Rebecca's story

I have now had pre-eclampsia twice. After my daughter was born at 35 weeks due to pre-eclampsia I was told the chances of getting it again were low and even if I did get it that it would be less severe. We didn't hesitat to get pregnant again but my second pregnancy was anything but less complicated.

At 22 weeks I began spilling protein with my daughter. I have type 1 diabetes and they chalked it up to having the diabetes for so long. My blood pressures were slightly elevated so my OB referred me to a perinatologist. There I went in every 2 weeks for regular ultrasounds and checks. Blood pressure stayed steady and so did the protein until about 30 weeks. I was admitted to the hospital where they did blood work, a 24hr urine and kept me in bed. After 3 days they sent me home. I went back in 3 more times for elevated blood pressures even though I was on bedrest the whole time. The 4th time I called the Dr. He told me to come in that I was having a baby. I was scared to death. They had done an amniocentesis 4 days before and it said the lungs were not mature. Never the less I went in and was induced. Nine hours after they broke my water my daughter was born 5lb 10oz 19inches long at 35 weeks. She was fine and breathed on her own. We held her that night and I nursed her and we saw her again the next day. She did spend 1 week in NICU when she had an apnea spell then developed jaundice. When she was 9 months old I became pregnant again.

Since I had been nursing we weren't sure of the due date so in I went to the perinatologist who determined I was 6 weeks along. We didn't tell anyone I was pregnant. My mother is an NICU nurse and didn't want me to have anymore children. We kept it a secret until I was 16 weeks along. Besides the normal morning sickness I felt great and was so excited. I was having regular ultrasounds and we had found out we were having a little boy. At 18 weeks Dr looks over my charts. Oh, blood pressure is up. Usually about 100/60 now is 140/90. Not good. They check again. 140/84, they make me lay down for 15 min. 140/94 The Dr sends me down for labs and wants to see me again in a week. I go back in a week and blood pressure is 140/84. The Dr tells me I have chronic hypertension. He's not my regular Dr so I try to argue with him but he won't agree that it's something else. I mention pre-eclampsia and he says it's too early to develop that. He decides to put me on blood pressure medication (hydralazine) and sends me home to return in two weeks.

At 21 weeks I go back in to a Dr I haven't met yet. He's really nice. Blood pressure is 148/94 and spilling 4+ protein. The Dr seems really concerned. He thinks I am developing pre-eclampsia AGAIN. He asks of other symptoms so I tell him about my headaches. He shakes his head and scolds me for not worrying more. I didn't know, the other Dr's made it sound like no big deal. He starts me taking the meds twice a week and checking my blood pressures at home. I get more labs see what's up. Hgb A1C is 6.5 (average of blood sugars over 3 months) and only showing 2+ protein. all other labs are good.

At 22 weeks I go in again. Been checking blood pressure all week. Mon high of 135/85, by Sat I have a high of 165/120. Sunday we go in to labor & delivery. Blood pressure is 170/120 and 2+ protein. Blood pressure fluctuates all day only going down to 140/80 then back up again. At night it goes down to 125/75. Looks good but by morning it is back up to 150/95. Fluctuates all day again. They do a 24 hour urine. All other blood work looks good. Hoping they'll send me home but when I talk to the Dr he says there is a zero to no chance of me going home. Tuesday morning all looks good again. BPs stable at 140/85 and protein from 24 hour urine has gone down (1800g)1+. Sent home on modified bedrest and taking blood pressure meds 3x/day with an appt to return in a week.

At my next Dr appt. blood pressure was 150/94 however protein level was down to 1+. Having pain off and on under my ribs on my right side. Dr says it may be HELLP syndrome so he runs labs to check liver function. All the labs look good so it may be my gall bladder or just the way the baby is growing. He is now 1lb 8oz and currently breech but all looks good. I'm still on bedrest although I have been cheating all week as I have no one to watch my daughter anymore and we have been trying to move. Still checking blood pressures and blood sugars and have Dr appts weekly now. At my 25 week appt. I go in for my regular Dr appt Wed. 3+ protein amd blood pressure is 156/94. He sends me over to be admitted. They do blood work and another 24hr urine. Blood work looks good, no problems but I'm still having pain in my side. They do ultrasounds on my gall bladder, kidneys etc but it shows nothing. Protein is down to 1300g (1+), no explanation for the high blood pressures. They are checking them every 4 hours and I've had a high of 186/112. Average is running at 145/95 with an occasional low of 130/75. They have no idea why. They start giving me labetrol (sp?) along with the hydralazine so I'm taking meds 5 times a day. Friday they begin giving me steroid shots (brethasone?) to mature the baby's lungs. I get one Friday morning which really starts messing up my blood sugars going from my usual 100 to 300+. Insulin is increased to 5x what I was on. They tell me there's no way they'll deliver me this early unless my blood pressure goes up over 200 so I then wonder if I should have been given the steroids. I've already had one so I have the second shot Saturday morning. My blood sugars rise even more. They do a biophysical on the baby. He passes with flying colors even making breathing motions. They tell me I may be able to go home next week. To my surprise they release me Monday afternoon with orders to be on strict bedrest.

