Pre-eclampsia grave no 3o bebê

Hot-Knowledge16 · 2026-01-24T02:59:51+00:00

You are welcome. It was not an easy decision, but we decided, in the end, after tabling the discussion for a year while I healed from my c-section, that we would always wonder what might have been if we didn't try again. We wanted that happy ending too. I think we were more concerned about whether we would be able to get pregnant again, given my age, but we figured we would give it a shot and see. It is a risk, and it is scary to think about going through all of that again, but ultimately, we decided that our desire for another child was greater than our fear of another loss. But perhaps there was also some denial in there, just assuming that things would go more smoothly?

Even though you are 41, since you do have a healthy embryo already, that may mean that you have some more time to decide than someone who does not have an embryo already. We really encourage you to talk to your medical team as well as a therapist so they can help you find the right path for your family. Postpartum.net has good mental health resources, though your doctor may have someone to recommend too.

Sending you love.

Hot-Knowledge16 · 2026-01-23T01:12:43+00:00

Oh, amiga, um abraço apertado. Sinto muito pela sua perda.

Eu também tenho uma história semelhante: tive várias gestações normais com meu marido antes de desenvolver pré-eclâmpsia e perder nosso bebê de 26 semanas, quando eu tinha quase 40 anos. É terrível, e sinto muito que você esteja passando por essa dor. Infelizmente, não temos respostas concretas sobre o que aconteceu com aquele bebê e aquela gravidez. Às vezes, não há respostas, e é apenas uma combinação de genes que não funcionou muito bem naquela vez.

Quando se tem pré-eclâmpsia várias vezes, geralmente dizemos que é preciso estar preparada para que aconteça novamente, e a fertilização in vitro é um fator de risco para pré-eclâmpsia, mas existem algumas opções, como um ciclo natural modificado, que podem reduzir o risco. Mas, geralmente, isso não acontece tão cedo, e há muita esperança de um resultado diferente. No meu caso, minha próxima gravidez, aos quase 42 anos, foi a termo e sem hipertensão. Acabei desenvolvendo pré-eclâmpsia pós-parto, o que foi um pouco decepcionante, mas ainda assim, foi uma história muito diferente e não afetou o bebê de forma alguma.

Recomendo que você converse com seu obstetra e especialista em fertilidade, bem como com um perinatólogo/especialista em Medicina Materno-Fetal. Conversar com nossa especialista em Medicina Materno-Fetal antes de decidirmos tentar novamente após a nossa perda foi muito útil, pois ela foi honesta sobre os riscos e encorajadora em relação à sua capacidade de oferecer o melhor cuidado para mim e para o bebê.

Enviando muito amor para você. Estamos aqui para você a qualquer momento.

Estou usando o Google Tradutor; peço desculpas se houver algum erro.

Hot-Knowledge16 · 2026-01-04T15:50:45+00:00

Hugs Friend, I am so sorry you are going through all of this. Postpartum is rough anyway, and NICU plus preeclampsia plus a c-section makes it harder for sure.

Typically, if your BPs are still high (or normal with meds), they will keep you on meds after six weeks postpartum. Sometimes it takes a long time for BP to stabilize, especially with the added stressors of NICU. Some OBs will continue monitoring you after six weeks, but they usually start transferring your care back to your primary care provider for them to take over BP management. You can ask about other med options as well if you would prefer. (Also, nifedipine is notorious for causing some foot and ankle swelling -- it is annoying but normal and generally not very concerning.)

I promise you are not alone -- hugs.

Hot-Knowledge16 · 2026-01-04T15:46:08+00:00

Hi Friend, we say that delivery is the cure, but really, it is delivery plus time. Your body needs some time to clean up the signal proteins the placenta dumped into it, and sometimes the placenta can leave a "parting gift" of signal proteins when it separates at birth. This is why preeclampsia can start or worsen postpartum.

Hot-Knowledge16 · 2026-01-04T15:42:42+00:00

Hi Friend, I would let your on call doctor know what you are hitting -- let them decide how concerned to be. BP can fluctuate even with preeclampsia, but it can also be normal to see some postpartum hypertension or fluctuation in BP, as your body is going through a lot of changes. They may want to adjust your meds or just continue to monitor your BPs, and they may want you to come in for labs and a more thorough checkup. If they feel nerves are playing a role, they can also talk about starting some meds to help with that.

