Specialist appointment

So, we had an appointment with the maternal-fetal specialist yesterday. It is recommended that any woman who had pre eclampsia see one before they get pregnant again. I decided to try to see the lady who actually delivered Bennett. I was expecting a battle with having to get a referral and other assorted medical hoops, but it was actually very easy. I just called and made the appointment. I spent quite a bit of time researching and preparing questions (thank you Pre-eclampsia Foundation Forms...I don't know if I would have made it through the last few months without you). She actually remembered us, which was comforting.

First, the news I have learned about my first pregnancy. I ordered my medical records (300+ pages) and have gone through them. I apparently had a hemorrhage after Bennett was born, which I don't remember. That must be why they were shoving a number of unknown pills down my throat. They took the placenta for a pathology report. There were problems with the blood vessels. It was also in the 20th percentile for size and partially abrupted. This means that it had started to separate from my uterus and if it would have continued, Bennett may have died. The blood vessel issues and size are hallmarks of pre-e. The problem is thought to occur at implantation. Something is screwy with mom's immune system which causes the placenta to implant too shallowly. This is fine until the baby gets too big. Then the need for blood etc outpaces the placenta's ability to provide and mom's system goes into overload and shutdown mode. Bennett was a good weight for his age, but if we had continued, he would have likely become growth restricted for lack of blood/nutrients.

Dr. Becker was positive about a second pregnancy, but also gave us fair warning. Since I had severe early onset pre-e, my chances are significantly higher of having it again in subsequent pregnancies. In most cases, women develop pre-e late in pregnancy (near labor/delivery) and only have it that one time. My own OB made it seem as though I was in the "only first pregnancy" group, but the specialist seemed to have more knowledge. She said the chances were between 25-60% Kind of scary at first glance. But since I am healthy overall and the first found tests for underlying disorders were negative she thinks my chances of having a normal pregnancy are greater than another bout of pre-e.

A second pregnancy would be considered "high risk." She would co-manage with my OB. I would have baseline labs and 24 hour urine test to find out what is normal for me. There are also a couple more of tests to run right when I get pregnant. If they were to be positive, it would be twice a day injectable blood thinners for me for the last two trimesters (fun!). I would have to take a daily aspirin when pregnant and prenatal vitamins for three months before I get pregnant. It sounds like I would have ultrasounds to check for growth every four weeks after week 12. Other interventions would come in as needed.

Whew...that was a lot of info. Sorry about that, but my brain is often occupied with these issues and I thought I would share!