Rare But Devastating- Read As Nurse Practitioner, Kerry Shares Her Battle With Preeclampsia
A woman who had experienced Preeclampsia has shared her story. A sharp, vivacious, and vibrant 36-year-old nurse practitioner, Kerry seems like the last person you’d imagine developing preeclampsia, a poorly understood pregnancy condition characterized by high blood pressure and other signs of organ damage.
Of course, that is part of what makes preeclampsia so dangerous. It affects 2-8% of all pregnancies, yet it’s difficult to know whom it will strike, or how it will proceed. Its disease course is notoriously unpredictable.
The best known risk factors—pre-existing diabetes, autoimmune diseases, kidney problems, or high blood pressure, carrying multiples, preeclampsia in a prior pregnancy—flag only a tiny fraction of the women who develop preeclampsia. Most have none of these risk factors.
Pregnant for the first time, everything proceeded smoothly for Kerry until 34 weeks. Then she noticed her ankles and feet had swollen and her whole body felt sluggish. As a nurse practitioner, she knew her symptoms could signal more than just third trimester malaise. They were common warning signs of preeclampsia.
Kerry, according to a health related site, BloomLife.com, immediately checked her blood pressure with an at-home monitor. It measured 170/110. Dangerously high. (Over 140/90 is high; over 160/100 is considered severe.)
She then called her doctor. Later that day, when her doctor rechecked her blood pressure, it had dropped a bit, to 160/100, but was still clearly high. Her doctor diagnosed her with “mild preeclampsia” and prescribed Labetalol, a blood pressure lowering medication.
Over the next two weeks, she monitored her blood pressure mostly at home, and seeing her doctor for bi-weekly checkups. It remained elevated. Twice her doctor increased her medication dosage. She recalls:
READ ALSO: Pre-eclampsia: An Expectant Nigerian Mom, Toyin Ajibade’s Nightmare
“On the day of my baby shower… my face was very swollen and my systolic were 170s. I called the office to make them aware. The doctor said, ‘You can come in if you want, but we won’t induce because of high blood pressure alone so we mostly would tell you to keep monitoring.’ So I stayed home.”
In its latest clinical bulletin, published in early 2019, the American College of Obstetricians and Gynecologists considers any blood pressure readings above 160/110 a “severe feature”—one signaling a high risk of future serious complications for the mother and her baby and a clear indication for inducing labor.
Other severe features include low platelet counts, elevated liver enzymes, visual disturbances such as seeing floaters, fluid in the lungs, and signs of kidney dysfunction.
At 36 weeks 2 days, Kerry went in for a fetal nonstress test to check on her baby. Instead of showing variability with movement, his heart rate remained stable, a sign of fetal distress.
Like many women with preeclampsia without other severe symptoms (such as signs of liver dysfunction, abdominal pain, or brain swelling), Kerry was scheduled for an induction at 37 weeks 0 days.
Preeclampsia often, but not always, resolves shortly after delivery, making early delivery a common treatment. So common, in fact, that preeclampsia accounts for 15% of all preterm births in the U.S.
At 36 weeks, Kerry and her baby fell in a medical gray zone, one where doctors must balance the risks from preeclampsia to the pregnant mother and her developing baby with the risks of preterm delivery for the baby.
According to the American College of Obstetricians and Gynecologists (ACOG), the risks of waiting until 37 weeks for the mother include severe hypertension, eclampsia (seizures) fetal death in utero, and placental abruption, a life threatening condition in which the placenta detaches from the uterine wall.
But these outcomes are uncommon, and they must be weighed against the risks of early delivery for the baby: long NICU stays, early breathing problems, and death. It is a balance without a fulcrum.
ACOG therefore stresses the importance of careful monitoring of mom and baby, and informed, in depth discussions between women and their providers about the possible risks and benefits of waiting to deliver.
For Kerry waiting did not bring a happy ending. At 36 weeks 4 days gestation, mere days before her scheduled induction, the technician at her follow-up ultrasound, had difficulty finding a heartbeat. Her baby had died.
The next hours were a blur. She remembers being induced and laboring for 18 hours. She remembers her OB sobbing as she delivered Kerry’s lifeless son.
SEE ALSO: Pre-eclampsia Risk During Pregnancy Lowered With High-Fibre Diet- Study
Stillbirth, like Kerry experienced, is a rare but devastating complication of pregnancy. It affects only 4 out of 1000 pregnancies in the U.S. For women with preeclampsia, it is slightly more common–rising to 6-10 in 1000.
For all the pain that she suffered, Kerry has refused to let her tragedy consume her. She has blogged extensively about her experience and freely shared her story so that other women might know about the potential risks of preeclampsia.
To that end, she has joined national groups like Preeclampsia, Eclampsia & HELLP Syndrome Survivors, a Facebook group run by preeclampsia educators, who work to raise awareness , provide an online community for those affected, and advocate for a cure.