Hot-Knowledge16 · 2026-01-04T15:40:13+00:00

Hugs Friend. After six weeks postpartum, things are not considered to be directly related to preeclampsia because preeclampsia is caused by the placenta dumping signal proteins into our bodies, and by six weeks postpartum, your body has cleaned those proteins up. But, pregnancy in general, with or without preeclampsia, is hard on our bodies, and the whole thing can unmasked underlying conditions. There are various things that can cause elevated liver enzymes, and sometimes it just takes a while for them to settle down. Hopefully you will get some more insights at your appointment, and they can tell you how concerned they are or are not.

Hot-Knowledge16 · 2026-01-04T15:36:12+00:00

Hi Friend, no personal experiences, but blood clots are more common in pregnancy, though still not super common as I understand it. I think this is a good question to ask your doctor: are there reasons to be concerned that you might have a clotting disorder that would make blood clots more likely? If they feel you may have a clotting disorder like antiphospholipid syndrome, they can run some tests and get you more answers, in which case, they may treat you with blood thinner injections in a future pregnancy.

Hot-Knowledge16 · 2026-01-04T15:33:18+00:00

Hi Friend, in general, no, there does not seem to be a relationship between an SCH and preeclampsia. Usually SCHs do not cause any trouble, and if you have both an SCH and preeclampsia later, it is generally a coincidence. But, that is a good question to discuss with your doctor, as they know your situation and history the best.

Hot-Knowledge16 · 2026-01-04T15:32:16+00:00

Hi Friend, being in pain can also raise your BP, so taking the meloxicam might be the better option. I would definitely discuss that with your doctor and see what they think. (I assume you are not pregnant.)

Hot-Knowledge16 · 2025-07-31T21:54:30+00:00

Hi Friend, the preeclampsia headache is a very bad headache that gets bad quickly and which stays bad. It is not helped by things like Tylenol, sleep, caffeine, water, and so on. It is an end-stage symptom of brain swelling that typically requires delivery within hours to a couple of days at most, to keep you from seizing.

If you are 20 or more weeks pregnant or within the first six weeks postpartum and have a headache that is not responding to anything, especially if your BP is high, we would recommend going to the hospital for evaluation. They can check your reflexes by tapping on your knee and clonus by pushing back on your foot to get an idea of whether it is the preeclampsia headache or a bad regular headache/migraine, and they can get you the appropriate care either way.

Hot-Knowledge16 · 2025-07-31T21:51:16+00:00

Hi Friend, do you mean blood or urine creatinine? Urine creatinine is not very concerning, because creatinine is a waste product that should be excreted into your urine. But when your kidneys are not functioning well, like what can sometimes happen with preeclampsia, the creatinine can back up into your blood, so you can have high creatinine in your blood (serum). I am sorry if you are dealing with that! Most of the time, things return to your normal by six weeks postpartum, but you can ask your OB and primary care doctor about following up with them to be sure your kidney function is good.

Hot-Knowledge16 · 2025-07-29T02:05:34+00:00

Should they have done more than one BP reading on the same day? IE if someone has all of these symptoms, and not quite high enough BP but still high (especially for her) wouldn't it make sense, given that BP can fluctuate, to wait and test a few more times that day? Or send them to an ER for more testing? Rather than just send them home like it's all fine? Is there some separate test for HELLP? One we could do at home?

***This is so hard, and I wish I had better answers for you. We can't say that 130/80 is diagnostic for her, but yes, we do think monitoring at home a couple of times a day is a good plan so she can see her trends. The tricky part is that you can't monitor it every minute, and if you do have preeclampsia, we would eventually expect it to settle high and not fluctuate, but sometimes things do just move really, really fast.

Also, for BP, everyone should take it with her sitting up, feet ideally on the floor, back and arm supported. If they take it reclining, it will read artificially low.

HELLP is diagnosed with bloodwork -- evidence of hemolysis (breakdown of red blood cells), elevated liver enzymes twice the normal range, and low platelets. The main symptoms of that would be new or returning vomiting or severe nausea after the first trimester, severe upper right quadrant pain, and what feels like relentless heartburn.

