Preeclampsia

[matrips]

This came up while I was looking for information on cytokines.  Just wanted to put it out there in case someone else wanted to look more into it.  I know many of us have suffered from preeclampsia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555132/

[kbutton]

I believe that both pre-ecclampsia and cytokines are also mentioned in some of the literature on antiphospholipid antibody syndrome (clotting disorder that presents many other ways with many other complications), especially catastrophic APS if anyone is interested in googling it.

Studies and information on how APS presents beyond the lupus community and pregnancy loss community are starting to pile up. I am hoping they get to the bottom of the genetics of it soon--it is known to sometimes run in families, but so far, it's not straightforward. Getting testing is difficult if you're not having multiple miscarriages or lupus, though I have no idea why doctors are so resistant to testing for it.

[happypamama]

I only skimmed the article a bit because preeclampsia caught my eye. They have found that women who get PE do tend to be low in vitamin D, but supplementing vitamin D has not been found to make a difference in PE rates. Blood thinners help prevent clots in moms with clotting disorders but don't prevent PE either. Calcium may help in women with extremely low dietary calcium intake, such as found in developing countries, not like "does not eat a lot of yogurt" diets. As of yet, the only thing shown to prevent PE, and only in a few women, is low dose aspirin, started by the late first trimester. 

 

Someday. . . Someday we will have a prevention and a cure, I hope. 

[BeachGal]

Fewer than 10% of pregnant women are getting the adequate intake (AI, a guesstimate) of choline which plays a major role in preventing pre-eclampsia.

Quote

During pregnancy, extra maternal choline reduces a woman’s risk of developing pre-eclampsia or having a baby with neural-tube defects, and babies born to moms who got ample choline have lower levels of the stress hormone cortisol. Caudill said these “choline babies” may have a lower lifetime risk of developing stress-related diseases like high blood pressure, type 2 diabetes and depression. After birth, choline continues to be vital for normal brain development in the infant and young child.

 

https://www.seattletimes.com/life/wellness/choline-the-essential-but-forgotten-nutrient/

Some people also need more choline than others due to their genetics. Chris Masterjohn has some articles online that explains this and more in detail.

https://chrismasterjohnphd.com/?sfid=1177&_sf_s=choline

 

Edited February 14, 2020 by BeachGal

[happypamama]

12 minutes ago, BeachGal said:

Fewer than 10% of pregnant women are getting the adequate intake (AI, a guesstimate) of choline which plays a major role in preventing pre-eclampsia.

 

https://www.seattletimes.com/life/wellness/choline-the-essential-but-forgotten-nutrient/

Some people also need more choline than others due to their genetics. Chris Masterjohn has some articles online that explains this and more in detail.

https://chrismasterjohnphd.com/?sfid=1177&_sf_s=choline

 

If more than 90% of women don't get enough choline, then why don't 90% of women have pregnancy complications?  PE only affects 5-8% of pregnancies, so why don't the rest of the women who don't get enough choline get PE?

And with basically the same diet (in fact, probably more eggs in the later ones), why did I only get PE in the sixth one and postpartum with the seventh?

[BeachGal]

36 minutes ago, happypamama said:

If more than 90% of women don't get enough choline, then why don't 90% of women have pregnancy complications?  PE only affects 5-8% of pregnancies, so why don't the rest of the women who don't get enough choline get PE?

And with basically the same diet (in fact, probably more eggs in the later ones), why did I only get PE in the sixth one and postpartum with the seventh?

 

Most women might be getting just enough choline to keep their placenta healthy especially if their bodies are taking it from other elsewhere such as moving fat out of the mother's liver, which is another thing choline does.

Choline deficiency is only one of a number of factors that are believed to cause pre-eclampsia. The article isn't saying it's the only factor, just an important one that has only been studied in the past two decades or so.

The problem with choline is that it's not really known how much a person or even a population needs. Currently, it's based on adequate intake which is an educated guess. Pregnant women, however, do need more, and in the past few years, there's been a push for manufacturers of prenatal vitamins to increase the choline.

[matrips]

Other research I was doing in cytokines last night also pointed to a genetic link/mutation in people prone to cytokine storms.  I guess I got the impression that a cytokine storm and preeclampsia could be related. And there has been work done on helping those prone to cytokine storms/inflammation issues. 

