Pregnancy Bliss | Reproductive Health Answers
Pre-eclamsia (APEC) + Miscarriage (MA) + Postnatal Illness (APNI) + Breast Feeding (ABM) + Active Birth (ABC)
I have had pre-eclampsia for the second time. Why wasn't I warned I could get it again?
When you have suffered from pre-eclampsia, part of the postnatal information that will be given is the estimated risk of a recurrence. The estimate is very crude and is nowhere near accurate. If, indeed this information was not given, then that is a significant omission. Sometimes, the information may take the form of, "Oh, it is unlikely that it will happen again," which is factually correct but which may have been taken to mean that it could never happen. It is important to ensure that the mother and the doctor are on the same wavelength when discussing such important matters.
Why does changing your partner make a difference?
It is a known fact that some women who have had problem free pregnancies in the past suddenly develop pre-eclampsia when they conceive following a change of partner. Why this is the case is not clearly understood. However, the hypothesis goes to the suspected root cause of the problem, which is thought to be immunological. The interaction of maternal and paternal immunological factors in the placenta may lead to conditions that are conducive for pre-eclampsia to develop. While the former partner may not produce this reaction, the subsequent partner, purely by chance, may produce the ideal conditions for this to happen.
Yes, it is true that a change of partner may lead to preeclampsia for one who has not suffered it before, but it is not, strictly speaking, a risk factor. It is purely chance. Some women go through five or six partners, each union blessed with a child or two, with not so much as a whiff of hypertension.
Giving credence to the immunological interaction hypothesis is the fact that unions between very close blood relatives (consanguineous) very rarely lead to pre-eclampsia.… not that we are suggesting anything!
Why did I get pre-eclampsia in my second or third pregnancy and not my first?
There is the issue of changed partner discussed above. If that does not apply to you, it may be that you are one of those with latent hypertension, where the pregnancy has just helped to unmask it through pre-eclampsia. This is plausible because the condition, even in its latent form, may not have developed yet in the first pregnancy, especially if there is a gap of a few years.
Another aspect may be the type of pregnancy: Are you carrying twins this time around? It is a known fact that multiple pregnancy increases the risk of pre-eclampsia. In other cases, an explanation remains elusive.
Should I warn my younger sister that she is at risk?
No. The evidence that this condition may run in families is very weak. Such advice would be misguided. Her chances of getting the complication are the average one in twenty, unless she has a specific risk factor. Being your sister is not one of them.
Will my daughter get it when she becomes pregnant?
Again, the answer should be in the negative. Your daughter will not be at increased risk of getting pre-eclampsia by virtue of being your daughter
The contact address for Action on Pre-eclampsia (APEC) is:
84-88 Pinner Road
HARROW, Middlesex HAl 4HZ
UK
Tel: 0208-427 4217 (Helpline): This is open daily
Fax: 0208-424 0653