IT HAPPENED TO ME: I Had Pre-eclampsia During Pregnancy
In the fall of 2012, I planted about 1000 flower bulbs that I hoped would come up in the spring*. There was an array of tulips, irises, daffodils and crocus set to start blooming around the due date of my first child the following May. The winter in between was the longest of my life; I couldn’t wait to see the flowers bloom and I couldn’t wait to greet the new little life that was growing in my belly.
My pregnancy was going smoothly until about March. I think I was around 34 weeks when I started feeling really terrible. I was beyond exhausted, having trouble breathing, easily overheated and my legs and feet were really swollen. I had always heard, and read, that some level of swelling was normal during pregnancy, but I was really having trouble getting around.
I was perplexed how it was that women all over the world went through this much discomfort more than once. Fortunately, I would later learn that most women don’t.
Two days after my baby shower, I went to the doctor for an unscheduled visit. After taking my blood pressure (well above typical high blood pressure of 140/90), the midwife examining me told me to go ahead and drive next door to the hospital, because I was staying overnight.
Terrified, I told my husband the news, and we went over to labor and delivery. The first stop was triage, where I got my first catheter put in. The nurses explained they had to get a clean urine sample in order to test me for a condition called preeclampsia.
Preeclampsia is defined by the Mayo Clinic as “high blood pressure and excess protein in the urine after 20 weeks of pregnancy in a woman who previously had normal blood pressure."
If left untreated, preeclampsia can escalate quickly into eclampsia, which causes seizures, and can take the life of the mama and the baby. In the US, preeclampsia is responsible for about 18% of maternal deaths. Recently, it was featured as a storyline on an episode of "Downton Abbey"; in that case, the mother died. It has also been speculated that it prompted Kim Kardashian's early delivery.
Overall, preeclampsia impacts about 5-8% of pregnant women. With routine prenatal care (blood pressure checks, urine testing), doctors can catch it and take the best course of action. The only cure is delivery, but sometimes bedrest and/or hospital care can help prolong the pregnancy long enough to help the baby get as far along as possible.
At this point in the game for me, my blood pressure was extremely high, but my urine test came back OK. After an overnight stay and more monitoring, I was able to go home on bedrest for about a week. At my next routine checkup, around 35 1/2 weeks, my blood pressure was high and I had protein in my urine, so I got sent back to the hospital. This time, though, the doctors informed me I wasn't leaving until I had my baby.
The goal was to keep me on bedrest in the hospital under constant supervision to keep the baby baking as long as possible. Before 37 weeks, a baby’s lungs aren't formed completely, so they wanted me to hold out as long as possible to give him a chance to develop fully.
As a normally active person, bedrest was rough, mentally and physically. My sinus problem got worse, to the point I couldn't really breathe. Most cold medicine raises blood pressure, so I couldn’t take anything that probably would have made me feel better.
The first few days I was in the hospital, I asked my husband for updates on my garden. He would send me pictures from the house -– he stayed with the dog a few nights there while my condition was stable.
It was the weirdest feeling in the world, being holed up in a hospital, unable to leave my bed, my muscles wasting away, while the flowers I had waited so long to see bloomed without me there. In a weird way, this made me feel close to death; it was a reminder that life will go on without you one day; your flowers will bloom from year to year whether you’re there or not.
I should also mention I lost my appetite by about the second day in the hospital, and also could not sleep for more than an hour or two at a clip for the entire time. So, between those two factors and being a nervous wreck about the bambino, my mental state was probably not the most optimistic.
From day to day my blood pressure would change –- there were two days before my ultimate delivery date it was so high they thought they were going to have to deliver. I would get amped up at the prospect of meeting my kid, and then, my blood pressure would go down. It was a weird little roller coaster ride -- being excited to deliver but scared my blood pressure was high; relieved when it went down but disappointed I still wasn’t going to meet my son.
I knew it was in his best interest to hold out delivering as long as possible, so I was grateful when they gave me a little more time.
Finally, after I think nine days in a hospital bed, on a Saturday night they said they were going to induce me. I had not quite reached 37 weeks, but the doctors thought it was too risky to wait any longer. So I got Cervadil, to try to get things moving overnight. Unfortunately, it was a no-go.
The next day, they started me on an IV of Pitocin and magnesium sulfate. The Pitocin was used to induce labor, the magnesium sulfate was used to prevent seizures. (Side Note: If any of you ladies have had magnesium sulfate, I am so sorry. It made me feel like my skin was on fire. )
Unfortunately, this round of induction didn’t work either. That Sunday night the doctor came in tell me that they were going to try to induce the next day, and my body, and my baby were having none of it. Throughout the whole ordeal, his heartbeat had been great. Despite the chaos ensuing in the rest of my body, he was doing well inside of me. At this point though, probably because I was so upset at the thought of going another round of induced contractions and even MORE magnesium sulfate, he was starting to show signs of distress, and they docs decided they could no longer wait to give me an emergency C-section.
Finally I heard the best sound of my life –- my son screaming! Thankfully, he was born healthy as an ox, and the pediatrician said he was further along than they initially thought, so his lungs were great.
After delivery, the symptoms of preeclampsia started to subside. I was put on heavy duty antibiotics and blood pressure medicine (eclampsia can still happen after delivery), and I think because of this cocktail, I lost 30 lbs. of water weight in the first week (it was nasty.) It took several weeks to recover from the C-section and other ailments, during which time my mom, husband, dad, in-laws, aunts and other family members and friends took amazing care of me.
When I was coherent enough, I talked to my doctor about what I could have done to prevent my condition, and he told me preeclampsia was still a little bit of a medical mystery. However, commonalities among women that develop it include:
• First pregnancy
• Preeclampsia in a previous pregnancy
• Over 40 or under 18 years of age
• High blood pressure before pregnancy
• Diabetes before or during pregnancy
• Multiple gestations
• Obesity (BMI>30)
• Lupus or other autoimmune disorders
• Polycystic ovarian syndrome
• Large interval between pregnancies
• In vitro fertilization
• Sickle cell disease
• Preeclampsia on mother’s or father’s side of the family
• High blood pressure in family
Yeah, I had some of those -– it was my first pregnancy and my BMI was high. But, with a risk factor being “first pregnancy,” it could happen to anyone. I hate to think of what would have happened if I didn’t go to the doctor early enough, and I hope any ladies out there who are with child make their best effort to receive regular prenatal care. Preeclampsia isn’t fun, but you have a fighting chance if you catch it early.
*Note: Despite my preeclampsia, my flower bulbs wound up coming up! OK, the two are unrelated but it was still exciting for me.