Spotting the early signs of pre-eclampsia

May is Pre-eclampsia awareness month and 22 May is World Pre-eclampsia Day. I want to share my experience with pre-eclampsia to raise awareness of this severe and dangerous pregnancy complication.

Pre-eclampsia, sometimes referred to as “toxaemia of pregnancy”, is a complication of pregnancy that affects approximately 2 out of 100 expectant women. The main symptoms for pre-eclampsia are elevated blood pressure and high protein levels in the urine. The condition can be very dangerous for both, mother and baby. Regular antenatal care is however most important to enable the detection of the disease as early as possible.

Part 1 – early signs of pre-eclampsia and hospital admission 

Up until 29 weeks my pregnancy had been textbook; however, at 29 weeks pregnant my feet started to swell but with the hot weather we were having I just pushed it aside. Over the next few days, it got worse and I wasn’t passing urine so much. My bump had gotten bigger and I was getting tired easily. Again, with the hot weather I could have easily ignored the symptoms for longer but when I started to get headaches I knew something wasn’t right.

I called the day assessment unit who asked me to go in to be checked. My blood pressure was high at 170 sys (my BP is normally textbook) so they debated admitting me. After repeat BPs I was sent home with medication to bring it down. 2 days later the headaches and swelling were getting worse. I now also had a lingering pain under my ribs which I just put down to my bump getting bigger all of a sudden.

I measured my own blood pressure to see out of interest what it was and was shocked at how high it still was given the medication I was taking so off I went to hospital again. Once on the delivery suite my blood pressure was back up to 170 and my urine was now showing protein – both signs of pre-eclampsia.

I was given a second medication as my BP was rising even higher. Repeat blood tests showed low sodium and blood count. I was kept in and put on IV fluids to try and increase my sodium levels and given steroid injections to help develop our baby’s lungs in case they had to deliver early.

Over the next 48 hours I had continuous migraines, pains in my legs, I was short of breath just laying in bed and pains below my ribs. Further blood tests showed my sodium levels dropping even further and they couldn’t understand why. My cortisol levels were also abnormal so I was referred to an endocrinologist who sent me for a scan on my kidneys and adrenal glands. The scans showed acute kidney injury but nothing too major. By this point I was barely eating and the consultants still couldnt find a cause for my continuously dropping sodium levels. The swelling was getting worse and was now pitted and all the way up my back, so bad I had indentations from my clothes when laying down.

I had continuous migraines, pains in my legs, I was short of breath just laying in bed and pains below my ribs. Further blood tests showed my sodium levels dropping even further and they couldn’t understand why.

To the doctors and midwives I didn’t look that swollen; however, when I showed them photos of me before the admission they realised how bad it had gotten and so quickly. A cortisol test was carried out to find out if my adrenal glands were working properly which they were (A bit of good news!). That night I couldn’t sleep because of the pain in my back and chest. I couldn’t lay flat or even complete a full sentence without becoming extremely short of breath. I knew this wasn’t right and called the midwife who asked the on-call doctor to assess me. His diagnosis… gastric reflux but I knew it wasn’t. I was too tired and in pain to disagree.

The next night I started getting nose bleeds due to my blood pressure being so high. I had a growth scan of baby which showed she was growing well with an estimated weight of 3lb 4oz. Finally some more good news! That day I had a visit from the endocrinologist who listened to my chest and back and sent me for an urgent chest xray. The chest Xray showed pleural effusion and heart failure which explained the symptoms I’d been having that night. My body was filling up with fluid and the consultants couldn’t understand why my sodium levels were still dropping. One summed it up when she called me an enigma.  As a result of their findings, a decision was made to deliver baby the next day via C-section as the risk to both of our lives was too high if we waited any longer.

I was moved to ICU for a magnesium infusion ready for the morning when our baby would be delivered at 30+3 under general anaesthetic because they were worried about my heart. I was taken off to ICU where I was kept in an isolation room because my COVID swab had been labelled incorrectly. My whole ICU experience and the following few days were a blur.

I had arterial access and was given a magnesium infusion which I couldn’t forget because I felt like my body was on fire.  Baby had monitoring throughout the night by a midwife and I was awake the whole night being monitored and given medication. I had an ECHO on my heart which gave us some positive news that I would be stable enough to have a spinal instead of general anaesthetic. This meant my husband could be in the delivery! 

