When preeclampsia strikes twice: A mother’s harrowing experience with preeclampsia recurrence

As a mother who’d already experienced preeclampsia during her first pregnancy, Crystal Dock went into her second pregnancy feeling somewhat cautious. Preeclampsia is a high blood pressure disorder that can restrict blood supply to the developing baby and increase the risk of pregnancy complications. Early detection is crucial to help avoid these complications.

“My second pregnancy was about 11 years after my first, so in addition to my history of preeclampsia, I was a little worried because I knew I was older,” says Crystal.

During her first pregnancy, Crystal recalls that everything moved quickly. "One minute I was in an appointment with my provider, the next they were telling me I needed to go to the hospital," she explains. "I don't think my provider ever even said, 'You have preeclampsia.'"

Fast-forward to her second pregnancy, and Crystal found herself in an oddly familiar situation. It started with a random bleed during her first trimester, shares Crystal. "I went to the emergency room, and they couldn't find any reason or cause for the bleeding."

After that, Crystal remembers seeing her provider multiple times as the random spotting continued throughout her first trimester. "I was still pretty calm, telling myself it was normal and that it would go away," she says. "But it lasted longer than I thought it should."

Despite the assurances from her healthcare team that her pregnancy was "not high-risk," Crystal remained vigilant. She had a feeling this was only the beginning of a long and complicated journey.

The precursors to preeclampsia

Given her concerns about her bleeding, Crystal decided to move in with her mother during her first trimester.

"I was also dealing with extreme morning sickness at the time, so it was easier to have some help," she adds. "Thankfully, with my mom there, I was able to take it easy during my first trimester."

By her second trimester, Crystal remembers noticing “the glow” that’s often associated with pregnancy. Still, she was nervous that something might go wrong again, whether it was more bleeding or another unexpected symptom.

Her healthcare team, however, remained mostly unfazed. At 20 weeks, they prescribed her a beta blocker medication to help manage her blood pressure. "They seemed optimistic," says Crystal. "At this point, the bleeding had stopped, and I was told to keep checking my blood pressure at home and visit my provider every two weeks. It wasn't clear that I should worry or expect more complications."

At 28 weeks, however, Crystal still wasn't seeing improvements in her symptoms. Her provider had even increased the dose of her blood pressure medication, yet she'd started to notice more swelling in her feet and legs. "They looked like they were about to pop," she says.

After mentioning her concerns about the swelling, her provider decided to run some more lab tests. Crystal remembers getting those tests at the beginning of a jampacked weekend. "It was the same weekend as my maternity shoot and my baby shower," she says. "There was a lot to do. I felt exhausted, and I was moving slowly, but I tried to just get through it."

Despite everyone telling her she looked great throughout the festivities, deep down, Crystal still felt that something was off.

When she went to sleep on Sunday, she woke up in the middle of the night to another bleeding. This time, though, it wasn't just blood-she was leaking amniotic fluid. In other words, her water had broken before she was in labor.

At the hospital the next day, Crystal was told, at 28 weeks into her pregnancy, that she had preeclampsia and would not be leaving until she delivered her baby.

“I went to the hospital where I was originally supposed to have my baby, but given my complications, I actually needed to be at a hospital with NICU capabilities, so they immediately transferred me,” she says.

Meanwhile, the provider who'd ordered those additional lab tests for Crystal at the beginning of the weekend was calling to tell her the results were in: Her labs showed elevated protein levels in her urine (another preeclampsia symptom), and she would need to see a maternal fetal medicine specialist immediately. Little did they know, she was already hospitalized.

A harrowing hospital stay

Throughout her first week in the hospital, Crystal remembers receiving blood pressure medication and being monitored around the clock. She also received an iron transfusion to manage her low iron levels. Thankfully, her baby's heartbeat was normal, but her own symptoms were not subsiding.

"I was still spotting a bit," she says. "I was very uncomfortable laying there while they checked my blood pressure and monitored the baby constantly. I'd also started having sinus issues-I just knew I couldn't stay in this situation much longer."

