Tuesday, October 31, 2006

Welcome to the PE Survivors Blog

Preeclampsia Survivors is proud to announce our newest addition to the preeclampsia community: our blog

http://preeclampsiasurvivors.blogspot.com

Some of you may know about blogs, and others may not. So, here goes. A blog is a website where entries are made in journal style. A typical blog combines text, images, and links to other blogs, web pages, and other media related to its topic. The term "blog" is a contraction of "Web log." "Blog" can also be used as a verb, meaning to maintain or add content to a blog.

So why did we decide to create a blog? Well, there are many reasons, but our first priority is to find other preeclampsia survivors in cyberspace and help them to feel less alone. This leads to our blog’s theme which is “a beacon of light in the storm of preeclampsia and beyond.”

Since most of us have experienced how preeclampsia can be such an isolating experience, our blog will be a place of support, hope, and information. While we are not medical experts, we can share our experience and provide support to one another. We do this everyday on this discussion board, but we’d like to reach out to more preeclampsia survivors in the blogging community. I personally have found many other bloggers who have suffered from preeclampsia, which is what inspired the idea for this blog.

Our blog will be a permanent place of information. It is easily searchable, and topics can be categorized. For example, there is already a place on the blog for preeclampsia stories. The blog will not replace our discussion board though. It is and always will be a place to come and support one another on a day-to-day basis.

Our blog is now registered on various blog search engines, and we’ve included an option for individuals to sign up for a subscription service which notifies them when the blog is updated.

Finally, you may be wondering how you can participate in our blog. Well, you can:
* Read posts
* Leave comments regarding posts
* Tell others about the blog
* Share your experiences by contributing content to the blog
* Provide feedback on the blog
* Post links to the blog on your personal web pages

As our blog coordinator, I invite you to ask any questions about the blog by email at pesurvivorsATgmailDOTcom

I’d love to post your stories or enable you with the ability to post your own content to this blog. We’d love to have regular bloggers posting on our blog. Let me know if that is something in which you’d be interested. With time, our blog will grow and the information will become more abundant. I guess you could say our blog is in its infancy right now. If we nurture it carefully, it will be a place of hope and inspiration to people affected by preeclampsia.

Thanks in advance for helping us to make this a success.

Tuesday, October 24, 2006

Preeclampsia

Alternative names: Toxemia; Pregnancy-induced hypertension

Definition
Preeclampsia is the development of elevated blood pressure and protein in the urine after the 20th week of pregnancy. It may be associated with swelling of the face and hands.

Causes, incidence, and risk factors


The exact cause of preeclampsia is not known. Many unproved theories of potential causes exist, including genetic, dietary, vascular (blood vessel), and autoimmune factors.

Preeclampsia occurs in approximately 8% of all pregnancies. Increased risk is associated with first pregnancies, advanced maternal age, African-American heritage, multiple pregnancies, and a past history of diabetes, high blood pressure, or kidney disease.

Symptoms

* Edema (swelling of the hands and face present upon arising)
* Weight gain
* In excess of 2 pounds per week
* Of sudden onset, over 1 to 2 days
* Headaches
Note: Some swelling of the feet and ankles is considered normal with pregnancy.

Additional symptoms that may be associated with this disease:

* Decreased urine output
* Nausea and vomiting
* Facial swelling
* High blood pressure
* Agitation
* Vision changes (flashing lights in the eyes)
* Abdominal pain

Signs and tests

* Documented weight gain
* Swelling in the upper body
* Elevated blood pressure
* Proteinuria (protein noted in urine)
* Thrombocytopenia (platelet count less than 100,000)
* Elevated liver function tests
* Preeclampsia may also alter the results of some laboratory tests.

Treatment

Currently, the only way to cure preeclampsia is to deliver the baby. However, if that delivery would be very premature, the disease may be managed by bed rest, close monitoring, and delivery as soon as the fetus has a good chance of surviving outside the womb.

Patients are usually hospitalized, but occasionally they may be managed on an outpatient basis with careful monitoring of blood pressure, urine checks for protein, and weight.

Optimally, attempts are made to manage the condition until a delivery after 36 weeks of pregnancy can be achieved.

Labor may be induced if any of the following occur:

* Diastolic blood pressure greater than 100 mmHg consistently for a 24 hour period, or any confirmed reading over 110 mmHg
* Persistent or severe headache
* Abdominal pain
* Abnormal liver function tests
* Rising serum creatinine
* HELLP syndrome
* Pulmonary edema (fluid in lungs)
* Eclampsia
* Thrombocytopenia (low platelet count)
* Non-reassuring fetal monitoring tracings
* Failure of fetal growth noted by ultrasound
* Abnormal biophysical profile (a test to monitor the health of the fetus)

In cases of severe preeclampsia when the pregnancy is between 32 and 34 weeks, delivery is the treatment of choice. For pregnancies less than 24 weeks, the induction of labor is recommended, although the likelihood that the fetus will survive is very small.

Prolonging pregnancies has been shown to result in maternal complications, as well as infant death in approximately 87% of cases. Pregnancies between 24 and 34 weeks gestation present a "gray zone," and the medical team and the parents may decide to attempt to delay delivery in order to allow the fetus to mature.

During this time, the mother is treated with steroid injections which help speed the maturity of some fetal organs including the lungs. The mother and baby are closely monitored for complications.