At 26 weeks blood pressures were high as usual until Wednesday when I started feeling really shakey. I checked and it had dropped to 100/59. I was supposed to take BP meds but I skip it thinking I may bottom out. I don't take them the rest of the day. Thursday blood pressures stay down 130/80 without meds. It goes up once to 130/92 so I take a dose of hydralazine (BP meds) and stays down the rest of the day. I've also been up moving around. Still having the pain in my right side but I've now gotten used to it and attribute it to the way the baby is growing.

At 27 weeks I go in for another appt. I was afraid they were going to readmit me. My blood pressure was 168/105 and 4+ protein. He rechecked my BP a few minutes later and it had gone down to 148/98. My blood pressures at home average 135/85 so he was pleased with those and told me to just keep doing what I am doing. They measured the baby. He is now 2lb 4oz, right on for my due date. Dr says he's not big from my diabetes and not small from the pre-eclampsia. Kinda makes me wonder if they are cancelling each other out. He has also turned and is partially head down, kinda transverse. They did a non-stress test (NST) and have started me coming in every Mon and Thur to have them done. The baby's heart never accelerated. They watch for the baby to move and for his heart to accelerate 15+ above the baseline. When I asked about it the nurse said not to worry that he is still too little. She said everything looks good and that they don't worry until I reach 30 weeks. At my next appt everything looks really good. The Dr wants me to do a 24hr urine just in case so I go home and do it and bring it back when I come in for my NST(non-stress test).

I ask about the labs before I go. BIG mistake! The nurse isn't sure how to read the results but says if there are any problems she'll have the Dr call me. He won't be in until Friday. Friday afternoon my husband checks his voicemail. There's a message from the office saying to come in to be admitted. I call them to see what's going on. They say something about protein and I need to come in right away. I have to find a babysitter for my daughter and we stop to get something to eat. Kinda upset as I really wanted to spend time with her this weekend. She ends up coming with us. They hook me up and I'm to spend the week there. Turns out my protein level came back at 4500g. They tell me if it gets to 5000g they will deliver. They start another 24 hour protein and blood pressure checks all week. I tour the NICU and they talk about delivery but by Tuesday things look better. Protein only at 2900g and stable blood pressures so they send me home with a promise I'll go in Thursday to be checked.

It's the Fourth of July and I've only been home 1day when I suddenly get sick and start throwing up. Blood pressure is 95/55 but I feel crummy. Blood sugar is 250 so I decide to go in just to get hydrated. I figure I'll get an IV and then they'll send me home. On the way to the hospital I start having contractions about 2 minutes apart. I get there and they start me on magnesium to stop the contractions. Blood pressures go down too and I feel great. The next day I had a really low blood sugar so they decided to keep me another day to make sure my sugars were ok. No one came in to tell me what was going on and I thought I was going to be released. By the time my husband came to see me he knew I was upset. I told him I was going home that they couldn't keep me there for no reason and that I could regulate my own blood sugars if that was the only reason they still had me there. I was having a really hard time making sense of everything and was feeling really alone. I hadn't been told I had pre-eclampsia, they kept saying PIH and although I knew I had pre-e I didn't think they knew it. I cried for a long time until finally my husband crawled up into the bed with me and I fell asleep still thinking that I would tell them I was going home in the morning. The resident Dr. had been called by my nurse and he wrote a note for my Dr so that I would be told what was going on. To my surprise my Dr. came in to see me in the morning. He explained that my blood pressures were a little high and that's why I was being kept. He said I had PIH and my husband said "Could it be pre-eclampsia". The Dr. laughed and told us it was the same thing, that I had had it for a very long time.

That afternoon my blood pressures went from 155/95 to 185/117 and everything in between. Finally my Dr. came back in. He proceded in telling me that my blood pressures were high and he was concerned. He checked my blood pressure one last time and it was 208/114. He then proceded in telling me that he needed to get the baby out for my sake and they were sending me to labor and delivery. I just nodded my head trying to act as if it was no big deal. I still didn't believe it. I was so sure I'd make it to 36 weeks and was in such denial. Just as I was being wheeled out my husband came in. He asked where I was going and I said to have a baby. He said "Nu-uh, where you really going?" The nurse told him I really was going over to have a baby.

