Pre-eclampsia after childbirth:Warning signs

[rachaelgoodman]

A little blog about my experience here:

wp.me/p2NS19-L

[daisyd]

I had Hellp syndrome. I wonder if this is the same. Now on Warfarin for sticky blood (Hughes syndrome, Antiphospholipid syndrome)

Now 55 but nearly died with this 30 yrs ago, sterilised at 23. Drs are more aware of this condition know than they were then

I have one son born 1 lb 14 oz 867 gms. And daughter who we adopted.

Have had several clotting events before treatment DVT, Heart attack.

Good luck, with your future sorry you have had such a rough time,

[Waterlily]

When I was pregnant with my first, 32 years ago I developed pre-eclampsia. I went into spontaneous early labour at 35+4. Fortunately I managed to give birth without intervention (other than breaking waters) and my BP stayed dangerously high but stable throughout. However, almost instantly on giving birth it climbed dramatically and I was thereafter kept flat on my back and sedated with heavy doses of phenobarbitone for the next six days. (not that I remember much of that!). The BP normalised and as far as I was aware that was the end of the problem. I had a second baby 5 years later, with a perfectly normal pregnancy and no BP issues, except that I delivered early, at 35+2 for no discernible reason. No investigation of cause took place, It was 'just one of those things'. I knew nothing of Hellp syndrome, but I suppose the quick intervention with phenobarb may have prevented it developing, I don't know. HOWEVER, when my daughter was l9 she had a pulmonary embolism and it was discovered that she had the hereditary genetic mutation Factor V Leiden, a form of inherited thrombophilia. On testing it was found I was the one who passed it on. (Since then, she herself had severe pre-eclampsia in first pregnancy and a trouble free second one). This mutation had only fairly recently been discovered when my daughter had her PE and little was known about it by doctors at the time. However, research has shown that if you have the clotting disorder and if you also have blood group A, then you have a higher risk factor for developing pre-eclampsia. (I should probably mention my mother, her sister, and my grandmother all had pre-eclampsia too). Despite this knowledge, and approx 1 in 200 women having it, obstetricians do not routinely screen for this condition. And yet.. when my daughter was pregnant, because she KNEW she had it, the whole system went into overdrive and literally made her life miserable because they wanted to intervene, and medicate way beyond what was a reasonable response to the risk and there were ructions because she refused to inject daily with heparin because she felt the risk of haemorrhage was far greater than for developing a clot. (borne out when they forcibly gave her anticoagulants during labour, and she then nearly died from blood loss after a midwife 'ripped' her placenta out instead of waiting for it to deliver naturally). As she argued, if they were not monitoring, then statistically, in a hospital with approx 2,000 births per annum, 10 to 20 mothers were being put at risk by not being treated in the way they were insisting she had to be treated, which as far as she was concerned defied logic.

Of course, when she did develop high BP, they went into overdrive again, and stress she experienced from the outright hostility of the OBGYN sent her into early labour and a cascade of interventions.

Factor V Leiden is still not routinely screened for. I don't know if, given my daughter's experience, this is good or bad. While it increases risk of clots and Pre-eclampsia, it is by no means inevitable that you will develop it. Thousands of women give birth safely every year without ever knowing they have the condition. It seems to me that if they are not going to screen, then they should be educating ALL pregant women about the condition and the symptoms, and making them aware of what to look out for. This along with some additional simple monitoring should be sufficient. It may not prevent pre-eclampsia developing, but at least it would have more chance of ensuring a successful outcome.

Sorry if that's a bit long and garbled. I just wanted to highlight that this is now a known risk factor for Pre-eclampsia.

[Waterlily]

I should maybe have mentioned that I had no further issues with my factor V status until 10 years ago when I had to have some chemotherapy and it rather trashed my veins. Chemo is a common cause of blood clotting and I had aDVT a couple of months after my treatment. But without that treatment, and my daughter's PE, I might well have gone through life and never known the cause of my pre-eclampsia.