Condessa Posted October 16, 2021 Posted October 16, 2021 (edited) I am 33 weeks 4 days pregnant. Every one of my pregnancies has been induced for blood pressure, earlier each time. Despite having been on daily aspirin and very careful about healthy eating and weight this pregnancy, my bp is rising right about on schedule, a little sooner than last time. I’m not on bp medication yet; they said they will put me on something when I am regularly reading at 150/100 or higher, and while I‘ve reached 162, it’s not staying that high, but dropping back down to the 130-140s/80-90s. I have started getting the headaches, though. My mom is planning on coming to help when I have the baby, or sooner if I get put on bed rest. My ds7 has cancer, and while his care is relatively simple for a cancer patient, I am pretty anxious about leaving that with someone else. He has been having more weak and wobbly days lately. His BMI is dropping as he grows and doesn’t gain weight even with all my efforts to get more calories into him, and the oncologist is talking about potentially turning to medication or a feeding tube. I would really prefer to have my mom here with the kids before I go into the hospital. But she has a life of her own, too. She has a conference and some other events for some organizations she helps run. When she comes out to help me, my dad struggles to get any work done from home while also managing my grandma with dementia. I keep telling myself it would be unreasonable to ask her to come early and hang around for who knows how many weeks before her help is needed, just because I’m nervous about leaving ds with a sitter for a day while she’s flying out here. (Especially since I would like to have her stay for a while afterwards, particularly if baby E has health problems like ds7 did. My 37-weeker acted very like an oversized premie.) There is a five-week spread between when my other kids came. If this baby follows the same pattern, my bp will be spiking up to dangerous levels before we reach term, but they will also be inclined to do more to keep him where he is longer. On the other hand, this baby has already broken some patterns that were consistent across my other pregnancies, so maybe bp will go differently this time, too. I am sure that dwelling on all my worries like this is the opposite of helpful with my blood pressure. I don’t know how to not worry, though. Edited November 16, 2021 by Condessa 3 Quote
Lecka Posted October 16, 2021 Posted October 16, 2021 I think talk to her about it. Maybe it's possible for her to come on short notice if she makes plans around knowing she might need to come on short notice. Then maybe you can have her come when you know you need it. 5 Quote
prairiewindmomma Posted October 16, 2021 Posted October 16, 2021 Broach the conversation with your mom and get her thoughts. She knows her immediate calendar best. It may also be possible for her to make two trips—perhaps one soon to help get things ready for baby and get you past the 34 week window by giving you a bit of a break now. If you had baby immediately, you’re looking at a NICU stay in much longer length than if you can get a few more weeks in. You could also wrap the gtube/Mickey button or whatever they are considering into this immediate visit. I wouldn’t be afraid of tube placement. I think the low BMI is of greater concern, imo. (Also—a Vitamix is most helpful for making blended meals if he isn’t going onto TPN or something formula based.) I have horrific end of pregnancies. Things are so much easier when baby is here. If it’s possible, I would rather have my mom here for end of pregnancy than for a long bit after baby is here. 1 Quote
mommyoffive Posted October 16, 2021 Posted October 16, 2021 Yes, I would talk to her. IS she taking care of your grandma? Can your dh take time off of work? 1 Quote
Condessa Posted October 16, 2021 Author Posted October 16, 2021 16 minutes ago, Lecka said: I think talk to her about it. Maybe it's possible for her to come on short notice if she makes plans around knowing she might need to come on short notice. Then maybe you can have her come when you know you need it. This is currently what we’ve talked about, that she will get a flight and come as soon as the doctor says it’s time to induce. With most of my others, that was sudden enough that they sent me directly from an appointment to the hospital. (Except for the last one. With him, they told me to go home and lie down with my feet up for the weekend, come back if x, y, or z happened, but otherwise be there on Monday morning when I hit 37 weeks.) I am mostly anxious about leaving ds with someone else during that time while she’s on her way here. Quote