A week later, her healthcare team ran a test on the baby and saw that her movements had decreased. "They said it was an option to deliver at that time, so they asked me to think about it," says Crystal.

However, by this point, Crystal's symptoms were escalating rapidly. "I'd developed an uncontrollable cough," she says. "I remember having a bad coughing fit where I spit up a little blood. The nurse left the room, and when she came back, she told me it was critical that I deliver now. I really didn't know what had changed from one moment to the next, but now I know that decision saved my life."

From there, everything moved very quickly. "My husband couldn't even get there in time," she says, though her sister and a few friends were there to support her.

At 29 weeks, Crystal delivered her baby via C-section. However, delivery was not smooth, she recalls. "I remember that, after I had my son during my first pregnancy, I had an issue with bleeding," she explains. "I didn't know if this had been mentioned to my current healthcare team, so I started freaking out in the middle of delivery. I was trying to get off the operating table and tell them to make sure they took care of everything, and they had to give me medication twice to calm me down."

Ultimately, Crystal delivered a healthy, though small (2 pounds and 10 ounces), baby girl. But it wasn't the end of her journey with preeclampsia.

The reality of postpartum preeclampsia

When Crystal had preeclampsia during her first pregnancy, she recalled getting out of the hospital about four days after her C-section. "My blood pressure peaked a day after delivery and quickly went down after they changed my medication," she says. "My OB monitored my blood pressure and prescribed me the medication until my six-week visit, then told me to follow up with my primary care provider after that. I was only prescribed blood pressure medication for maybe a year longer before stopping."

With her second pregnancy, however, Crystal didn’t leave the hospital until three weeks after delivery.

"I also didn't see my baby until three days after her delivery because my blood pressure was all over the place," she says, adding that her numbers were as high as 200/105 at one point. "I was dizzy and uneasy."

"I started freaking out," says Crystal. "I knew my blood pressure was not going to go down after seeing that. I also noticed the lights were flashing in the hallway outside of my room, and a nurse was standing by the door with a crash cart, just waiting."

As scared as she was, Crystal remembers surrendering to the moment. "I never told anyone this, but I just laid there, tried to relax, and decided to take whatever was going to come. There was nothing else I could do. I just had to let it go however it was going to go."

Fortunately, Crystal's blood pressure began to drop to more stable levels. "The nurse and I high-fived each other, and she said I had her feeling so scared. I said, 'You're scared? You know what you're doing, I don't know what's happening!'"

Despite the improvement in her blood pressure, Crystal wasn't out of the woods just yet. Her healthcare team was still trying to get the dose right for her blood pressure medication, while Crystal's sister was meeting with hospital staff to discuss the protocol they'd been using for her medication.

"We'd been through the protocol a few times by this point, and it wasn't doing anything for me," says Crystal. "My sister was speaking to the hospital staff to see if we could try something different, but they insisted it was part of their protocol, even though it clearly wasn't working for me."

Unfortunately, Crystal says her healthcare team misread the notes from that meeting between her sister and the hospital staff. As a result, they accidentally gave her a dose of medication that caused her blood pressure to drop too low.

"At one point, I got up to go to the bathroom, and my blood pressure was so low that I fainted," she says. "Then the nurse accidentally pressed 'code blue' for my room, which called a flood of people from all over the hospital to my room. It was wild."

Crystal ultimately stayed in the hospital through Thanksgiving. "By Thanksgiving, I couldn't eat," she says. "I was so depressed and still felt like I'd never get out of the hospital."

In early December, Crystal was finally discharged from the hospital. Her daughter stayed in the NICU for approximately three more weeks so she could grow to a healthy size. 

"She was exactly 4 pounds the day she came home, which was Christmas Eve," says Crystal. "She had difficulty feeding at first, but we did feeding therapy, and she had a frenotomy (an oral surgery that improves the tongue's range of motion to support breastfeeding), which improved her latching and allowed her to gain more weight."