During induction of labor and delivery, medications are given to prevent seizures and to keep blood pressure under good control. The decision for vaginal delivery versus Cesarean section is based on how well the fetus is able to tolerate labor.

Expectations (prognosis)

Maternal deaths caused by preeclampsia are rare in the U.S. Fetal or perinatal deaths are high and generally decrease as the fetus matures. The risk of recurrent preeclampsia in subsequent pregnancies is approximately 33%. Preeclampsia does not appear to lead to chronic high blood pressure.

Complications

Preeclampsia may develop into eclampsia, the occurrence of seizures. Fetal complications may occur because of prematurity at time of delivery.

Calling your health care provider

Call your health care provider if symptoms occur during pregnancy.

Prevention

Although there are currently no known prevention methods, it is important for all pregnant women to obtain early and ongoing prenatal care. This allows for the early recognition and treatment of conditions such as preeclampsia.


Update Date: 8/8/2005

Updated by: Sharon Roseanne Thompson, M.D., M.P.H., Clinical Fellow, Department of Obstetrics & Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.


Source: http://www.nlm.nih.gov/medlineplus/ency/article/000898.htm

Grief and Loss

Posts about grief and loss here

Parents of Preemies

Posts regarding preemies here.

Monday, October 23, 2006

Tribute to Dr. Giles

When I was pregnant with my oldest daughter, Grace, I developed severe preeclampsia. A c-section later and a few days post partum, I was still being treated with a life saving drug called Magnesium Sulfate and a narcotic for pain relief.I'm not certain which medication gave me halucinations, but I had them. Visions of baby faces, foot prints, and bugs...the creepy, crawling version. Needless to say, I became quite distraught at what was appearing before my eyes. It was 2:00 AM, and I was not sleeping. My husband, Charlie, was stretched out on the equilavent of bamboo mat passed out. I started freaking out, and he didn't wake up. I called the nurse and explained the creepy, crawlies and baby faces/foot prints. All the while, I'm thinking: "Am I insane?"

Soon after, Dr. Giles, a second year resident, walked into my room. I asked him if I was going insane. He said, "I don't know you very well so I can't answer that question." Dr. Giles then turned to the sleeping hump also known as my husband and said, "Hey, is your wife insane?" In his sleepy stupor, Charlie grumbled, "Yes, very." To which, I became a crying ball of post partum emotions, high blood pressure, and tears. The doctor didn't seem too impressed by my description. Dr. Giles discontinued the magnesium sulfate and my PCA for pain relief.

By morning, I became a normal emotional post partum mommy, but I didn't see any more visions. Hooray!The next morning, I remember thinking that doctor was a jerk. He seemed annoyed by being awaken at 2:00 AM and dealing with me, an "emotional" mommy. )Looking back on it, I can see how he was tired, and had probably been on rotation for more than 24 hours.) For quite some time after, I replayed the scene in my head. It was a low point for me in my preeclampsia and NICU journey.

A little more than two years later, I was inpatient in the hospital again pregnant with my second daughter, Meghan. I was almost 27 weeks along with soaring blood pressure, a baby that was too small (IUGR), about 40 pounds of swelling, and the worst headache of my life. Preeclampsia was back with a vengence.

It was day 8 of bedrest, and I noticed that my baby had not been moving around as much. It was a Sunday, and there were several mommies on my antepartum floor whose pregnancies were giving the nurses and doctors much to do. Well, it took what seemed like forever for my nurse to come. She finally came, and hooked me up to a fetal heart monitor. Within two minutes, nurse Yulia was watching and listening to the monitor with a concerned look on her face. She quickly left the room, which gave me some anxiety. When she returned, she walked into the room with Dr. Giles, who was now the chief OB resident.

Needless to say, I was none too happy to see Dr. Giles. I'm not sure what experiences Dr. Giles had been through in the prior two years, but he was a completely different man. His dedication to his chosen profession, desire to answer my questions, and general bed side manner were exceptional. He explained that my baby was experiencing heart decelerations, which meant fetal distress. I would need to be sent to Labor and Delivery to start the dreaded Mag. This also meant that my baby would be coming 13 weeks too soon. 13 weeks! Crap!

I had been trying to prepare myself for this reality all the while on bedrest, but it hadn't quite sunk in yet. I had been a NICU mom with Gracie, but she was only 6 weeks early...small, but mostly healthy. This baby would be around 1 1/2 pounds and need immediate ventilation support. Her chances of survival within the first 4 days would only be 75%. There were so many risks to my dear sweet baby still growing (albeit quite slowly) inside of me...too many to comprehend completely.

For twenty minutes, Dr. Giles sat down in a chair while carefully, quietly, calmly, and lovingly walking me and my husband through what was about to unfold. He also explained that I'd probably have preeclampsia with any future pregnancies. Before he left the room, he walked over to my bed. While touching my hand, he said, "I hope this turns out okay for you Jennifer. Good luck." How Dr. Giles morphed from "that jerk doctor" into a genuine caring human being I'll never know. But I do know that I'll always remember his kindness and concern. So, Dr. Giles, I pay tribute to your growth and how in the end, all became right in my world. I delivered Meghan Rose the next day weighing 1 pound, 9.5 ounces. She was cared for in the NICU for 79 days, and then came home to our loving arms. Meghan is our living, breathing miracle.