Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Recurrent Pre-eclampsia in Second Pregnancy | | | QUESTION | | | Dear Dr. Greenfield,
I gave birth to a healthy baby girl four years ago, but I almost died. The doctor called my condition a form of severe pre-eclampsia called HELLP syndrome. I had kidney failure, liver damage, and my blood platelets were at 20. I was in a very bad shape and I am wondering what my chances are of developing this illness if I get pregnant again. Thank you.— Brandy02 in Indiana | | | ANSWER |
January 29, 2002 | | | Dear Brandy02,
As you know, HELLP syndrome is a form of severe pre-eclampsia, which can be life threatening. For two out of three mothers, pre-eclampsia will not come back, but there are some risk factors for recurrence such as high blood pressure when you aren't pregnant, and thrombophilias, which are disturbances of the blood's clotting mechanisms. Getting tested for thrombophilia may be helpful in assessing your risk of recurrence. Also, the earlier in your pregnancy that you developed severe pre-eclampsia, the higher the risk when you try again. New evidence indicates that waiting longer between pregnancies also might increase the risk of recurrence or pre-eclampsia, while closely spaced pregnancies offer some protection.
Your best bet is to talk with your doctor about your own individual situation, or have a consultation with a maternal-fetal medicine specialist about your risk and your options. There are some preventive measures that may be helpful, particularly if you have a thrombophilia, and of course you will be watched closely throughout the next gestation. If your blood pressure started to go up, you would be monitored even more closely, either at bedrest or in the hospital, and before you got very sick they might induce labor or do a cesarean.
While you will be considered higher risk than average, the likelihood is that your pregnancy will go better this time, and that you will have a healthy baby. Take care, and good luck!— by Marjorie Greenfield, M.D. |
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