) 190/110...that is
EXTREMELY high! A quick call to me at work, a quick trip to our home
where her folks were watching our eldest, and we were off to the
hospital to be induced...it was, coincidentley, our due date. At
admission, her BP was 200/115....enough to cause a mild panic in the
nursing staff. The baby's vitals were fine. She was on total bedrest,
with an automatic BP monitor, which chekced her, initially, every 10
minutes. When her BP went down to a more tolerable 140/85, they set it
to take the BP every 30 minutes. She was on an IV with Pitocin, to
induce labor. It did and didn't work...contractions were very strong
and regular, but dilation went to 4cm. and stayed. And stayed. And
stayed. For about 24 hours. They finally gave her an epidural, so they
could up the Pitocin, because, at this point, if they'd upped it,
without the epidural, she might have killed them! 24 hours of hard
labor (contractions lasted about 75 seconds and came 2-3 minutes
apart...the whole 24 hours) had left her exhausted. She slept deeply
for about 30 minutes after the epidural, and woke up amazingly
refreshed. BP continuted fine, and so did babie's vitals. After 2 hours
on the increased Pitocin she was still at 4 cm. They brought in teh
portable ultrasound to check that the baby hadn't turned...it had
not...still head down. All of a sudden (this within about 5 minutes
from last internal which showed just 4 cm.) she sits bolt upright with
the announcement she feels like pushing! They ran in, and checked
her...she was a full 10cm.! Just like that! Really weird. They rushed
us to the delivery room (As she had little control over her legs
yet)and our daughter was born about 10 minutes later. She was in some
distress right before birth (the baby, that is), her heartrate dropping
below 100. The doctor was almost ready to use forceps, because he felt
he had to get her out *immediately*. But the next push popped her out.
She did not cry. We were, to say the least, frightened. After a little
oxygen, she did cry loudly, however, and her Apgar's were 8 and 9.
My wife's BP went almost immediately back to normal, and even was a bit
low in the next 2 days. On her third pregnancy, there was no sign of
pre-eclampsia, BP was normal throughout (hoever, she did becomde
gestationally diabetic!).
Best advice...rest, rest, rest! And...follow your doctor's advice!
Here's hoping for a short dlivery and a healthy baby!
--dave--
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| I had it, although I didn't get it until the 39th week. I was sent
immediately to the hospital, where I had to stay laying down on my left
side (or right when the left fell asleep) for 3 days. It started getting
worse so labor was induced, but after 7 hours nothing was happening except
my blood pressure was going up and the baby's down, so we did a c-section.
Just stay down as much as you can. If you start feeling dizzy or seeing
'tracers', lay down ASAP--or call your doc. My ob said it's common in
about 10% of first pregnancies, and doesn't necessarily happen on
additional pregnancies.
Yes, it can be very serious, so treat it right--lay down as much as
possible!
Marty
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| Only work 4 hours a day! Yikes! I'm surprised your doctor is letting
you work at all.
The day after Katie's due due, we went to the hospital because I had
regular-increasing-in-intensity-5-min-apart contractions (ie. I thought I was
in labor). Well, I didn't have Katie that night, but I did have high blood-
pressure. Even after lieing down for an hour, my BP was 145-95. My blood
pressure tends to be low (Last night it was 90/63) so this was quite high for
me. After determining that it was false labor, the labor room sent me home
to lay on my left side with instructions to see my doctor immediately if a
had any visual disturbances or a headache. The next morning I woke up with
a headache.
My OB prescribed COMPLETE bedrest on my left side. His exact words
were "up to go to the bathroom, sit up to eat, lay back down, nothing else."
He also informed me that if I couldn't do that, he could and would hospitalize
me so I could lay on my left side there. But "It's more expensive, you won't
sleep as well, and all we'd be doing is enforcing the bedrest." So I took him
seriously and stayed home and stayed on my left side. (Those of you who have
been confined for months, I stand in awe of you, 8 days was enough to just
about turn me into an axe murderer!) I had non-stress tests every other day
until I went into labor (7 days later). During labor I had to lay on my left
side. If I rolled onto my right side, my BP would shoot up and Katie would
show signs of distress.