I had preeclampsia in my only pregnancy, but I also had triplets.  So they were on the lookout for it my whole pregnancy.  But I’m not sure I remember anything about Vitamin D (15 years ago).  I remember iron supplements and folic acid. I’m seeing quite a few links when googling that mention the importance of Vitamin D during pregnancy, even while they do say more research is necessary to verify the claims.  I’m glad research is being done.  It’s a heartbreaking condition for so many.

[JustEm]

I've had preeclampsia twice. My csection for this baby is Monday and they have been monitoring me closely since at 24 weeks my blood pressure was already showing signs of creeping up. I've been on baby aspirin and Labetalol most of the pregnancy. No mention of vitamin d being something to help decrease the risks.

It fascinates me how little they know about ways to prevent preeclampsia.

[LarlaB]

3 hours ago, kbutton said:

I believe that both pre-ecclampsia and cytokines are also mentioned in some of the literature on antiphospholipid antibody syndrome (clotting disorder that presents many other ways with many other complications), especially catastrophic APS if anyone is interested in googling it.

Studies and information on how APS presents beyond the lupus community and pregnancy loss community are starting to pile up. I am hoping they get to the bottom of the genetics of it soon--it is known to sometimes run in families, but so far, it's not straightforward. Getting testing is difficult if you're not having multiple miscarriages or lupus, though I have no idea why doctors are so resistant to testing for it.

I was just diagnosed with APS last month.  History of multiple miscarriages, preeclampsia, migraines, livedo reticularis and so on.  For DS, the pregnancy where I had high BP and preeclampsia, I also had a clot/thrombosis on the umbilical cord, next to placenta. DS & I were very fortunate. 

I’m now on a blood thinner for life and it is helping with my chronic headaches.

It baffles me in many regards, how little is known and researched for women’s health issues.  Why isn’t a simple blood test administered more often?  Why do we have to endure multiple devastating miscarriages before we “look into it”?  And don’t ge time started on preeclampsia.  It’s like Drs know little more than they did 50 years ago.

I won’t drag out my soapbox, but I have more medical issues (Postural Orthostatic Tachycardia Syndrome-POTS, being one of them) which demographic wise, affects primarily women.  Very little is known and very little significant research is being done.  Most POTS patients are at some point, usually treated as “hysterical women” who only have anxiety disorders.  It’s deeply angers me to see the inequality in medicine. 

[happypamama]

59 minutes ago, hjffkj said:

I've had preeclampsia twice. My csection for this baby is Monday and they have been monitoring me closely since at 24 weeks my blood pressure was already showing signs of creeping up. I've been on baby aspirin and Labetalol most of the pregnancy. No mention of vitamin d being something to help decrease the risks.

It fascinates me how little they know about ways to prevent preeclampsia.

Part of the reason for that is because preeclampsia itself is a symptom of a conflict between the Mother's body and the placenta that then leads to a cascade of other symptoms. The problem is that there can be a lot of reasons for that conflict, and it can develop along different pathways. So for one couple, it might be that their genes just don't play well together and make placentas that her body can tolerate. Some mothers get it right at term in their first pregnancy because their body just hasn't done that before, and then they're fine the next time. Some others (yours truly) have underlying conditions, known or unknown, that contribute. Sometimes it's a genetic issue in the baby. And so on. It's really, really complicated! We know a ton more than we did fifteen years ago, but research is ever ongoing. 

 

Good luck Monday @hjffkj!!!

[Junie]

1 hour ago, hjffkj said:

I've had preeclampsia twice. My csection for this baby is Monday and they have been monitoring me closely since at 24 weeks my blood pressure was already showing signs of creeping up. I've been on baby aspirin and Labetalol most of the pregnancy. No mention of vitamin d being something to help decrease the risks.

It fascinates me how little they know about ways to prevent preeclampsia.

Best wishes for a safe delivery!

[kbutton]

2 hours ago, LarlaB said:

I was just diagnosed with APS last month.  History of multiple miscarriages, preeclampsia, migraines, livedo reticularis and so on.  For DS, the pregnancy where I had high BP and preeclampsia, I also had a clot/thrombosis on the umbilical cord, next to placenta. DS & I were very fortunate. 

I’m now on a blood thinner for life and it is helping with my chronic headaches.

It baffles me in many regards, how little is known and researched for women’s health issues.  Why isn’t a simple blood test administered more often?  Why do we have to endure multiple devastating miscarriages before we “look into it”?  And don’t ge time started on preeclampsia.  It’s like Drs know little more than they did 50 years ago.

