Preeclampsia: Risks, Symptoms, and Future Pregnancies

Preeclampsia

Hello, doctor.
Last year, I gave birth to my first child at the age of 36.
My blood pressure started to rise at 33 weeks of pregnancy, reaching 160 by 36 weeks.
There were abnormalities in my liver function, but I forgot the values.
The doctor indicated that I had developed preeclampsia, so I was induced at 37 weeks and 0 days.
During the induction process, I could not receive pain relief due to abnormal coagulation function.
I would like to ask the doctor:
1.
Is abnormal coagulation function a common occurrence in preeclampsia? The diagnosis certificate noted HELLP syndrome.

2.
Now that I am 37 years old, is it suitable for me to prepare for a second pregnancy given the circumstances of my first? If all goes well, I would be 38 or 39 at the time of delivery.

3.
During the induction process, I was administered magnesium sulfate.
Although it was a natural birth, I experienced full-body weakness and was unable to get out of bed for the first two days.
On the third day, I could only sit in a wheelchair.
Is this a side effect of magnesium sulfate?
4.
Is cesarean delivery more suitable for preeclampsia? The induction process was very painful, and I was constantly worried about my blood pressure rising and the risk of stroke.
It took two weeks postpartum for my blood pressure to return to normal values.
Thank you.

Niming, 30~39 year old female. Ask Date: 2017/06/15

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, coagulation dysfunction is not a necessary diagnosis for preeclampsia, but it can occur in severe cases.
The next pregnancy does not necessarily mean that preeclampsia will occur.
Administration of magnesium sulfate generally does not lead to generalized weakness postpartum.
Preeclampsia is not an indication for cesarean delivery.
Wishing you good health.

Reply Date: 2017/06/15

More Info

Preeclampsia is a serious condition that can occur during pregnancy, characterized by high blood pressure and signs of damage to other organ systems, most often the liver and kidneys. Your experience with preeclampsia and HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelet count) raises several important considerations for future pregnancies.

1. Coagulation Abnormalities in Preeclampsia: It is not uncommon for women with preeclampsia to experience coagulation abnormalities, which can manifest as HELLP syndrome. This condition can lead to increased risk of bleeding and clotting issues during and after delivery. The presence of HELLP syndrome indicates a more severe form of preeclampsia, which can complicate both the pregnancy and delivery. While not every case of preeclampsia results in coagulation issues, the risk is certainly heightened, and close monitoring is essential.

2. Planning for a Second Pregnancy: Given your history of preeclampsia and HELLP syndrome, it is crucial to consult with a maternal-fetal medicine specialist before attempting to conceive again. While many women with a history of preeclampsia go on to have successful pregnancies, the risks associated with advanced maternal age (37 years and older) and previous complications must be carefully managed. Your healthcare provider may recommend a preconception counseling session to discuss your specific risks and the potential need for closer monitoring in subsequent pregnancies.

3. Magnesium Sulfate Side Effects: Magnesium sulfate is commonly administered to prevent seizures in women with severe preeclampsia or eclampsia. While it is effective in this regard, it can cause side effects, including muscle weakness, fatigue, and lethargy. The symptoms you experienced post-delivery, such as difficulty getting out of bed and needing a wheelchair, could indeed be attributed to the effects of magnesium sulfate. These symptoms typically resolve within a few days after the medication is discontinued, but it is important to communicate any lingering concerns to your healthcare provider.

4. Delivery Method Considerations: The decision between vaginal delivery and cesarean section in the context of preeclampsia depends on various factors, including the severity of the condition, the health of the mother and fetus, and the progression of labor. While cesarean delivery may be considered in cases of severe preeclampsia or HELLP syndrome, many women successfully deliver vaginally. However, the fear of complications such as stroke due to high blood pressure during labor is valid. It is essential to have a well-prepared birth plan that includes strategies for managing blood pressure and pain during labor, as well as a clear understanding of when a cesarean may be necessary.

In summary, your experience with preeclampsia and HELLP syndrome highlights the importance of careful planning and monitoring for future pregnancies. Consulting with a specialist can provide you with tailored advice and support, ensuring that both you and your future baby are as healthy as possible. Additionally, understanding the implications of magnesium sulfate and the delivery method can help you make informed decisions moving forward. Always feel empowered to discuss your concerns and preferences with your healthcare team to ensure the best outcomes for you and your family.

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Hello, I have previously responded to your question. Wishing you good health.