Is there another E in my future?
July 9, 2015 11:20 AM Subscribe
37 weeks with baby #2. Traces of protein in my urine, blood pressure tip toeing up, very minor pitting. Is pre e coming my way again or normal end of pregnancy stuff.
I am currently 37 weeks with baby #2. My 1st was born via c section at 40.3 weeks after being diagnosed with pre e on my due date. I am keeping a look out for everything that I had last time. I had severe pitting, protein, high bp, and severe edema.
The last 2 visits have seen my BP a tiny bit higher than the previous visit, but according to them, still in a great range. Today I noticed on my print out they give me that I have trace amounts of protein. I had not had any up to this point. Dr didn't even mention it. I have also started to notice a tiny bit of pitting, but I probably wouldn't have even noticed if I weren't actually looking for it.
I am worried that we are about to go down the same road again, but I know I am looking at all these things with the lens of someone who has had pre e. Is it possible that these are just normal, end of pregnancy things? Like I said, my dr seems unconcerned.
I am really hoping for a VBAC this time, but if I get pre e and am not already in labor, then it's a repeat section. Have you or your partner had all these things and have it not turn in to pre e?
I am currently 37 weeks with baby #2. My 1st was born via c section at 40.3 weeks after being diagnosed with pre e on my due date. I am keeping a look out for everything that I had last time. I had severe pitting, protein, high bp, and severe edema.
The last 2 visits have seen my BP a tiny bit higher than the previous visit, but according to them, still in a great range. Today I noticed on my print out they give me that I have trace amounts of protein. I had not had any up to this point. Dr didn't even mention it. I have also started to notice a tiny bit of pitting, but I probably wouldn't have even noticed if I weren't actually looking for it.
I am worried that we are about to go down the same road again, but I know I am looking at all these things with the lens of someone who has had pre e. Is it possible that these are just normal, end of pregnancy things? Like I said, my dr seems unconcerned.
I am really hoping for a VBAC this time, but if I get pre e and am not already in labor, then it's a repeat section. Have you or your partner had all these things and have it not turn in to pre e?
Is this the same doctor you saw in your last pregnancy? If not, maybe it would be reassuring to have a conversation about pre eclampsia with this new one--remind him that you had it, maybe ask him to explain some of the cutoff points (for BP, and for proteins) that he's looking for.
About the pitting edema, we are talking about your feet, yes? If it's somewhere other than your feet, then definitely call your provider about it if you haven't mentioned it to him yet, but a bit of foot edema (even with mild pitting) is common in late pregnancy. Definitely still something to keep an eye on, and to mention to your doctor at your next prenatal, but don't let it psych you out. (I'm not a doctor, though, just a doula!)
posted by snorkmaiden at 12:02 PM on July 9, 2015
About the pitting edema, we are talking about your feet, yes? If it's somewhere other than your feet, then definitely call your provider about it if you haven't mentioned it to him yet, but a bit of foot edema (even with mild pitting) is common in late pregnancy. Definitely still something to keep an eye on, and to mention to your doctor at your next prenatal, but don't let it psych you out. (I'm not a doctor, though, just a doula!)
posted by snorkmaiden at 12:02 PM on July 9, 2015
Response by poster: The pitting is in my shins, same place as last time. It really is barely noticeable, I am really looking for it. Last time it would dent about half the depth of a finger pad and stay for 3-5 minutes. This time it's just a barely there dent that is gone in less than a minute. I didn't mention it this last visit because it seems so minor compared to last time.
I am seeing a different dr this time but he is aware of my pre e being the reason for my cs last time and I remind him every time. I will have to add it to my list of questions for the week about his cutoffs.
posted by MayNicholas at 12:24 PM on July 9, 2015
I am seeing a different dr this time but he is aware of my pre e being the reason for my cs last time and I remind him every time. I will have to add it to my list of questions for the week about his cutoffs.
posted by MayNicholas at 12:24 PM on July 9, 2015
Trace protein is really common at this stage. Swelling is also really common, especially in the summer. It's hard, and I understand your fears - those symptoms are all pretty common late-pregnancy things but they're also the tiny starts of pre-e symptoms too. If your doctor is unconcerned, I would take that as a good sign. Obviously you want to keep an eye on things, but it's possible that you'll stay within the normal or high-normal ranges of these things until you go into labor.
Is there a reason it'd be an automatic c-section if you do get pre-e? You might ask to be induced with a foley bulb to give yourself a chance to VBAC.
In case my story is helpful to you: I had pre-e with my first and was induced at 36w6d, and it ended in a c-section at 37w0d. I had the same symptoms as you - high blood pressure (or borderline, it was around 140/90), protein, severe swelling and pitting edema. I felt "fine" (or what I assumed was fine given I had nothing to compare it to) and never had any headaches or dizziness or epigastric pain.