prairiewindmomma Posted October 16, 2021 Posted October 16, 2021 Maybe the problem that you could solve is the Ds care issue. Do you have anyone who would be a safe place for him? Do you have a sister or niece who could come visit for a few days? An older woman in the ward without kids who is a good fit? I think if the answer to all of that is no, that is what I would discuss with mom. She may be entirely baby focused and not realizing the degree of anxiety you are feeling about your son. 4 Quote
Condessa Posted October 16, 2021 Author Posted October 16, 2021 (edited) 1 hour ago, prairiewindmomma said: Broach the conversation with your mom and get her thoughts. She knows her immediate calendar best. It may also be possible for her to make two trips—perhaps one soon to help get things ready for baby and get you past the 34 week window by giving you a bit of a break now. If you had baby immediately, you’re looking at a NICU stay in much longer length than if you can get a few more weeks in. You could also wrap the gtube/Mickey button or whatever they are considering into this immediate visit. I wouldn’t be afraid of tube placement. I think the low BMI is of greater concern, imo. (Also—a Vitamix is most helpful for making blended meals if he isn’t going onto TPN or something formula based.) I have horrific end of pregnancies. Things are so much easier when baby is here. If it’s possible, I would rather have my mom here for end of pregnancy than for a long bit after baby is here. This is a great idea, we are going to do this. She is coming out for a week—not this coming one, but the next, when ds has his monthly day of appointments downtown. So she can babysit for that, or if they put me on bed rest by then, she will be able to take him for me. I still don’t know what or when it might be with the feeding situation with ds. The oncologist is watching his BMI and saying maybe soon, not yet. I am worried about dealing with premie problems after the baby comes, too. The first month home with my 37 week baby was rough. Edited October 16, 2021 by Condessa Quote
Condessa Posted October 16, 2021 Author Posted October 16, 2021 39 minutes ago, mommyoffive said: Yes, I would talk to her. IS she taking care of your grandma? Can your dh take time off of work? She manages the bulk of grandma’s care during the day, with help from my sister at times. My wonderful parents would send her without hesitation if I asked, but I know it would be hard on my dad and that my mom would feel bad about dropping her other commitments. Dh will be taking some time off when the baby is in the hospital and if necessary again after my mom leaves, but there is some financial pressure to keep that to a minimum because he will have to be taking days off pretty often to take ds to appointments that the hospital will not allow me to bring the baby to. (The oncologist’s office has said they will make an exception for the baby until he begins to crawl. The other specialists are a no go.) 2 Quote
Condessa Posted October 16, 2021 Author Posted October 16, 2021 26 minutes ago, prairiewindmomma said: Maybe the problem that you could solve is the Ds care issue. Do you have anyone who would be a safe place for him? Do you have a sister or niece who could come visit for a few days? An older woman in the ward without kids who is a good fit? I think if the answer to all of that is no, that is what I would discuss with mom. She may be entirely baby focused and not realizing the degree of anxiety you are feeling about your son. We have some very kind and helpful people in our ward who are happy to help when available, but none I think who both have an open schedule and are physically capable of dealing with it if he’s chemo sick or falls down the stairs or something. I think I need to talk to my sil. She lives a ways away, but in the same direction we have to go for the hospital. I have avoided asking for her help with all the medical stuff whenever possible because it’s clear that my bil considers it an imposition. But she is great, and probably our best option for watching the kids until my mom gets here. 1 Quote
ktgrok Posted October 16, 2021 Posted October 16, 2021 Can you discuss this with your OB or midwife at your next visit? Explain that childcare is an issue, due to son having cancer, and so as much planning as can be done, needs to be done. Can you discuss options - like "under what circumstances would you induce before 37 weeks", under what circumstances would you induce at 38 week? 39 weeks? What is the goal? Is it induction at 39 weeks? Did meds help bring down pressure safely in last pregnancies? Did you have preeclampsia, or just pregnancy induced hypertension? I get PIH each time, stay around 140/80-85, but we go full term, no meds. If you stay where you are, OR if you can get down to these levels with meds, when would they have you deliver? Can you schedule a date for that now? 3 Quote
TexasProud Posted October 16, 2021 Posted October 16, 2021 I have no advice. Only prayers. That is a lot on your plate. 2 Quote
gardenmom5 Posted October 16, 2021 Posted October 16, 2021 Talk to her, find out what her schedule is like. If she's a good mom, she'll want to be as helpful to you as she can be. 1 Quote
