Preeclampsia Expert?

[Anonymous]

Anonymous wrote:Does anyone know a specialist in the area where I can get a consult about the likelihood of developing preeclampsia in a future pregnancy? I can always talk to my OB, but I'm wondering if there's anyone who specializes in the subject.

For background, in my last pregnancy I developed preeclampsia at 34 weeks. It had a very rapid onset and involved severe features. I think this means we won't try for another child, but I'd like to discuss the risks before making a final decision.

I had pre-eclampsia without severe features onset during my last week of pregnancy, was induced at 41+1 due to that. I continued to have symptomatic hypertension during the first 2 weeks pp that was not taken seriously by my provider but did resolve on its own.

With my second pregnancy, I did a few things differently to prevent pre-eclampsia and monitor for it:
1. Lily Nichols Real Food for Pregnancy diet, specifically emphasizing protein
2. FullWell prenatal vitamin started while TTC
3. Acupuncture while TTC, first trimester, and third trimester
4. Baby aspirin daily starting at 13 weeks per my provider’s recommendation
5. 5000IU vitamin D started while TTC
6. Monitoring my BP weekly at home starting ~20 weeks
7. Ongoing monitoring with my MFM from ~20 weeks (BP monitoring in office, additional scans and consultation) Richie Broth at TLC Perinatal is who I saw. He’s excellent
8. Was going to induce at 39 weeks but I went into labor on my own at 38+5 (with the help of induction acupuncture and induction massage) had no BP issues during or after labor.

[Anonymous]

I had HELLP with my first. Not diagnosed until the day before FT (BP was high for me, but not high; OB ignored symptoms -- including horrendous abdominal pain that came & went -- as a result). Ended up being borderline able to have a c-section (hit the minimum for platelets exactly) when my condition spiraled during attempts to induce. Emergency, running down the hallway style c-section. Ended up with a healthy kid (a little smaller than predicted, so may have lost weight in the last few weeks), but stuck in the hospital for a week on a mag drip with clotting issues, etc. It was miserable. BP took awhile to come down, but eventually did. (I actually fainted in the shower a few weeks in, which is how we discovered I didn't need BP medication any more.)

Consulted an MFM who said coin flip whether it would happen again, especially because I had a weird/late presentation. Said I'd have increase monitoring and they'd deliver if any issues arose once we hit 32 weeks, so the danger was really more to the kid than me.

No issues with kid #2. They would induce after the previous experience nor let me go past due. Everything looked so good at 39 weeks the OB was willing to let me wait a little longer, but tests indicated no signs of labor at all (no dilation and head not even fully down), so we went with the c-section recommendation at 39 weeks in the end. No issues at all. Kid a pound bigger than #1.

Kid #3 I ran out of amniotic fluid the week before my planned c-section. No definite signs of pre-e/HELLP before that, but awful nausea from 36 weeks on & high BP for the first time the morning of the c-section. Placenta showed some issues (already aging at 38 weeks), so seems like it was lucky I had the increased monitoring. Kid was totally fine post-38 week c-section, though more like kid #1 size. Post-c-section labs for me were all fine, so hard to know whether high BP was actually something or just nerves.

Never wanted more than 3. My BP has been a little bit higher than pre-kids but holding sub 130/85, so no intervention yet. Apparently this isn't uncommon with HELLP.

[Anonymous]

Don’t do the Lily Nichols diet. I did it for GD and was basically eating crazy keto. She demonizes insulin so I tried insanely hard to avoid it and was not eating enough carbs. Baby came out with extremely low blood sugar and was small and scrawny compared to my other child who I did not have GD with. Her carb recs are not supported by evidence. In hindsight I should not have followed her fringe diet.

I had postpartum preeclampsia with my first but not my second. I took the baby aspirin and had an MFM. Thankfully I didn’t get it a second time.

[Anonymous]

My mom had pre-eclampsia with me but they were able to keep it under control for my sister. I don't know the details but this was the 90s I was born early, she wasn't.