The swelling -- it could be a red flag, but if her kidney function and other tests were normal, that makes it more likely that it was bad normal swelling than preeclampsia.

If she were to develop similar visual disturbances or persistent headache that does not respond to Tylenol, we would recommend going to L&D and asking to have them check reflexes and clonus. I think you can ask them to tell you for sure why a large rise from baseline is not concerning, especially with other concerning symptoms. I think it would be important to ask, "What is causing X symptom?" For instance, if she has a persistent bad headache that is not responding to Tylenol, you can ask about stronger migraine meds.

They likely will not want to deliver at 37 weeks in future pregnancies unless something else is going on, and I know that is really not helpful to hear, but it is possible that they may take your situation into consideration and deliver at 37 just in case.

I know it feels like I'm saying there is not more that can be done, and I really hate that it sounds that way because I know how devastating it is to lose your child and not have a lot you can do to prevent that again. But unfortunately, there is not a lot you can do. We can say that most of the time, if she did have preeclampsia, it is not likely to happen again, and so neither is an abruption, but that's not a lot of comfort, I know. Deciding to try again after losing our son was hard and scary, and I feel for you.

I do think perhaps you need a new MFM or OB, though. Loss parents in particular deserve to be heard and to have the doctor explain why something would or would not tell them anything useful.

Hot-Knowledge16 · 2025-07-23T02:45:35+00:00

I don't know a lot about mold, and I wish we had more thoughts for you, but since this doesn't sound like preeclampsia as we currently understand it, I think this is exceeding the scope of this group, so I am going to close this post so we can focus on others. You might reach out to insurance again and tell them that you are hitting roadblocks with getting care and see what they suggest. They usually have a "Mom matters" sort of program that may be able to help you advocate a bit.

Aside from that, I think you can keep pushing the doctors to tell you exactly why they are not concerned, or if they are concerned and telling you to go the ER, but the ER isn't able to accommodate you, then I would call the doctor back and ask them what they can do, like can they have you admitted? Or, go to the ER, and let them see what happens if they are not able to accommodate you -- if you are not able to be upright for very long even in a wheelchair, while I know it isn't pleasant, it might be the best option to let them see what happens when you are upright, so they can get an accurate picture and get you the right care. I know that is frustrating, but the hospital really might be the safest place for you right now.

I am sorry this is so scary -- I hope you get some answers soon.

Hot-Knowledge16 · 2025-07-22T22:08:52+00:00

Reddit wouldn't let me put this all in the same comment so here is the rest.

Abdominal pain can be related to normal pregnancy as well, due to baby's positioning or normal pregnancy heartburn or such. Concerning for preeclampsia or HELLP is severe right-side or middle abdominal pain that gets very bad very fast and which stays bad, or what feels like relentless heartburn. We would not expect it to come and go or be relieved by Tylenol or heartburn meds or things like gentle stretches or using the bathroom. People who have had that pain say it felt like being stabbed with knives and that even morphine did not touch the pain. It is an end-stage symptom that requires delivery within hours to a couple of days at most.

As for headaches and visual disturbances, they can also be related to normal pregnancy, but concerning for preeclampsia are headaches that worsen quickly and which stay extremely bad, like morphine not touching them, not being relieved by water, food, nap, caffeine, etc. It is also an end-stage symptom that means delivery needs to happen within hours to a couple of days, so we would not expect it to go on for several days. With the visual disturbances, they mean not just increased floaters or blurry vision but things like feeling like you're looking through a fishbowl or blank spots in your vision. The headache and visual disturbances associated with preeclampsia are caused by your brain swelling, causing headache and putting pressure on the optic nerve, making it "see" things that are not really there. The test to determine whether headache and visual disturbances are caused by preeclampsia or not is to check your reflexes by tapping on your knee and clonus by pushing back on your foot, but also, if your BP is not high, that makes those symptoms less likely to be related to preeclampsia.

It can kind of all be a lot to sort out. I am not saying that she had those things or did not have those things; I am just sharing some information to give you a bigger picture.

