Pre-eclampsia and high blood pressure in pregnancy

Betty

Female
Age at interview: 38
Age at diagnosis: 37

Brief outline: I developed symptoms of pre-eclampsia from around 6 months (28 weeks) into my first pregnancy. I was officially diagnosed and had an emergency c-section at 7 months (32 weeks). My baby was sent to SCBU (Special Care Baby Unit) and spent six weeks in hospital overall.

Background: My name is Betty, I am 38 years old and a marketing manager. I am married and have one son. My ethnic background is Chinese.

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Developing high blood pressure problems

I had pre-eclampsia in my first pregnancy. At 6 months (28 weeks) into my pregnancy, I had swelling of my feet and wrists but I didn’t think much of it. I was going to regular check-ups and, at five of these appointments, protein in the urine was detected. I was told the sample would be sent to the laboratory for testing. I didn’t hear anything back on the results except for one, which said the cause was a urinary tract infection (UTI). My heart rate was fast at one of the routine checks. It was checked again in triage and I was told it was okay. 

At 7 months (32 weeks), I started to get some cramp-like pain in my stomach. I woke up in the night and felt blood on my bed sheets. My husband and I went to hospital and we were told that my blood pressure was high because I had severe pre-eclampsia and would need to deliver the baby right away. This was the first time I had ever heard of pre-eclampsia. We found out that the bleeding had been caused by the placenta coming away from my uterine wall as a result of the high blood pressure. 

I was given medicine to lower my blood pressure (atenolol) and I had an emergency c-section that night. My husband was allowed into the theatre, and he helped keep me calm and informed about what was happening. We briefly saw our baby son and then he was taken to SCBU (Special Care Baby Unit). 

Being unwell after the birth

Immediately after my baby was born, I felt very sleep. My husband tried to keep me awake. I’m not sure if it would have been dangerous for me to fall asleep. I have other unanswered questions about what happened in hospital too. I was taken from the operating theatre to a High Dependency Unit (HDU) and monitored. I remember being very thirsty but the set-up on the ward meant I had to ask nurses to bring me some water each time. I also have a long-term problem with my sinuses which means the monitor alarms would go off when my breathing slowed each time I fell asleep. I didn’t want to be a nuisance to the nurses and so, using my husband’s private medical insurance, I arranged to be moved to a private wing. This was good because it was nearer to the SCBU so I could visit my baby often. I was discharged from hospital after seven days and I was able to stay in charity-provided accommodation at the hospital for two nights to be near my son.

My baby’s health

My baby stayed in SCBU. He was given treatments, such as CPAP (Continuous Positive Airway Pressure) which kept air blowing into his airways so he could breathe more easily. He had a bit of jaundice and so was put under a UV light to help. I wasn’t able to visit him until the second day. It was upsetting seeing him attached to various monitors and tubes. My husband and I didn’t know whether our baby would survive, and the chances of this weren’t communicated to us at the time. After two weeks of my baby being in SCBU, I was told that he would be transferred to my local hospital. I didn’t want this as the local hospital had a bad reputation. I tried to delay the move at first. It was reassuring when I spoke to staff who said that the bad reputation of the local hospital was unfair and that they had a good medical team. My son stayed in hospital for six weeks overall. It was hard being apart from him and I wasn’t able to have much physical contact, which felt strange: you know that technically you’re a mum but you don’t feel like it. I struggled with feeling guilty that something I had done could have caused the pre-eclampsia and premature birth of my baby.

Over time, I was able to get more involved in caring for my baby. I liked being invited to help feed him via a tube and knowing that he was benefitting from my expressed breast milk. Being included in looking after my son also meant that I was more prepared when he was ready to come home. However, there seemed to be more pressure on me at the local hospital that my baby was transferred to. There was an expectation that I would be at the hospital at set times, which was tricky since I couldn’t drive after the c-section and my parents were visiting from abroad in anticipation of looking after us both post-partum. Despite my initial reluctance about the transfer, I’m pleased with the care my baby received at both hospitals. In particular I remember a nurse who was caring and on shift a lot of the time – he provided me with an established point of contact.

Getting more information

I had weekly GP appointments after I was discharged from hospital. I was also given a machine to measure my blood pressure at home, though I think it was a bit of a waste of time because I hadn’t been shown how to interpret the results. My GP referred me back to the hospital after a month as my blood pressure stayed high. This gave me a chance to find out more about what had happened to me and why my pre-eclampsia hadn’t been picked up sooner. The case was investigated for mismanagement as there had been five occasions when tests showing protein in the urine which had not acted upon and the UTI diagnosis might have been incorrect. I learnt more about pre-eclampsia at this meeting. I was also given information about next steps if I want to become pregnant again in the future, but there seems to be contradicting advice on this topic. I think a debrief meeting like mine should be built into the aftercare for all women who have had pre-eclampsia. I would encourage other pregnant women to get symptoms, like swelling, checked out and to not dismiss it as just part of pregnancy.

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