ktgrok Posted October 16, 2021 Posted October 16, 2021 Can you hire some household help for now, to help you not be so overwhelmed before baby comes? Or a postpartum doula or cleaning or what not after the baby comes, if need be? I do hear you on those early babies being hard - my 38 week one was totally different than my nearly 42 week kids. Night and day difference regarding feeding, sleeping, etc. 2 Quote
Condessa Posted October 17, 2021 Author Posted October 17, 2021 17 hours ago, ktgrok said: Can you discuss this with your OB or midwife at your next visit? Explain that childcare is an issue, due to son having cancer, and so as much planning as can be done, needs to be done. Can you discuss options - like "under what circumstances would you induce before 37 weeks", under what circumstances would you induce at 38 week? 39 weeks? What is the goal? Is it induction at 39 weeks? Did meds help bring down pressure safely in last pregnancies? Did you have preeclampsia, or just pregnancy induced hypertension? I get PIH each time, stay around 140/80-85, but we go full term, no meds. If you stay where you are, OR if you can get down to these levels with meds, when would they have you deliver? Can you schedule a date for that now? The main goal is to get baby to term, though I would really prefer to get further along than just 37 weeks after my last one’s lung problems. I was never given bp meds during a previous pregnancy, just after birth, and I didn’t even know it was an option. But my babies were at or close to term by the time my bp went up and stayed up. After ds7, the doctor told me that if I was pregnant again, we’d likely have a situation where they might have to induce early to prevent me having a stroke. So we didn’t have any more, until this little surprise. Bp medication was effective after I had my babies, but not immediately. It took a week or two to settle down, and they’d take me off the meds after a few weeks to a month. No preeclampsia, just PIH, but the last time I also started having unexplained shaking episodes that had my doctor nervous. The plan is to induce if/when my bp goes up and stays up if the baby is term; or to try medication, bed rest, hospitalization, induction (in that order) if it happens before baby reaches full term. We hadn’t really even discussed the possibility of inducing at some point if my bp stays under control. It’s a good question to ask. I’m not sure if they would even consider an induction that wasn’t medically indicated, as my births are vbac and hospitals tend to have strict rules around those. (My oldest’s induction failed and resulted in c-section.) Quote
Condessa Posted October 17, 2021 Author Posted October 17, 2021 16 hours ago, ktgrok said: Can you hire some household help for now, to help you not be so overwhelmed before baby comes? Or a postpartum doula or cleaning or what not after the baby comes, if need be? I do hear you on those early babies being hard - my 38 week one was totally different than my nearly 42 week kids. Night and day difference regarding feeding, sleeping, etc. We can’t really afford that. Or I guess technically we could, except that I have been nervous about affording the medical bills, especially if the baby is premature, and so we’ve been on a budget to set extra aside for that contingency. It took us three years to pay off ds7’s baby medical bills. We have a very good insurance arrangement now, with the kids double covered, but even a small fraction of the care needing to come out of pocket for whatever reason they’re not covering it adds up very quickly. Quote
ktgrok Posted October 17, 2021 Posted October 17, 2021 3 hours ago, Condessa said: The main goal is to get baby to term, though I would really prefer to get further along than just 37 weeks after my last one’s lung problems. I was never given bp meds during a previous pregnancy, just after birth, and I didn’t even know it was an option. But my babies were at or close to term by the time my bp went up and stayed up. After ds7, the doctor told me that if I was pregnant again, we’d likely have a situation where they might have to induce early to prevent me having a stroke. So we didn’t have any more, until this little surprise. Bp medication was effective after I had my babies, but not immediately. It took a week or two to settle down, and they’d take me off the meds after a few weeks to a month. No preeclampsia, just PIH, but the last time I also started having unexplained shaking episodes that had my doctor nervous. The plan is to induce if/when my bp goes up and stays up if the baby is term; or to try medication, bed rest, hospitalization, induction (in that order) if it happens before baby reaches full term. We hadn’t really even discussed the possibility of inducing at some point if my bp stays under control. It’s a good question to ask. I’m not sure if they would even consider an induction that wasn’t medically indicated, as my births are vbac and hospitals tend to have strict rules around those. (My oldest’s induction failed and resulted in c-section.) Ok, I'd talk to the doctor some more about how the childcare issues, child with cancer, etc. Maybe discuss even starting medication sooner, to try to keep it low enough? No idea if that is an option, but worth bringing up. Basically, make sure you care team knows the whole picture of what you are dealing with and see if they can help brainstorm a plan. 6 Quote