I was afraid that the baby had turned as he had been kicking low a few days before. The Dr did a quick ultrasound and said the baby was head down so they would go ahead and try for a vaginal delivery. I was at least glad for that. The nurse explained that they would be using Cytotec to ripen my cervix. She went on and on about how well it works. They had used cervidel to ripen my cervix with my daughter but they wanted this one out a little faster so every 4 hours they put another one in. The nurse talked about how sometimes they didn't even need to give pictocin with this medication. I was glad she wanted to talk as it seemed so quiet and I didn't want to be alone with my own thoughts. They started the Mag drip again and I was surprised that it wasn't making me sick. I felt good and was hoping that everything would be smooth sailing but soon I began throwing-up. I continued to throw-up the whole night and made very little progress. In the morning they checked me after I began complaining about the pain. They said I was only 2cm. I had the worst headache and was still throwing-up so they finally gave me a shot of morphine to relax me and to make sure my blood pressures stayed down. I slept for a little while but woke up to very bad contractions. They said the monitor wasn't picking them up as my uterus was still small. I begged that they either stop me from throwing-up or give me an epidural. I couldn't handle the contractions, the headache and being sick. They checked me again, still 2cm but the Dr was concerned that if I didn't relax my blood pressures would get too high so they called the anathesiologist in. The morphine they had given me made me so groggy I couldn't open my eyes so when the anesthesiologist came in I just listened to what he told me to do and never opened my eyes. I still have no idea what he looks likes. The epidural was in place and he kept asking me if I felt better but I was feeling worse. I told him it wasn't working. I knew what it had felt like with my daughter and it wasn't even dulling the pain. They said to give it some time. My husband asked if it was ok if he went home and took a nap. I told him yes that I would call him when I got closer to delivering. We only lived 20 minutes away. He left and they finally pulled out the epi and put another one in. This one took and I felt so much better I passed out from exaustion.

I awoke about 4 hours later and was told I was only 3cm dialated. I debated whether I should call my husband or not but thought I'd wait until I was at 5cm. The Dr. came in and said he needed to put a lead on the baby's head because he had a decel. I knew they had to break my water to do that as that is what happened with my daughter. I was also having bloody show and they thought I might be loosing my mucus plug. Omar had missed them breaking my water with Audrí and was upset so I asked the Dr if I could call him first. He said no that he'd break my water first then I could call him. He broke my water and I started having severe pain. The anesthesiologist came right over and said he'd have to dose me again as my epidural had completely worn off. Meanwhile the Dr was placing the lead on the baby's head and I was trying to call my husband. The Dr asked me how far away he was and I said 20 min. He said "he isn't going to make it". I was on the phone saying the baby was coming now and to get over here. He kept asking how far along I was and I was trying to explain that I was complete and the baby's head was coming out but I was so out of it I had no idea what I was saying. I quickly hung up the phone and they began rolling me down the hall. They needed to be in a room attached to the NICU so they could hand the baby through a window straight into the NICU center to a team there. They arrived in the room and the NICU team wasn't there yet. I was concentrating on not pushing and holding the baby in as I was afraid he was going to be born in the hall. I asked if I could wait for my husband and the Dr said no that I needed to give a little controlled push to see where the baby was at. I was in so much pain I thought I was going to throw-up and the anesthesiologist was still there trying to get the epi to work. I figured I might as well stop trying to hold him in and kept saying to myself that women have babies all the time without pain medication. I took a deep breath and relaxed my muscles. I didn't even begin to push when I felt the greatest stinging and yet the greatest relief. It was such a mixed sensation. I immediately sat up to see my baby laying on a table right below my legs. They had no one to hand him to so they quickly checked that he was breathing and continued working on me. I could see his tiny body and touched his tiny foot. I could see that he was wiggling and even heard his soft little cry. I was so relieved. The next thing I knew they wisked him away and I closed my eyes again. I had had my eyes closed through the whole thing. I hadn't even seen where they had rolled me to. I heard the Dr talking about me retaining the placenta and they began pushing on my stomach. I had stopped cramping and they were afraid the placenta wouldn't be delivered so the Dr reached inside me and scrapped the uterine wall. The pain was worse than giving birth and the anesthesiologist was still there working on getting me relief. I was told later that they sent the placenta to the lab to find out that I had clotting on one side which meant I had partially abrupted. I can't begin to imagine what might have happened if I hadn't delivered early.

I don't remember much else after that. I called my husband after they wheeled me back to my room. He was 5 minutes too late and was trying to find a parking space. My active labor lasted only 15 minutes. I didn't find out how the baby was doing for a few hours after. They brought in a polaroid of him and wrote down his stats for me. He weighed 3lbs 6oz and was 16½ inches long. He was surprisingly big for his age. The Dr thinks it might be because of my diabetes but in this case it turned out to be a good thing. They ended up putting him on a ventilator but he was only on it one day then on a canula with oxygen.

I remained in the hospital for 3 days with constant blood draws and blood pressure checks. My blood pressures went down returning to 100/60 so they let me go home. The day after I went home I awoke not being able to open my eyes. I was so swollen I couldn't walk and it hurt to move. I went into the hospital to see my son (in NICU) so I stopped by the perinatology dept to ask about the swelling. The nurse took one look at me and made me lay down. She checked my blood pressure and it was 190/120. The Dr came in to see me, started me on procardia to lower my blood pressure and sent me down for more labs. My platelets came back lower than usual but still in the normal range. The Dr thinks I had developed HELLP syndrome. He came into my hospital room right after my son was born and said "why don't we see what we can do about getting your tubes tied". I was devestated. My son was in NICU and he was there telling me I shouldn't have anymore children. My husband and I have decided to wait a few years and then start looking for second opinions. I don't want another pre-term baby but I would also like to experience one normal pregnancy. I already miss being pregnant and feel so cheated of that experience.

Rebecca