With my second, I was way more in-shape pre-pregnancy, ate a much higher protein diet, and didn't have any pre-e symptoms at all throughout my pregnancy. I went into labor naturally at 39w3d. I had planned a homebirth VBAC that went south when my baby started showing signs of fetal distress once I was pushing, and when I was admitted to the hospital they did bloodwork and discovered I had elevated platelets and other weirdo stuff going on. I ended up being diagnosed with atypical HELLP syndrome (the worse version of pre-e! Fun times). That pregnancy ended in a c-section as well, which was a huge bummer.
All this to say that I totally get the pre-e panic. I had that fear my entire second pregnancy and was so excited that I had dodged that bullet. Except... despite being totally asymptomatic, my liver was still crap and my kidneys were crap and I guess what I'm trying to say is that the best you can do is monitor your symptoms and take care of yourself. Had my VBAC been successful, we never would have known I was entering HELLP territory.
Best of luck to you and I really hope things work out well.
posted by meggan at 12:29 PM on July 9, 2015 [2 favorites]
Is there a reason it'd be an automatic c-section if you do get pre-e? You might ask to be induced with a foley bulb to give yourself a chance to VBAC.
In case my story is helpful to you: I had pre-e with my first and was induced at 36w6d, and it ended in a c-section at 37w0d. I had the same symptoms as you - high blood pressure (or borderline, it was around 140/90), protein, severe swelling and pitting edema. I felt "fine" (or what I assumed was fine given I had nothing to compare it to) and never had any headaches or dizziness or epigastric pain.
With my second, I was way more in-shape pre-pregnancy, ate a much higher protein diet, and didn't have any pre-e symptoms at all throughout my pregnancy. I went into labor naturally at 39w3d. I had planned a homebirth VBAC that went south when my baby started showing signs of fetal distress once I was pushing, and when I was admitted to the hospital they did bloodwork and discovered I had elevated platelets and other weirdo stuff going on. I ended up being diagnosed with atypical HELLP syndrome (the worse version of pre-e! Fun times). That pregnancy ended in a c-section as well, which was a huge bummer.
All this to say that I totally get the pre-e panic. I had that fear my entire second pregnancy and was so excited that I had dodged that bullet. Except... despite being totally asymptomatic, my liver was still crap and my kidneys were crap and I guess what I'm trying to say is that the best you can do is monitor your symptoms and take care of yourself. Had my VBAC been successful, we never would have known I was entering HELLP territory.
Best of luck to you and I really hope things work out well.
posted by meggan at 12:29 PM on July 9, 2015 [2 favorites]
Was there some other reason that you ended up with a c-section than the pre-e? Because here, at least, pre-e around the due date will get you induced, but not an emergency c-section. (Went through pre-e with 3 of my 4, and my sis did a couple years back with her twins.)
With my most recent one, because the maternity ward was "too full", they actually stalled four days before inducing, because while I had some swelling and was losing proteins, progressively more each day, it didn't ramp up into worrisome territory. (By the time my 4th came along and I didn't get it, I was used to it and sorta missed all those non-stress-test visits... lol.)
Then again, they refuse to do VBAC around here anymore... so maybe it's something that depends on where you are?
posted by stormyteal at 6:47 PM on July 9, 2015
With my most recent one, because the maternity ward was "too full", they actually stalled four days before inducing, because while I had some swelling and was losing proteins, progressively more each day, it didn't ramp up into worrisome territory. (By the time my 4th came along and I didn't get it, I was used to it and sorta missed all those non-stress-test visits... lol.)
Then again, they refuse to do VBAC around here anymore... so maybe it's something that depends on where you are?
posted by stormyteal at 6:47 PM on July 9, 2015
What meggan said, having edema in your legs in late pregnancy is very common, and having protein in your urine can happen, but the real issue is your blood pressure. As long as your blood pressure is normal range, you're good.
The definition of pre-eclampsia is that you have to have a BP of 140/90 or greater on more than 1 measurement.
posted by treehorn+bunny at 9:34 PM on July 9, 2015 [1 favorite]
The definition of pre-eclampsia is that you have to have a BP of 140/90 or greater on more than 1 measurement.
posted by treehorn+bunny at 9:34 PM on July 9, 2015 [1 favorite]
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Relax and go on bed rest to keep your blood pressure as controlled as you can and just hope.
My wife had preeclampsia with our first, but avoided it with our second and our third (and we had vaginal births on all three). But she had high blood pressure and protein in her urine with all three. The protein just didn't get high enough with #2 and #3.
posted by cmm at 11:33 AM on July 9, 2015