As long as stayed on down on and on my side, my BP stayed low(er) and
everything was fine.
As everyone else has said, REST, REST, REST!
Tracey
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| Interesting article in 12/90 Harvard Health Letter on nature &, possible,
prevention of Preeclampsia & Eclampsia -- conditions formerly known as
toxemia. My wife suffered from both of these, and the Harvard article is
the first piece we've read that provides at least some explanation for what
happened.
For those unfamiliar, preeclampsia and eclampsia can be dangerous to mother and
unborn child. According to the article, Preeclampsia occurs in about 5% of
first pregnancies and is marked by swelling of hands and feet, protein in
urine, and higher-than-normal blood pressure. These symptoms mmay remain
fairly stable; however, sometimes small blood vessels all over the body begin
to constrict. This can cause reduced blood flow and very high blood pressure.
These changes, in turn, can damage such organs as the kidney, the central
nervous system & the liver. If the disease progresses further, convulsions --
threatening to mother and fetus -- can result. With the onset of
convulsions, the disease has moved from preeclampsia to eclampsia.
It turns out that problems with the placenta are at the root of the condition.
To quote, from the Harvard Health Letter:
"Because the growing fetus demands a rich supply of blood from the mother,
controlling blood flow is an important task for the pregnant body. Early in
pregnancy, the uterus develops a special set of arteries to supply the
placenta. To meet the needs of accelerating fetal growth ... a second phase
of arterial growth is required. During the sixth month the placenta therefore
reaches farther into the uterine wall for better access to nutrients in the
mother's blood. The arteries in the uterine wall dilate at least fourfold to
facilitate this process.
"If arterial growth [during this second phase] fails or falters, fetal growth
may slow, and the distressed placenta is believed to release one or more
substances into the mother's circulation .... that are capable of
damaging the tissue they contact.
The cells which are damaged are those that "help to regulate the diameter of
smaller blood vessels (and therefore the resistance to blood flow). They
[the cells] also maintain the balance between the fluidity and clotting of
the bllod. In women with preeclampsia ... the small [blood] vessels
constrict and micrscopic clots form .... Injury to delicate vessels in
the kidney leads to protein loss in the urine ... and the function of
almost any other organ may go awry."
....
"Preeclampsia is self perpetuating. Once the disease is established it makes
itself worse.... Bed rest, treatment with antihypertensive drugs, and early
delivery may be required."
On the treatment side, there is some hope -- at least in terms of prevention
It turns out that small doses of aspirin can substantially reduce the risk
for preeclampsia. However, aspirin should NOT be taken unless a women
is at high risk for the condition, because aspirin itself can be harmful,
especially during the 1st trimester.
At-risk factors associated with preeclampsia, include preeclampsia during a
prior pregnancy, first births, multiple births, diabetes, preexisting high
blood pressure, very young mothers, "very old" mothers, and family history
of preeclampsia. However, "even among women who meet more than one of
[these conditions] .., only a fraction will develop preeclampsia."
Unfortunately, no good tests yet exist to identify women who are at risk.
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I had pre-eclamsia with both of my pregnancies. My first son was
delivered by c section after 13 hours of non-progressive labor. He was
about 3 weeks early. I had been on left side rest at work for about six
weeks, and on total bedrest for two weeks after that.
My second son was only 5 days early, but I had been in the hospital for
the pre-eclampsia for two weeks before. (This in addition to being
pulled out of work and on total bed rest for five weeks before that....)
He had to be recessitated in the delivery room, and have to have chest
xrays and spinal taps due to the magnesium sulfate, but was ok. The second
child was a vbac, due to the eclamsia (believe me, I was BEGGING for a
repeat c-section !). I also had magnesium sulfate, so my labor was 25
hours, with two hours of pushing ! My OB said that I would have a 100 %
chance of getting pre-ecalmpsia again with a third pregnancy.
I also had liver and kidney issues - they tested for this constantly.
PLEASE do what you doctor says - no cheating - and let us know how you
are doing !
If you want to talk off line, my DTN is 483-4297.
Leeann Campagna
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