Sometimes Things Get Complicated: Preeclampsia

While I'd like to only talk about the fun parts of pregnancy, the reality is that sometimes things go wrong. That said, I'm occasionally going to have guest posts from women in the area that have experienced complications during pregnancy.  These aren't meant to scare you -- but to illuminate and educate you about things that could happen (regardless of how well you take care of yourself)  and give you the signs to look for.  As GI Joe used to say: "Knowing is half the battle."   



Preeclampsia

Guest entry by Allison Hyra (Alexandria, VA)



I was pregnant with our first child in the fall of 07/spring of 08. Never threw up, didn’t feel too big, was very happy with the whole experience. When we got back from Christmas with my family, the midwife said I put on 6 pounds in two weeks and need to slow down. I thought maybe I had had too many cupcakes and vowed to do better. A couple of weeks later on a Monday (32 weeks pregnant) my blood pressure at my exam was 140/90. My doctor, at Physician and Midwives in Alexandria, asked me to come back in a couple of days to recheck. That Thursday, my pressure was 170/110. The doctor told me to drive straight to the hospital. At Alexandria Inova hospital the perinatologist confirmed our fears– I had preeclampsia, my placenta was failing and our baby was suffering – he was measuring 3 weeks behind. They immediately gave me steroid shots to help mature our son’s lungs and hoped on hospital bedrest to get me to 34 weeks. That was not to be. By Saturday evening, my lungs were filling up with fluid and after several failed breathing treatments, I had an emergency c-section at 2:50 am Sunday morning, just as I became 33 weeks pregnant.

Our son Avery was born at 3 lb 5 oz and was quickly whisked off to the NICU. I continued to have very high pressures for about 12 weeks post-birth and did not get to meet him until that afternoon. Avery received breathing help for a couple of hours, but was only on supplemental oxygen when I first saw him. He had leads all over his body, an IV in his forehead and an NG tube threaded up his nose and down to his belly. He was stripped to a diaper and a face mask, lying in an incubator under a blue billirubin light. I first held him when he was three days old. In retrospect, we were lucky. Avery never developed any of the common preemie ailments such as vision problems, cerebral palsy, brain hemorrhages, or NEC, where parts of their intestines die and become necrotic. He lived in the NICU for the first 24 days of his life, growing, getting stronger and learning how to eat by mouth.

Needless to say, those 24 days were the hardest of our lives. I pumped every 3 hours, 24 hours a day to keep my milk supply up and to provide the NICU with breastmilk that was pumped into his belly. My husband drove to the NICU every day at 5:30 to see him before catching the bus at 7 to go to work. He said he would cry in the elevator at work because it was the only time he was alone and could break down.

We are now parents to a wild, ornery, loquacious and cheerful two and a half year old. Aside from being skinny and a little short for his age, you would not know he was a preemie. We’re actually pregnant again and hoping to avoid preeclampsia this time. We have decided to stay with the same practice and hospital. I’ve learned from the preeclampsia message boards that many people’s doctors miss catching this disease early, but my practice (Physicians and Midwives) was on the ball. Also Inova Alexandria has a level III NICU (the highest level) so our son would have been able to receive all of the care he might have needed without a transfer and the NICU has less than 20 beds so we received personalized care from nurses that got to know us.

Although preeclampsia is a leading cause of maternal and fetal death, most people have never heard of the disease or are familiar with its symptoms. Please call your doctor immediately if you have any of the following symptoms while pregnant or within six weeks of giving birth:
* High blood pressure, especially anything 140/90 or higher;
* Swelling in your feet that doesn’t go away, or swelling in your hands/face;
* A sudden, unexplained weight gain of more than 2 pounds a week;
* A dull, throbbing headache that won’t go away;
* Nausea or vomiting;
* Changes in vision;
* Right shoulder pain;
* Or a gut feeling that something just isn’t right.

We know very little about preeclampsia, its causes, how it works or why it happens. Currently, the only cure is delivery of the baby, and it’s unclear how effective current treatments such as bed rest are. It’s truly a very scary disease that is largely a medical mystery. Hopefully, future research will be able to provide additional insight into this disease, preventing thousands of deaths, premature births and poor child outcomes. For more information about this disease, please visit www.preeclampsia.org.