prairiewindmomma Posted October 17, 2021 Posted October 17, 2021 FWIW, I would seriously consider asking about starting blood pressure medication earlier (you can totally take it in pregnancy) and doing regular pre-eclampsia screenings. If you don't already have this information: https://www.marchofdimes.org/complications/high-blood-pressure-during-pregnancy.aspx 6 Quote
Condessa Posted October 17, 2021 Author Posted October 17, 2021 1 hour ago, ktgrok said: Ok, I'd talk to the doctor some more about how the childcare issues, child with cancer, etc. Maybe discuss even starting medication sooner, to try to keep it low enough? No idea if that is an option, but worth bringing up. Basically, make sure you care team knows the whole picture of what you are dealing with and see if they can help brainstorm a plan. 1 hour ago, prairiewindmomma said: FWIW, I would seriously consider asking about starting blood pressure medication earlier (you can totally take it in pregnancy) and doing regular pre-eclampsia screenings. If you don't already have this information: https://www.marchofdimes.org/complications/high-blood-pressure-during-pregnancy.aspx Thanks. Earlier in the pregnancy they said they would not put me on bp medication until I was repeatedly measuring 150/100. At my appointment this week I will ask why they want to wait until that threshold. They have had me taking baby aspirin daily since 16 weeks, and monitoring my bp at home. Quote
ktgrok Posted October 17, 2021 Posted October 17, 2021 1 hour ago, prairiewindmomma said: FWIW, I would seriously consider asking about starting blood pressure medication earlier (you can totally take it in pregnancy) and doing regular pre-eclampsia screenings. If you don't already have this information: https://www.marchofdimes.org/complications/high-blood-pressure-during-pregnancy.aspx It does seem weird that so many OBs will do an induction rather than try meds. (realizing taht any signs of preeclampsia change the equation) I always wonder if it is because once the baby is out, the doctor isn't the one dealing with things anymore, and doesn't realize what a difference a few more weeks inside can make on things like irritability, breastfeeding, sleeping well, etc. None of those are "critical health issues", so may not be something the doctors are really even fully aware of. But the moms sure know! 2 Quote
Condessa Posted October 17, 2021 Author Posted October 17, 2021 30 minutes ago, ktgrok said: It does seem weird that so many OBs will do an induction rather than try meds. (realizing taht any signs of preeclampsia change the equation) I always wonder if it is because once the baby is out, the doctor isn't the one dealing with things anymore, and doesn't realize what a difference a few more weeks inside can make on things like irritability, breastfeeding, sleeping well, etc. None of those are "critical health issues", so may not be something the doctors are really even fully aware of. But the moms sure know! I found this on https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768605/#r17 “The level at which antihypertensive treatment is initiated for non-severe hypertension remains controversial, depending on whether treatment is focused on maternal or fetal wellbeing.16,17 Most physicians commence antihypertensive medication when the systolic blood pressure > 140–170 mm Hg or diastolic pressure > 90–110 mm Hg. Treatment is mandatory for severe hypertension when the blood pressure is ⩾ 170/110 mm Hg. Once treatment is started, target blood pressure is also controversial, but many practitioners would treat to keep the mean arterial pressure < 125 mmHg—for example, a blood pressure 150/100 mm Hg. Overzealous blood pressure control may lead to placental hypoperfusion, as placental blood flow is not autoregulated, and this will compromise the fetus.” According to their linked sources, mothers’ use of bp medication is linked to low weight-for-gestational-age babies. Quote
Ausmumof3 Posted October 17, 2021 Posted October 17, 2021 I don’t have much advice at all but just wanted to say I really wish you all the best for the smoothest possible end of pregnancy and birth. That is a lot going on. I do wonder if there’s any child cancer charity groups or similar who could help with finance for you to have someone help out? It’s the kind of thing that I would love to think money we donate is going towards, but please ignore if that’s not a helpful suggestion. 2 Quote