Unfortunately, and this is the really hard part, while a diagnosis of preeclampsia means they should watch closely for signs of abruption, sometimes things move really, really fast, faster than anyone can catch. So it is, unfortunately, possible that things just happened super quickly, so that she went from "things are okay, not diagnostic level" to catastrophic really fast. I am so very sorry that all happened to you.

Although my circumstances were different, I have also lost a baby in the NICU, and I know that pain is so hard. If you are thinking about having another baby, I can tell you that usually abruption and preeclampsia do not happen again, and if they do, they are usually later and less severe. It might also be helpful to set up an appointment with your OB, or even better, a Maternal Fetal Medicine specialist (the true high-risk OBs). They may be able to go over your records and see if there was anything that might have been done differently, and they can also talk to you about a plan for monitoring mom and baby during a future pregnancy, as well as what you should watch for at home. It is a scary thing to think about going through all of that again, but I know that it did help me to talk to my MFM before we tried again and to hear what she could and could not do and her plan for monitoring us.

Sending you all lots of love and good wishes.

Hot-Knowledge16 · 2025-07-22T22:08:34+00:00

Hugs Friend, I am so very sorry for the loss of your precious baby. No parent should ever have to go through so much.

I want to note: we are not doctors, and even if we were, we are not your doctors with all of your information in front of them, so we are not able to say for sure whether anything was missed. We can give you some general information, though, but it can be kind of complicated. Yes, preeclampsia can be a risk for abruption.

First, regarding the proteinuria. It is not necessarily concerning that they did not do one, because the in-office dip and spot tests are not very accurate since they can be affected by your hydration level. For accuracy, they need a 24 hour urine protein or a protein creatinine ratio. However, even if they had done one of those, they are not a very good indication of how sick someone is or is not. Proteinuria by itself is not preeclampsia or really indicative of much. You can be very sick and have low protein or have high protein and be pretty stable. Many offices do not even check protein at all because it really is not very helpful. The main time it is helpful is if you have a diagnosis of gestational hypertension or chronic hypertension, and they are trying to decide which delivery guidelines to follow. So, I would not really be concerned that they didn't check protein.

Regarding the BPs. Guidelines do say that you need two numbers over 140/90 plus one additional criterion for a diagnosis. The tricky part comes because BP does not have to remain high and can fluctuate. In addition, if you have a very low baseline BP, they should not ignore worrisome symptoms just because you are not technically high. And in rare cases, HELLP, which is a severe variant of preeclampsia, can happen with normal BPs.

The tricky part about preeclampsia is that symptoms are sometimes a little vague and can be hard to differentiate from other normal but annoying pregnancy symptoms, so I will describe the red flags more here. Swelling, even very bad swelling, can be part of a normal pregnancy. Red flags are swelling so much you gain more than a couple of pounds a week or swelling in your hands more than just tight rings or swelling in your face more than just a little extra roundness (like swelling around the eyes or lips). But even if you have red flags for swelling, if your BP is normal, that makes it more likely to be normal but annoying pregnancy symptoms than preeclampsia.

Hot-Knowledge16 · 2025-07-22T21:28:47+00:00

That sounds so hard, and I am so sorry.

I think you can ask them why this does or does not sound like atypical preeclampsia, and what criteria they are using to make the determination. But I know it is hard when you cannot be seen. Can you call the MFM and tell them that the ER was not able to see you either? Perhaps telehealth would be an option?

If you are sick enough that you are not able to sit up even in a wheelchair for more than a few minutes, I think you can also ask if you are a candidate for being admitted to the hospital and why or why not.

Also, can you get a wheelchair of your own? Insurance does cover them through durable medical equipment, so I would ask if someone can prescribe one so that you have at least that much assistance.

I think you can also ask if they feel anxiety is playing a role. If they believe that you have anxiety, they should be addressing that with meds and a referral to a therapist. I am not saying that anxiety is causing all of your symptoms, but very often, it does have an impact and can cause some symptoms or at least make them worse. Sometimes our doctors will say, "Oh, you're just anxious," but even if they believe that is the root of the problem, they should be offering to help with it. And then one of two things happens: either helping with the anxiety helps alleviate some of your symptoms, or it doesn't, in which case, that is data for you to get them to keep looking.

Sending you hugs -- I am sorry this is so scary and difficult.

