Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Preparing for Pregnancy after Severe Pre-eclampsia | | | QUESTION | | | Dear Dr. Greenfield,
I was diagnosed with severe pre-eclampsia in my 6th month of pregnancy. I was hospitalized for three days till my blood pressure and liver/kidney levels returned. Unfortunately, our baby’s heart had stopped beating, and I had to deliver her. My doctor has referred me to a maternal fetal doctor. What can I expect when I go for this appointment? I have been reading that the chances of me getting this again are higher since I got it so early in my pregnancy. Is this true, if so how can I prevent it? And will I be put on bed rest for the whole pregnancy when we do try again? Also, how soon can we try again? Thank you.— Brigitte in Winter Springs, FL | | | ANSWER |
March 22, 2002 | | | Dear Brigette,
I am so sorry to hear about what you have been through. It sounds like the worst nightmare. While pre-eclampsia is fairly common, it is rare to lose the baby. While you are reading the rest of this information, please keep in mind that even if you get severe pre-eclampsia again, the most likely outcome is that you and the baby will end up healthy.
To answer your specific questions: at the consultation appointment, the maternal-fetal medicine or MFM specialist will question you about your own medical and family history and will then probably run some blood tests. If you have high blood pressure when you aren't pregnant, or test positive for a blood condition from the group called thrombophilias, you will be more at risk for recurrent pre-eclampsia. The most common of the thrombophilias is called lupus anticoagulant. If you do have a thrombophilia, taking aspirin in pregnancy may help prevent recurrent pre-eclampsia.
Without knowing the results of any tests, I can tell you that on average two out of every three women who had bad pre-eclampsia will not have problems with their next pregnancy, but one in three will develop pre-eclampsia again. But even if you do develop problems, knowing that you are high risk will help your care providers to monitor you and your baby more closely, and hopefully the baby can be delivered before she gets into trouble. Most likely you will have a baby to bring home the next time around, although there is still some chance that she will need to be born early and/or that you will need to do bedrest for a period of time.
There is some newer research indicating that having a baby within a few years, rather than many years later, also offers some protection from recurrent pre-eclampsia. On the other hand, waiting to get pregnant for at least a year after a birth is generally recommended for everyone in order to make sure your body has recovered fully. The maternal-fetal specialist can advise you about timing and planning for your next pregnancy given your specific situation and will tell you whether any medications, like aspirin, would be appropriate for you to take.
Take care, and good luck!— by Marjorie Greenfield, M.D. |
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