New - Just want some clarification

Hi All,

I am new to this - and not even sre I should be here!!

I had my little girl 2.5years ago. This was my first pregnancy and I found out quite late in thatI was pregnant. I suffered from very high blood pressure during the pregnancy and was completely bloated. At one ante-natal (about 34 weeks) I had a reading of Protein +++. I was sent to hospital immediately for blood pressure check over 1 hour then told it was a false alarm. My bump semed to stop growing around this time. I told my Midwife my concerns but these were brushed off and I was told "people carry differently". When my little girl was born she was IUGR and weighed 1.72kg (3lb 12oz).

I am now pregnant with my second and have just had my booking in appt. I was told that my blood pressure is within normal range - but I have protein +++ again. The midwife doesn't seem concerned because my blood pressure isn't high - but I am worried this could cause the same problems again.

Should I be concerned that the midwife/Doctor don't seem concerned at this point? Is Protein+++ a problem at this point or are they right to ignore it at this point.

I would appreciate your advice.

Hi Sweetness,

Welcome to the site. I am sorry to hear of your experience of pre-eclampsia with your daughter but many congratulations too on your new pregnancy.

(I will reply as best I can here but will also PM you)

You are right to be concerned, as you have had PE in your first pregnancy this does increase the risk of you getting it again and as such any subsequent pregnancy needs to be managed as a 'higher risk'.
This should mean your care is Consultant level lead as s/he will have the experience & knowledge to manage your care effectively. He should consider starting you on baby dose aspirin and possibly heparin. Your monitoring should be increased & everyone (including you & your family) aware of the PRECOG guidelines.
The guidelines are like the 'Gold standard' of best possible practice and as such what you should expect from your care givers.

The happier news though is, IF you are to get PE again, (and I say if because although you are at a higher risk of recurrance, it is not the case that you will definately get it again) then it tends to follow the same or similar pattern as in the previous experience, up to 2 weeks later and generally speaking, less severe.

The fact that you already have protienuria at booking (so I am assuming you are about 12 weeks.) is significant. There is alot of research that is quite clear that protienuria is as much a significant feature if not more so than high blood pressure, so again you are right to demand that your care not be 'brushed off'. Having said that, is it possible you have a urine infection? This will also show as protein in the urine. Safest practice though, is to assume it is PE until it is proven clinically (by blood testing etc) that it is not.

I would suggest asking for either a 24 hour urine collection or a PCR (Protein / Creatinine ratio) urinalysis. If nothing else they will be baseline recordings. I would also suggest that you ask for a full liver & kidney function screen. If these organs are not working efficiently then this is likely to impact on you.

I would also be quite insistant that at 18-22 weeks a doppler scan is completed. This is a specialised scan that focusses on the efficiency of the placenta and is a very good tool in determining how likely PE is to occur in this pregnancy.

I do hope this helps but if I can offer you any more information or support, please do let me know.

Warmest wishes
Liz