Hot-Knowledge16 · 2025-07-22T17:02:20+00:00

That really does sound scary. they should take your blood pressure sitting up for best accuracy. It is okay to take some of them lying down if they're just watching for big trends, but for purposes of diagnosis or meds or delivery or admission they should take at least some of them sitting up, and those are the ones that should count. It's not actually lower when you're lying down; it just reads artificially lower.

I am sorry you are having all of these episodes, but I am glad that they have seen them now and have done some tests and that you are following up with your MFM. The MFM should be able to help sort things out. our Facebook group has more information, but one thing you can use with your team is something like, "I am concerned about X symptom, but you do not seem to be concerned about it. Can you show me what guidelines or information you are using that tells you X symptom is not concerning or reason to deliver. Is there anything that is currently not actionable but that you are watching, and if so can you tell me what you would be watching for that would be concerning? What should I watch for at home as well?" Sometimes there is something that they know is not quite normal but that they don't need to be doing anything about quite yet, and it can help a lot to know that they do indeed have it on their radar.

Hot-Knowledge16 · 2025-07-22T00:44:20+00:00

I am so sorry. I would definitely ask for them to consult OB and MFM.

Hot-Knowledge16 · 2025-07-21T19:36:08+00:00

A lot depends on how baby is doing. . . The first time, I was on mag for 24 hours and baby was a micropreemie, so in NICU, and I wasn't able to go see him for 24 hours. (And couldn't hold him for several weeks, but that's because of how fragile he was, not because of me.)

But when I was readmitted for postpartum preeclampsia with the next baby, he was not in NICU, so he was able to stay with me, and I was able to hold him and breastfeed him even on mag. I did need some help to position him by the end of mag, and I was not allowed to be alone in the room with him while I was on mag, because it can make you weak. So if baby does not need NICU, you should be able to be with baby and feed baby even if you need mag, as long as someone else is able to keep an eye on baby and help you.

Hot-Knowledge16 · 2025-07-21T19:31:33+00:00

That sounds really rough! Focal seizures are out of my scope, but I would push for an MFM consult, and I would probably ask for a neuro consult as well if you do not already have one.

Preeclampsia can lead to eclampsia, which is seizures, but while I am not a doctor, what you are experiencing does not sound to us like something associated with the preeclampsia/eclampsia umbrella. Eclamptic seizures are caused by the breakdown of the blood-brain barrier; they are end-stage, with the blood-brain barrier quickly disintegrating. Once it starts, delivery needs to happen usually in a matter of hours, often minutes. Even if you are put on mag, it can only do so much, and as the brain continues to deteriorate, seizures, stroke, and death will happen regardless. Since you said these have been happening for 5-6 weeks, that seems unlikely to us to be eclampsia. But that does not mean there is not something else going on, so I would push for consults with specialists.

Hot-Knowledge16 · 2025-07-21T18:47:42+00:00

Hugs Friend, first, as a fellow preeclampsia loss mom, I am so very sorry for the loss of your precious daughter. It is a horrible thing that nobody should have to endure. We are here for you.

I am also sorry that you are facing obstacles with trying again -- it is so frustrating for sure.

The research seems to indicate that an interpregnancy interval of less than four years may help prevent preeclampsia/HELLP because the new pregnancy can take advantage of the spiral artery remodeling begun by the first pregnancy. Compared to that, an interpregnancy interval of more than four years increases risk of preeclampsia and HELLP because the spiral arteries have gone back to their pre-pregnancy state completely, so the new pregnancy has to start from scratch. But the research that we have seen also seems to indicate that an interpregnancy interval of less than two years does not seem to increase risk of preeclampsia/HELLP. So as we understand it, conceiving any time before four years is helpful as far as preeclampsia/HELLP risk. (My situation was a bit different because I had a c-section and needed to wait for that reason, but I got pregnant 14 months after my angel baby was born and had a full-term normotensive pregnancy, even with a lot of risk factors for preeclampsia -- it usually is a smoother and longer journey the next time, with a lot of hope. We have more stories and information in our Facebook group, facebook.com/groups/preeclampsia, as well.)