prairiewindmomma Posted October 17, 2021 Posted October 17, 2021 1 hour ago, Condessa said: I found this on https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768605/#r17 “The level at which antihypertensive treatment is initiated for non-severe hypertension remains controversial, depending on whether treatment is focused on maternal or fetal wellbeing.16,17 Most physicians commence antihypertensive medication when the systolic blood pressure > 140–170 mm Hg or diastolic pressure > 90–110 mm Hg. Treatment is mandatory for severe hypertension when the blood pressure is ⩾ 170/110 mm Hg. Once treatment is started, target blood pressure is also controversial, but many practitioners would treat to keep the mean arterial pressure < 125 mmHg—for example, a blood pressure 150/100 mm Hg. Overzealous blood pressure control may lead to placental hypoperfusion, as placental blood flow is not autoregulated, and this will compromise the fetus.” According to their linked sources, mothers’ use of bp medication is linked to low weight-for-gestational-age babies. They've changed the guidelines on when to begin medication in the last few years. FWIW, while placental hypo perfusion is an issue, there is some controversy over whether the correlation to low for gestational age babies is due to blood pressure management or whether it's due to other indicators. Older maternal age, whether mom is a person of color, and other things are all correlated to an increased likelihood of premature birth in general, and these risk factors also make them more likely to have hypertension. It's a chicken/egg scenario. 1 Quote
Condessa Posted October 20, 2021 Author Posted October 20, 2021 I had my appointment. My blood pressure was 164/102, and I had some protein in my urine, which I have never had with my prior pregnancies. They sent me up to Labor and Delivery, where they monitored me for a couple of hours and did labs. My bp came down while I was there. I have small amounts of protein and slightly low platelet counts, but everything else came back good. Because of the concern about preeclampsia, they will not medicate me for blood pressure. They are concerned that if they do it will mask the signs of the onset of preeclampsia. I am very worried about having to induce early. It would be surprising if, barring any treatment, my blood pressure did not continue to rise in its previous pattern and put us in dangerous territory within a week or two. I know that preeclampsia is the more dangerous condition, but it is still just a potential right now. And honestly, while I am worried about premie health problems and NICU time and all of that, my greatest fear is deeper and less rational. After all the breathing problems my 37 weeker had for the first three years of his life, all those chest X-rays as an infant, he only had three healthy years of childhood before we found the tumor in his spine. I know it is not logical, but I am terrified that if E is premature, he will get cancer, too. 17 Quote
maize Posted October 20, 2021 Posted October 20, 2021 (edited) (((Condessa))) having not-entirely-logical fears is completely understandable; this is a lot to be dealing with all at once. Edited October 21, 2021 by maize 3 Quote
mommyoffive Posted October 20, 2021 Posted October 20, 2021 Sending you lots of prayers and good thoughts. I am sorry you are worrying right now. I am hoping for a good delivery and healthy baby. 1 Quote
KSera Posted October 20, 2021 Posted October 20, 2021 On 10/17/2021 at 12:33 PM, Condessa said: Thanks. Earlier in the pregnancy they said they would not put me on bp medication until I was repeatedly measuring 150/100. At my appointment this week I will ask why they want to wait until that threshold. They have had me taking baby aspirin daily since 16 weeks, and monitoring my bp at home. I'm sorry things were not great today! I wanted to reply to this, because I find it super suprising they didn't start medicating you early on. I've had PIH for all of my pregnancies except my first (who was induced at the end due to my blood pressure rising and liver enzymes changing). Each time, they have put me on medication as soon as I was starting to run my pressures too high. The goal was to keep my blood pressure controlled so that we didn't end up in a situation of having to induce early due to the hypertension. I became chronically hypertensive after my third, so have been on bp meds the entire pregnancy with my last couple babies, and my bp has to be watched carefully. I was induced this last one at 40 weeks because it was deemed at that point the risk of baby staying in was higher than the downsides of induction (I hate induction!) All that to say, there are a number of very well researched bp meds that can be used in pregnancy (labetalol and atenolol are the ones I've used) and they can work very well. There is some concern about dropping pressure too much though, since the placenta has developed with a certain pressure through it, and there is concern dropping pressure too much could result in less perfusion for baby. I have had weekly growth scans with umbilical artery dopplers at the end of pregnancy with the last couple babies to make sure they were still growing fine. I can't recall all the details anymore, though. I hope your pressure can be controlled and baby can stay put several more weeks. 3 Quote
