Pre-e and the risks of another pregnancy?

Hi ladies, I'd love some feedback about this scenario.

I've had T1 for over 30y, hypothyroidism, PCOS. I'm 32, almost 33. In October of 2010 we gave birth (heck, who am I kidding, *I* gave birth!) to our daughter who's healthy and happy and active. I had a great pregnancy, kept by A1c's in the 5's and 6's, and felt great until the end. I developed hypertension in the last 8 weeks, and full blown pre-eclampsia when I hit the labor deck at 39w1d. I was apparently pretty sick (they pumped me full of magnesium sulfate, tons of fluids of various kinds, and I was severely hypertensive for days, developed pulmonary edema). I will say, though, that the "sick" was about the pre-e, not the diabetes (though I know the latter made me at risk for the former).

We want another baby. bad. I met with my OB (community, not high-risk OB) who basically said "count your blessings. you're healthy. your baby is healthy. call it quits". I almost screamed. and cried. But I went to a high risk OB for a preconception consult and she basically said, "look, all the stuff that made you high risk before still makes you high risk now. but because you developed pre-e, your risk of getting it again doubles, as do the risks of a pre-term delivery and super preemie baby". Now, mind you, the risks doubling look like this: risk of pre-e went from 10% to 20%, risk of delivery before 37 weeks goes from 10 to 20% and risk of severe prematurity (<28 weeks) goes from 1 to 2%. How the heck am I supposed to know whether these are "acceptable" risks? I mean, if pre-e comes back, it could some whenever it wants, and the cure is delivery. So if it comes at 29 weeks, or 39 weeks, same outcome, but different consequences for baby. I am scared about starting down this road and running into trouble (esp with a toddler at home) but I also am so committed to the idea of having a sib for our little girl (and for various and sundry reasons, adoption and surrogacy aren't options for us right now).

Would love some perspective. :) thanks!

You certainly have a lot to consider....not an easy one, I'm sure.

I don't have any personal experience myself with pre-e, but a close friend of mine (not a diabetic) developed pre-e in her first pregnancy and her baby was born early, at 34 weeks. She was in pretty rough shape, baby was in NICU for a long time, etc. (but now they both are a-ok and baby is a perfect little 4 year old boy)

She got pregnant again about 2 years later and had a wonderful pregnancy, no pre-e, and carried her second baby to full term. So a completely different experience the second time around. I think the big difference for her between the 2 pregnancies was that for pregnancy #1, she was under an incredible amount of stress in her personal and work life and for pregnancy #2, she was not - in fact, she made a conscious effort to scale back her entire life and be as stress-free as possible.

Just an experience that I can share with you - hope this perspective helps and good luck with your decision!


My OB told me that with type 1 diabetes there's an increased risk of developing pre-e, however he followed that statment with "if you do develop pre-e we will monitor you like crazy and get you on blood thinners for all future pregnancies". My friend (non diabetic) had pre-e with her first son and then was given blood thinners for each of her following pregnancies and monitored like crazy and they were all perfect! Has your OB mentioned or suggested blood thinners? I'd look into it if you're looking to have more kiddos. Just remember, diabetes and whatever else healthwise is going on can be monitored and managed...and your plans for a family are just as important!

thanks amanda, and everyone else! just such a hard decision...