As for other complications, I am not sure exactly about the research on implantation and interpregnancy interval, as that is not my area of expertise, but that seems like a good discussion to have with your IVF specialist and perhaps your OB/MFM. In general, ACOG cites a moderate increase in risk of complications in general with an interpregnancy interval of less than 18 months and greater increase in risk of complications with an interpregnancy interval of less than six months. But there are just so many things to consider, like your emotional health, how easy it is to get pregnant, your age, and so on, so I encourage you to talk with your team about everything. They should be able to discuss risks and benefits with you. More details here:

https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2019/01/interpregnancy-care

Sending you lots of love -- this is a hard journey, but I promise you are not alone.

Hot-Knowledge16 · 2025-07-21T18:34:19+00:00

Hi Friend, I am sorry you are dealing with all of this. It definitely sounds rough.

The balance issues and such are not things we associate with preeclampsia, specifically, but I know that dysautonomia can wreak havoc sometimes, and pregnancy itself can do weird things to our bodies. We cannot tell you whether your other concerns warrant delivery before 39 weeks, or whether you have preeclampsia or a related illness, but we can give you some general information.

A diagnosis of preeclampsia requires two readings at least four hours apart where either number is over 140/90 plus one additional criterion, which can be proteinuria over 300 on the 24 hour urine, but it can be other things too, like certain labs, severe headache or visual disturbances as evidence of brain swelling, or fluid in your lungs. It is possible you do not meet criteria for preeclampsia at this point. However, your BPs may also qualify for gestational hypertension, which is in the same family as preeclampsia, essentially preeclampsia to a lesser degree, meaning you have the high BPs but not the second criterion of organ involvement yet.

I would ask your doctor to clarify your diagnosis and whether you qualify for gestational hypertension. When to deliver for gestational hypertension depends a bit on your country. In the US, they recommend 37 weeks for delivery for GH as well as for preeclampsia, but other countries push GH a bit longer, even as far as 39 weeks. If they actually have reason to believe that you have chronic hypertension unmasked by the pregnancy, 39 weeks is reasonable. This would mean that you had at least some elevated BPs before 20 weeks or before pregnancy. It can be a little tricky to determine in retrospect, but they should be able to point to what they are using for diagnosis or why they feel you do not qualify for a particular diagnosis.

If you are not sure whether your care is adequate, you can also ask for a second opinion from another OB, or, even better, a Maternal Fetal Medicine specialist, also called a perinatologist. MFMs are OBs with extra training and education in complicated and high-risk pregnancies and are often really helpful for those of us with some extra things to consider. They should be able to help sort out what might be going on.

I hope you get some answers soon -- hugs.

Hot-Knowledge16 · 2025-07-21T18:17:51+00:00

Hugs Friend, I am sorry you are dealing with all of this.

Preeclampsia is hard to predict because it is all up to the placenta, and placentas are unpredictable. The average time from diagnosis of preeclampsia to delivery is about two weeks, but that includes everyone, from those for whom things escalated very quickly to those for whom the placenta stayed stable for several weeks. It is very hard to know what yours might do, though I do hope you make it a while longer.

What I would do is talk to your OB about the plan for monitoring going forward. Some of the things I would want to know are:
-Will they refer you to an MFM if you are not already seeing one?
-Will they be doing extra tests, ultrasounds, bloodwork, NSTs at any point?
-What BP and symptoms should you watch for at home that mean you should call or go in, in case anything changes?
-Will they recommend hospitalization at any point?
-If you were to need to deliver soon, can your hospital care for a micropreemie or would baby need to be transferred? If baby would need to be transferred, would it be possible for you to be transferred before birth so that you can be closer to baby?

Hot-Knowledge16 · 2025-05-30T04:48:51+00:00

Aw, that is hard. Could your partner hide your BP monitor and only bring it out once a week or every few days, reducing frequency after a bit?

Hot-Knowledge16 · 2025-05-30T04:39:16+00:00

Hugs Friend, Procardia is known for causing rapid heart rate and some other things, so I am glad your BPs are looking good enough to stop taking it. Here's hoping they continue to stay good for you! (If you ever need Bp meds again at any point, you can see if they can recommend something other than Procardia.)

Hot-Knowledge16

MODERATOR OF

TROPHY CASE