I won’t drag out my soapbox, but I have more medical issues (Postural Orthostatic Tachycardia Syndrome-POTS, being one of them) which demographic wise, affects primarily women.  Very little is known and very little significant research is being done.  Most POTS patients are at some point, usually treated as “hysterical women” who only have anxiety disorders.  It’s deeply angers me to see the inequality in medicine. 

In my family, the only person who has a diagnosis is male, and another male in the family who has very clear signs of it has been told there is no point in testing since he's now on blood thinners for life (even though a diagnosis would add more data to the pile, allow for him to have the best treatments as research catches up, etc.), and with his brother having it, he should assume he does. There are females who have symptoms consistent with APS, but most of them had really rare stuff that has only been recently associated with APS, and the issues are spread out over several generations (bowel/esophageal ruptures that were likely from micro-clotting, leg ulcers, etc.). My grandmother had multiple signs and symptoms but only one non-live birth (stillborn, deformed baby, far enough along to require burial). 

With pre-e, I don't have APS (my levels are not diagnosable, but apparently they are higher than the normal range? would be nice to know what that means!), and my pre-e was not diagnosed (2nd pregnancy). It was tested for, and I was just barely short of the standard at the time, so they didn't treat me. I have read newer guidelines, and the same issues now would be diagnosed as pre-e. It's so frustrating! I hemorrhaged with that birth (not caught right away--it was nuts). 

Family history of migraines is at least three generations. We have a lot of family members with POTS-like symptoms but nobody severe enough to have been diagnosed so far.

[happypamama]

52 minutes ago, Arctic Mama said:

That would be my question.  Sigh.  If only diet helped, I’d feel a lot better about trying again.

I know, mama. It's so hard. I wish I could tell you something more concrete.

[Guest]

I had none of the APS antibodies, or any of the known or suspected causes when tested after my severe HELLP pregnancy. In my 2nd pregnancy, I was part of a study and was on low dose aspirin, vitamin D, B6, and C, plus folate, with a carefully monitored diet. I ended up on Phenobarbital for seizure activity, and Vitamin K  from about 30 weeks because my clotting was slowed from the phenobarbital and there were concerns since I had to have a C-section. I made it to 34 weeks, but still have no clue what worked (and ended up being unable to carry past about 8-10 weeks). At the time, the top researcher on HELLP was local to me, and as soon as my pregnancy was diagnosed, I was enrolled in the study, which also let me be followed closer than my insurance really wanted to pay for. (I have a full baby book just of high level ultrasounds). 

 

I was later DX'd with Hashimoto's and LADA, and my endocrinologist, who specializes in women of reproductive age and reproductive endocrinology says my medical records are full of red flags for autoimmune issues, and is frustrated that I was apparently not tested for such. She believes that I almost certainly had thyroid involvement and unstable blood sugar in both pregnancies, and that if I had been properly tested and diagnosed, at minimum, after the HELLP pregnancy, and been supported and monitored, my second pregnancy might have been a lot less harrowing-and I might have been able to have a 3rd. 

I also have a long-time history of migraines, including basilar arterial migraine, and blood pressure swings related to  migraines. 

 

DD says she is never going to have biological children, and I know a lot of it is fear. And, honestly, I can't blame her, because I am scared of the idea of pregnancy for her, too. There is just too much uncertainty, and I don't want her to go through what I did. 

Edited February 15, 2020 by dmmetler

[matrips]

15 hours ago, hjffkj said:

My csection for this baby is Monday and they have been monitoring me closely since at 24 weeks my blood pressure was already showing signs of creeping up. I've been on baby aspirin and Labetalol most of the pregnancy. No mention of vitamin d being something to help decrease the risks.

Praying for a healthy outcome for you and your baby on Monday 🤗

So your doctor doesn’t have you on Vitamin D?  I wonder why.  Everything I look up seems to emphasize D during pregnancies, pre-e or not.

[mumto2]

On 2/14/2020 at 7:00 PM, hjffkj said:

I've had preeclampsia twice. My csection for this baby is Monday and they have been monitoring me closely since at 24 weeks my blood pressure was already showing signs of creeping up. I've been on baby aspirin and Labetalol most of the pregnancy. No mention of vitamin d being something to help decrease the risks.

It fascinates me how little they know about ways to prevent preeclampsia.

Sending prayers for a good outcome tomorrow.......

[JustEm]

Thank you all. I'm heading to the hospital in about a half hour. Surgery is at 1. I'm equally excited and anxious. I know everything will be fine but there is always the voice saying 'what if.'