Information on Preeclampsia and Gastroesophageal Reflux (GER)

Preeclampsia

What is Preeclampsia?

Preeclampsia is a disorder that occurs only during pregnancy and the postpartum period and affects both the mother and the unborn baby. Affecting at least 5-8% of all pregnancies, it is a rapidly progressive condition characterized by high blood pressure and the presence of protein in the urine. Swelling, sudden weight gain, headaches and changes in vision are important symptoms; however, some women with rapidly advancing disease report few symptoms.

Typically, preeclampsia occurs after 20 weeks gestation (in the late 2nd or 3rd trimesters or middle to late pregnancy), though it can occur earlier. Proper prenatal care is essential to diagnose and manage preeclampsia. Preeclampsia, Pregnancy Induced Hypertension (PIH) and toxemia are closely related conditions. HELLP Syndrome and eclampsia are other manifestations of the same syndrome. It is important to note that research shows that more women die from preeclampsia than eclampsia and one is not necessarily more serious than the other.

Preeclampsia and other hypertensive disorders of pregnancy are a leading global cause of maternal and infant illness and death. By conservative estimates, these disorders are responsible for 76,000 deaths each year.

It is potentially life-threatening to mother and baby if allowed to develop and progress undetected.

Pre-eclampsia is curable only by delivery, which puts some babies at risk of death from prematurity. Pre-eclampsia cannot be predicted, reliably prevented or treated to allow the pregnancy to continue. Although first identified more than 150 years ago, its prime cause remains unknown.

I suffered from Preeclampsia. You can see the swelling in my feet and ankles in this photograph. By the time I had Zachary I was swollen like this all over. My knees, elbows, neck all were swollen. No wonder I had a massive bump!

 

Preeclampsia caused me to go into premature labour. In the end I started to rupture, tear and bleed inside. I was very lucky that when my labour did actually start it progressed very quickly and that I had the most amazing midwife with me. Joannie was old school and realised something was wrong informing the consultant that she was going to deliver the baby with me before I was fully dilated as she was worried about the baby's health. I delivered at 9cm. Afterwards when they checked my placenta they noticed the tearing and blood and we all realised that further delays could have oxygen starved baby Zachary with very serious results. The internal rupturing could potentially have been very serious for my health too. As it is I am still suffering the after effects of this and still struggle with water retention (swelling) around my joints. Both Zachary and I were lucky. It concerns me that more is not known about Preeclampsia.

 

Gastroesophageal Reflux (GER)

GER is a common condition suffered by premature babies and occassionally in full term babies. Doctors now believe that many babies labelled as simply colicky and sickly were actually suffering from GER.

What is Gastroesophageal Reflux (GER)?

GER is the return of stomach contents into the oesophagus. Normally during swallowing, the oesophagus propels food or liquid down into the stomach by a series of squeezes. Once food has entered the stomach acid starts to digest it. When the mixing of acid occurs the circular band of muscles at the lower end of the oesophagus tighten to keep food in the stomach. In premature and sometimes full term infants the junction between the stomach and oesophagus is not properly formed and the valve and muscles sometimes relax when they should tighten. This relaxing allows the liquid and food to come back up. Reflux of the acidic stomach contents irritates the lining of the oesophagus causing a form of heartburn.

Symptoms of Gastroesophageal Reflux (GER)

Sometimes:

  • Chronic coughing
  • Frequent red or sore throat
  • Frequent ear infections
  • Respiratory problem

How we are coping with Gastroesophageal Reflux (GER)

Zachary displays most of the symptoms of GER. Sometimes he can be sick in his sleep hours after eating and the food comes up so forcefully it comes up his nose. He chokes and gags and wakes in a panic because he thinks he can't breath. I have to hold him upside down and then right way up patting him hard on the back to make him take breaths and clear his throat. I have got used to the projectile vomits that happen for no reason sometimes and contain the contents of his stomach. We simply clean up, calm down have a break then prepare some more feed. He always smiles afterwards and thinks he is hungry - he has an empty stomach so of course he is. I know that to feed him I have to keep him as upright at possible and keep him upright for 1 to 2 hours after feeding. I found that out by trial and error. I spent many days and nights in the first few months walking around with him held upright. All night on more than one occasion.

He almost always has a mouth full of dribble and a bib around his neck to catch the milk that constantly comes back up.

Zachary and I have just got on with it and despite the sickliness he doesn't look a sickly baby. He has gained weight rapidly and looks solid and happy. Our doctor praised both of us in dealing with this problem so calmly and said that he thought Zachary was very lucky to have a mummy who would devote so much time to making sure he was comfortable and happy as actually living with heartburn and sickness was not nice for anyone least of all a small baby.

 

I know Zachary well now and I know he doesn't like lying down flat and now I know why. When you have acid heartburn it rises up faster if you are lying flat. I think its a shame it has taken so long to diagnose and that initially I was simply told it was colic and that some babies are simply sickly. Anyone who has spent time with us has started off telling me how they know a baby that was quite sickly then rapidly reassessed their evaluation after witnessing him being sick a few times. We know that he does not travel well and that for a long time he did not even like being in his pushchair because he lying too flat. I have learnt now that you can buy special wedge shaped pillows that go underneath the mattress to create an incline which helps with GER. Now I know why the incubator was always set at a slope.

I almost always have a muslin square on my shoulder.

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