Baby had monitoring throughout the night by a midwife and I was awake the whole night being monitored and given medication.

Part 2 – C-section delivery at 30+3

The next morning I was told that I would be able to have the C-section under spinal rather than GA as the ECHO showed my heart was strong enough. I was then told the C-section had been delayed until the afternoon. At this point what I didn’t know was that my consultant had been on the phone to Norwich to fast track my COVID swab which would enable us to have the C-section in the normal theatre and would mean we didn’t have to self isolate for 14 days post-surgery and consequently not see our baby for 2 weeks.

Warren was aware of all this going on but they chose to keep me out of the loop. I was too exhausted and unwell to take in any information at the time. The next thing I know I was ready to go. Ringing Warren telling him to meet me on my way to theatre he managed to meet us on route and give me a kiss. I next saw him in the theatre.

I had a spinal anaesthetic and our baby girl was delivered via C-section at 15:46 weighing 2lb 10oz. Warren was able to cut the cord but she was too premature to cuddle so she was taken away by the NICU team. During the C-section I could barely keep my eyes open however I do remember feeling so grateful for the ice pack the aneathatist put on my head. I felt like I was in a completely different world but when they told me to turn to see my daughter I turned my head to see this tiny beautiful girl who I instantly fell in love with. It was torture seeing her being taken away.

I had a spinal anaesthetic and our baby girl was delivered via C-section at 15:46 weighing 2lb 10oz.

Part 3 – recovery in ICU and an NICU stay for my premature daughter

I was taken back to ICU where I was now able to go into the green zone as my COVID swab was negative so I went onto HDU. The next few days were a blur. I was bed-bound as I was hooked up to so many wires, probably one of the worst things to be post C-section. I couldn’t have visitors and I couldn’t see my baby. The first night I had a visit from NICU telling me our baby had a tension pneumothorax (collapsed lung) I broke down. I needed to be with her. My baby was having a chest drain put in and I couldn’t be there. It was decided between ICU and NICU that I could go up and see her when it was done. The pain was horrific and the nurses had to help me into a wheelchair and manouvere my monitoring.  I felt like the multiple layers of stitches were being ripped apart but it was worth it to see that she was ok.

Warren had been driven to the hospital and it was the first and only time we would be with our little girl together before discharge. From that moment on Warren would spend hours on end in NICU. I was desperate to leave ICU but my BP was now even higher (hitting 200 sys) and I was also having hallucinations. My sodium levels returned to normal and my swelling dramatically decreased straight after delivery. When they made the C-section incision they said I was full of fluid which is why my bump had suddenly grown. Two days later I was finally let back to the maternity ward where Warren was able to stay with me.

We would take it in turns going to NICU spending as much time with our little girl as we could.

We would take it in turns going to NICU spending as much time with our little girl as we could. I had a repeat ECHO which showed no lasting damage to my heart. On my 11th day of being in hospital I was finally discharged with multiple medications. I was bruised inside and out and mentally and emotionally exhausted and yet we were still on that rollercoaster of emotions.

We walked out of hospital without our baby, something we never imagined happening. The next day I had my daily BP check. Once again it was too high and was readmitted but thankfully just for one night to have my medication changed.

Getting discharged from NICU

Our daughter Freya spent 37 days in total in NICU. Due to the pandemic my husband and I couldn’t see her together so had to take it in turns. We live 15 miles from hospital and due to the C-section I couldn’t drive meaning my husband would drive to and from hospital multiple times.

We would spend 12+ hours a day with her, sitting by her side. Every night we would sit anxiously praying the phone wouldn’t ring with bad news. Freya was progressing well and apart from her collapsed lung and 2x infection scares she was doing really well. It finally got to the point where we were going in to care for our baby and just wanted her home.

Finally, 37 days later Freya was successfully breastfeeding and maintaining her weight. Our breastfeeding journey (which you can read here) was tough but with perseverance and working together we got there! We had a trial sleepover which I had to do on my own due to covid. The sleepover was a success and Freya passed her tests. We were finally able to take her home. We took our baby girl home for the first time at 5.5 weeks old (35weeks gestation) weighing 4lb 6oz.

Finally, 37 days later Freya was successfully breastfeeding and maintaining her weight.

Now Freya is a healthy 22-month-old who is full of character and has the biggest, cheesiest smile. I’m so thankful that I recognised the symptoms of pre-eclampsia and listened to my body.

You can find out more about preeclampsia here.