happypamama Posted October 20, 2021 Posted October 20, 2021 Okay, I want to clarify a few things here. One, Pregnancy Induced Hypertension is an outdated term. The current term is Gestational Hypertension (new onset of high BP after 20 weeks), and I'd be cautious about any provider using PIH as a term, because it may mean they are not up on the current guidelines and standards of care. Preeclampsia is GH plus one additional criterion such as proteinuria, labwork, certain visual disturbances, pulmonary edema, and so on. Both are serious because they are on the same spectrum of placenta-mediated illness. American guidelines call for meds to be started at or around 160/110, whether for GH or for preeclampsia. Meds will not mask PE; if you do have PE, then you'll likely see BP continuing to go up even with meds. If you're hitting 160/110, either number, regularly, meds really should be given to keep your BP in a safe range. If you're unsure, you can ask to see a Maternal Fetal Medicine specialist. They don't like to start meds until you're getting close to that upper point because they don't want to reduce blood flow to the baby, but too high is no good for you or baby either. In addition, BP meds will not slow the process down -- they can sometimes manage the one symptom of blood pressure IF that's the only thing going on, but they won't stop GH from turning into PE, and they won't stop PE. (Case in point, I was put on BP meds, but four days later, things went catastrophically badly -- my BPs hit 200/130, despite additional meds, and then my son's placenta completely crashed, necessitating a crash delivery at 26 weeks.) American guidelines call for delivery for both GH and PE at 37 weeks. Some doctors like to push that if it's GH, but guidelines from ACOG do say 37 weeks for either. For severe features (protein is not a severe feature, but labs can be), delivery at 34 weeks is recommended. I know that sounds scary, but 34 weekers mostly do tend to do very well. BPs at 160/110 can count as preeclampsia all on their own, even without that second criterion, and 34 weeks may well be indicated. I would be asking why they don't feel you have severe features, and if they feel you do, why they don't want to deliver at 34 weeks per guidelines. If you're on Facebook, I moderate a huge Preeclampsia support group there (30,000 people and 50+ posts a day all about preeclampsia and related topics) and would love to have you join us, so we can give you additional help, at https://www.facebook.com/groups/preeclampsia 2 7 Quote
Drama Llama Posted October 20, 2021 Posted October 20, 2021 (edited) . . . . Edited October 26, 2021 by BaseballandHockey 2 Quote
happypamama Posted October 20, 2021 Posted October 20, 2021 On 10/17/2021 at 2:17 PM, prairiewindmomma said: FWIW, I would seriously consider asking about starting blood pressure medication earlier (you can totally take it in pregnancy) and doing regular pre-eclampsia screenings. If you don't already have this information: https://www.marchofdimes.org/complications/high-blood-pressure-during-pregnancy.aspx I have to say: a lot of the info on that page is just plain wrong, according to current ACOG guidelines. Crisis level in pregnancy is 160/110, and eating healthily, exercising, etc. will not prevent preeclampsia. I'm quite appalled that the MOD can't get their info from ACOG. 2 Quote
Condessa Posted October 21, 2021 Author Posted October 21, 2021 16 hours ago, KSera said: All that to say, there are a number of very well researched bp meds that can be used in pregnancy (labetalol and atenolol are the ones I've used) and they can work very well. There is some concern about dropping pressure too much though, since the placenta has developed with a certain pressure through it, and there is concern dropping pressure too much could result in less perfusion for baby. I have had weekly growth scans with umbilical artery dopplers at the end of pregnancy with the last couple babies to make sure they were still growing fine. I can't recall all the details anymore, though. I hope your pressure can be controlled and baby can stay put several more weeks. 