The importance of self-advocacy and early detection in preeclampsia

Fortunately, Crystal’s primary care provider was on top of things after her difficult hospital stay.

"She helped me significantly," says Crystal. "She didn't make me come in for a bunch of appointments; instead, she let me measure my blood pressure at home and send her the readings, so I could relax as much as possible. From there, we figured out the proper dose for my blood pressure medication."

Today, Crystal and her baby girl are healthy. "My daughter is now a healthy 16-month-old," she says. "We go to a special infant clinic at the hospital where she's getting all the testing and follow-ups recommended for premature babies."

As for Crystal, she's still living with high blood pressure. "It's controlled with my medication, but I stay on top of my appointments and routinely check my blood pressure at home," she explains. "Thankfully, it only took a few changes in the medication after leaving the hospital to get the right dose."

While she admits the experience made her stronger, she also says it was a huge challenge to endure.

"Physically, I would say it took me about three months to start feeling like I could manage things on my own. I was a bit dizzy and off-balance for a while with the blood pressure medication," she explains.

Emotional recovery, however, is ongoing. "I started therapy when my baby was 3 months old, and it's helped tremendously," she shares. "I remind myself all the time that we survived, that it could have been worse."

After her experience with preeclampsia both during and after pregnancy, Crystal wants to raise awareness of the condition for new mothers.

"I'm just learning about postpartum preeclampsia and the seriousness of it now," she explains. "For some women, it goes on for months and months. It can even lead to a stroke in some cases. I thought I would be out of the hospital in a few days like I was with my first child. It's important for new mothers to know that there are others going through the same thing. The timeline is different for everyone. You have to give your body time to heal and lean into your support system until you feel better."

While she “doesn’t want to scare women who are pregnant,” Crystal maintains that we need to talk more about preeclampsia—particularly postpartum preeclampsia.

Bottom line: Advocating for your health is crucial, says Crystal. Despite the protocols that are in place for preeclampsia treatment, not everyone fits the same protocol.

According to Sydney Strickland, PhD, DABCC, biochemical genetics discipline director and laboratory director for Labcorp Women's Health and Genetics, preeclampsia can present in diverse ways. "Oftentimes the warning signs of preeclampsia can look like regular pregnancy symptoms, and therefore they can be difficult to identify and diagnose early enough to avoid progression to life-threatening conditions," she explains.

While we can't always prevent preeclampsia altogether, we can improve our methods for early detection. To help determine the risk of developing the condition early in pregnancy (i.e., before symptom onset, which is typically around 20 weeks' gestation), Labcorp offers a first-trimester preeclampsia screening. Given between 11 and 14 weeks into pregnancy, the first-trimester screening test looks at a combination of maternal factors and biomarkers associated with blood pressure, fetal development and placental health. Using a proprietary algorithm of these factors to assess the risk of developing preeclampsia later in pregnancy, this screening test can be given to any pregnant patient.

For prognostic confirmation of preeclampsia in hospitalized pregnant patients, Labcorp also offers an FDA-cleared second/third trimester preeclampsia test. Using biomarkers associated with blood vessel and fetal health, the test is given between 23 and 35 weeks' gestation to assess the risk of preeclampsia progressing to severe complications within the following two weeks.

“These biomarker measurements serve as an extra tool to help providers make important decisions for their patients in a timely manner,” says Dr. Strickland.

Preeclampsia is a serious pregnancy complication that affects 5% to 7% of pregnancies globally and is a leading cause of maternal illness and death. In the U.S., the risk is significantly higher for Black patients, who are three times more likely to die from pregnancy-related complications compared to white patients. 

Learn more about preeclampsia and Labcorp’s comprehensive preeclampsia testing solutions, and start a conversation with your healthcare provider.

Crystal Dock is an employee of Labcorp. No compensation or remuneration of any kind was paid in connection with this story.