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This is your Pea in the Podcast for week 30 of your pregnancy. I’m Bonnie Petrie joined by Dr. Laurie Swaim, an obstetrician with Houston Women’s Care Associates in Houston, Texas.
You’re probably seeing your doctor or midwife every two weeks now and you’re probably starting off every visit by peeing in a cup. Why? “Mostly just because we worry about the development of preeclampsia in an otherwise young healthy person. People who have pre-gestational diabetes or people with renal disease or people with lupus or that kind of thing then we’d also want if they have proteins for other reasons; are they getting kidney disease actually. But, by and large, we check otherwise low risk women for proteins just to make sure they’re not developing preeclampsia. Do we have to do it every time? I suppose if their blood pressure is fine then no, we don’t have to, but typically it’s done first because they walk in and they pee first before they get their blood pressure taken.”
So what is preeclampsia? “Preeclampsia is a disorder that is characterized by elevated blood pressures and certain quantities of protein in the urine that can only occur during pregnancy and no one knows the cause of it. It probably brews for a long time before we see the outward manifestation. Swelling used to be used as part of the diagnosis but almost everyone has swelling so it is no longer part of the criteria. Preeclampsia can come in mild and severe forms. When a woman has severe preeclampsia she pretty much has to be delivered although there are some extenuating circumstances where she may stay pregnant but it develops depending on the type of severe frequencies she has and the gestational age. I would say the vast majority of times it is ‘happy birthday’. And the reason for that is the risk to the baby and mother are significant. There’s a risk of seizures in the mother, risk of kidney damage, risk of liver rupture, they’re all bad things that can happen, people with anemias and the list can go on and on. The risk to the baby could be abruptio placenta and severe growth restriction, intolerance of labor, that kind of stuff. When a woman has mild preeclampsia, if she’s term, that’s greater than 36 weeks, then she likely gets delivered as well. Sometimes she has mild preeclampsia at 36 weeks, this is her first baby and her cervix is terrible, then we won’t necessarily deliver her right away. If she’s less than 36 weeks then we watch her very closely to make sure that she doesn’t develop severe preeclampsia in the meantime.” So preeclampsia is very, very serious, you should pay attention for signs and symptoms and as Dr. Swaim said, swelling is no longer part of the criteria for diagnosis but if you notice your hands or face swell up suddenly or that you have a sudden spike in weight, you should let your doctor know. If you’re having severe headaches and are seeing spots or flashing lights while at rest, let your doctor know. Abdominal pain, nausea, vomiting and feeling sick are all symptoms to which you want to pay attention. Preeclampsia can progress rapidly and is more common in multiple pregnancies and in women who’ve had it before.
Now can you do anything to prevent preeclampsia and who’s at risk? “Whoever figures that out can win the Nobel prize. There’s a group of disorders called thrombophilias where woman who have this disorder, there’s a number of them though the list is too long to go over, but basically they probably tend to clot their blood too much and it’s been associated with excessive miscarriage and also the development of severe preeclampsia early in pregnancy. Women who have experienced that may benefit in the future from anticoagulant drugs like Heparin or Lovenox. There was also some data that suggests giving a woman an aspirin, or baby aspirin, when she’s had preeclampsia before may decrease the risk of it again but it also increases the risk of abruptio placenta. That information came out before we started learning more about thrombophilias. So in some instances there may be a way to prevent it in a second or subsequent pregnancy but usually in the first no, we don’t know who’s going to develop it.” Preeclampsia affects approximately 5% to 10% of pregnant women. Some studies indicate proper nutrition may reduce your chances of developing this condition. By the way, preeclampsia is also some times called toxemia.
Now this week measuring from your belly button, your uterus is about four inches above it and things are steadily becoming less comfortable in your world. You may be feeling achy and probably more constipated and you may be dealing with more frequent heartburn, your growing baby is displacing all of your other organs, slowing down your digestion. You can eat smaller, more infrequent meals and remain upright for about a half hour to 45 minutes after eating to give your system a helping hand. Keep the fiber coming too to ease constipation at this point, maybe add a bowl of oatmeal to your diet, and try to keep walking too. If that doesn’t help your doctor may be able to prescribe a stool softener for you. Your baby is starting to grow like crazy. This week the bean weighs in at about 3 pounds, but starting this week and until about week 37 he or she will gain about a half pound a week. They’ll also gain about a half an inch in length. Remember that soft lanugo hair that protected your baby in early pregnancy? It’s starting to come off now, your baby may still have a little bit of it at birth, that is normal, but it will all go away soon after. You can see and feel your baby moving now, one of the great thrills of pregnancy, in my opinion anyway. You may be playing ‘guess the body part’ as it pokes you. Multiples moms can often tell which baby is moving and when. Your baby is practicing hard to be a good breather at birth right now, they’re mimicking breathing movements by repeatedly moving their diaphragm, that makes for hiccups that you may feel. If your little one was born now they have lungs that are capable of breathing air although they probably need some help, every week makes a huge difference in your baby’s development now. You’re 30 weeks pregnant; you have 10 weeks to go until week 40.
That’s your Pea in the Podcast for week 30 of your pregnancy. Dr. Swaim and I look forward to talking to you again next week. Enjoy this week. For a transcript of any of our Pea in the Podcasts go to our website peainthepodcast.com. For Pea in the Podcast, I’m Bonnie Petrie, thanks for listening.