"...The largest risk for developing preeclampsia or HELLP in a future pregnancy is having had it in the past..."

Q: - I developed HELLP Syndrome a day after I had delivered.  They said I had a slight abruption during delivery and I was wondering if that could have contributed to it.  I have normal blood pressure and maintain a healthy lifestyle and weight of 110 lbs.  I was on a low dose beta-blocker throughout my pregnancy for racing heart episodes related to mitral valve prolapse.  I was actually free of any heart symptoms the whole pregnancy.  Because I developed what was told to me to be a mild case of HELLP Syndrome after the delivery am I at a lower risk for a future pregnancy than someone who would develop it early on.  My daughter was only 5 lbs 2 oz at almost term so they said I must have had some placental problem as I also had bleeding throughout my pregnancy.  I would appreciate any insight.  I do plan on seeing a high-risk specialist when we think we may have all the answers we need to even "consider" risking my life again.  Thanks so much.

A: The largest risk for developing preeclampsia or HELLP in a future pregnancy is having had it in the past. A milder case that occurred near term does moderate but does not eliminate the risk. Abruption is associated with hypertension in pregnancy. Probably, hypertension does more to cause the abruption than the abruption causing hypertension.

The treatment with a ß-blocker probably decreased the severity of your case.

With careful attention to your blood pressure and symptoms, I would expect that a pregnancy could be managed without undue risk to your life and health. It would require treatment by a specialist that recognized the risk. The risk that cannot be controlled as easily is that of a premature birth. Fortunately, you delivered near term last time.