PIH/HELLP In Subsequent Pregnancies
with a history of HELLP probably are at significant risk for the development
of pre-eclampsia with or without HELLP in the next pregnancy. HELLP has
up to a 27% chance of reoccurance in the next pregnancy. Especially
if it was class I HELLP.
Pre-eclampsia is more likely to
happen in a second pregnancy especially if HELLP and pre-eclampsia were
both diagnosed. Mild pre-eclampsia at term is less likely to recur (5-10%)
and when it does it's usually mild again.
characteristic of pre-eclampsia-eclampsia that is frequently overlooked
is the tendency of the condition to occur in daughters and sisters of women
with a history of pre-eclampsia (read
an article about autoimmune disorders that cluster among families).
Diabetes is frequently complicated
by pre-eclampsia, with the incidence stated to be as high as 50 percent
of diabetic pregnancies.
2 sources of support, encouragement
and information for those who are debating on getting pregnant again or
are pregnant again can check out the following mailing lists:
- The HELLP Syndrome List
- Post Preemie Pregnancy Group
One very important
suggestion is to have an Maternal Fetal Specialist or Ob that you trust.
One that you know will be concerned over entire pregnancy.
Ask your OB what measures he or she will be
taking to monitor this next pregnancy such as:
-The Basics -
Blood Pressure - at every visit
Urine - at every visit
Weight - at every visit
Although remember that only monitoring of the
platelet level will give a definte indicator of whether or not HELLP is
developing. Weight gain and some protine levels in the urine can
be considered normal for 3rd trimester pregnancies.
-Beyond the Basics -
*Liver function testing
*Amniotic Fluid monitoring
*Ultrasound to measure growth and fluid levels
*Frequent visits to your OB before during
and after the time HELLP manifested itself in your last pregnancy (with
*Non-Stress Testing during and after the time
HELLP manifested itself during your last pregnancy (with HELLP).
Ask your OB also:
Has your OB reviewed your last pregnancy with
Did he request the medical records from the
What chance does your OB think that you will
have HELLP or PRe-Eclmapsia again?
If you have had HELLP and still have health
problems or are considering getting pregnant again after HELLP discuss
with your OB further testing to help guide yourself to a healthy pregnancy.
Does he see any signs of any autoimmune disorders
that you should be tested for such as Systemic
Lupus Erythematosus and Antiphospholipid Antibodies ?
Autoimmune testing should include:
1.Lieden Factor V mutation R560Q (DNA test
2.Hyperhomocysteinemia MTHFR Mutation (DNA
3.Prothrombin Gene Mutation 20210 (GA) DNA
test by PCR
4.Protein C levels;
5.Protein S levels; and
6.Activated Protein C activity.
1.Antibodies to six phospholipids of the IgM,
and IgA classes;
2.Lupus anticoagulant antibody;
3.Russell Viper Venom Time;
4.Activated Partial Thromboplastin Time (APTT);
5.and Prothrombin Time (PT), Partial Prothrombin
Don't stop asking your OB about
something that bothers or concerns you until you get an answer that you
are comfortable with. If you feel like you have the flu, if you think
that baby isn't moving enough, if you have indigestion that won't go away
call your OB even if it's after hours and if you are still concerned go
to the hospital.
looking for more HELLP information? Prevention
take you to the next page. Also if you have a HELLP story to share
please stop by the HELLP
Syndrome Birth Stories Page and leave or read a story. Here you
will also find up to date HELLP/Pre-E net articles and books. You
wil also find WebRing information at the above listed url.