15 hours ago, happypamama said: American guidelines call for meds to be started at or around 160/110, whether for GH or for preeclampsia. Meds will not mask PE; if you do have PE, then you'll likely see BP continuing to go up even with meds. If you're hitting 160/110, either number, regularly, meds really should be given to keep your BP in a safe range. If you're unsure, you can ask to see a Maternal Fetal Medicine specialist. They don't like to start meds until you're getting close to that upper point because they don't want to reduce blood flow to the baby, but too high is no good for you or baby either. In addition, BP meds will not slow the process down -- they can sometimes manage the one symptom of blood pressure IF that's the only thing going on, but they won't stop GH from turning into PE, and they won't stop PE. (Case in point, I was put on BP meds, but four days later, things went catastrophically badly -- my BPs hit 200/130, despite additional meds, and then my son's placenta completely crashed, necessitating a crash delivery at 26 weeks.) American guidelines call for delivery for both GH and PE at 37 weeks. Some doctors like to push that if it's GH, but guidelines from ACOG do say 37 weeks for either. For severe features (protein is not a severe feature, but labs can be), delivery at 34 weeks is recommended. I know that sounds scary, but 34 weekers mostly do tend to do very well. The doctor in L & D and my doctor were both in very firm agreement about not giving me bp meds because of the potential to not catch the onset of preeclampsia quickly enough if medication successfully controlled my blood pressure. I am frustrated that the plan is apparently to therefore not treat the problem I have. They said yesterday, "We're on this train, now, we know where it is going to go. We just need to watch carefully to see how fast it will go so we know when to get you in here to induce you." They were also talking about giving me the steroid shot for baby lung development when I come in for going over 160/110 and trying to start the induction slowly so as to have 24 hours they need for that. It occurred to me later that I should ask them if I were at the bp where they were having me come in to the hospital, if they could watch for preeclampsia with lab tests instead and try medication for the bp at that point. I know that statistically 34+ week babies usually do well, but after our experience with our last, knowing that doesn't help much. I've always wondered if my babies just take longer than average, if I would be a ten month mom if I were ever able to go until the baby was ready to come on its own. Even my first, at 41+6 (with an early ultrasound for accurate dating) was 7 lbs. 2 oz. and covered in vernix. Her doctor pulled her out and said, "Huh. She looks like she could have cooked for a few more weeks." They just all seemed young for their gestational ages, especially ds7. Quote
ktgrok Posted October 21, 2021 Posted October 21, 2021 I think scheduling an appointment with a maternal fetal specialist is a good idea. If only for your own peace of mind. They are the experts in this kind of stuff, and can coordinate with your OB. 5 Quote
KSera Posted October 21, 2021 Posted October 21, 2021 36 minutes ago, ktgrok said: I think scheduling an appointment with a maternal fetal specialist is a good idea. If only for your own peace of mind. They are the experts in this kind of stuff, and can coordinate with your OB. I agree with this. My last three pregnancies all were in consultation with a maternal fetal specialist once my blood pressure went up. still seems really odd to me that they aren’t wanting to treat the blood pressure. They wanted to keep mine as well controlled as possible and then preeclampsia was screened for by checking my urine and blood work. Near the end, that was twice a week. Are there any maternal fetal specialists near you? 1 Quote
Condessa Posted October 21, 2021 Author Posted October 21, 2021 3 hours ago, ktgrok said: I think scheduling an appointment with a maternal fetal specialist is a good idea. If only for your own peace of mind. They are the experts in this kind of stuff, and can coordinate with your OB. 2 hours ago, KSera said: I agree with this. My last three pregnancies all were in consultation with a maternal fetal specialist once my blood pressure went up. still seems really odd to me that they aren’t wanting to treat the blood pressure. They wanted to keep mine as well controlled as possible and then preeclampsia was screened for by checking my urine and blood work. Near the end, that was twice a week. Are there any maternal fetal specialists near you? I looked it up, they have some MFM specialists based in the same hospital as my maternity care. It looks like you have to be referred. I will talk to my doctor about it. 5 Quote
ktgrok Posted October 21, 2021 Posted October 21, 2021 2 hours ago, Condessa said: I looked it up, they have some MFM specialists based in the same hospital as my maternity care. It looks like you have to be referred. I will talk to my doctor about it. You probably can call up the front desk at your OB and request the referral - rather than waiting until your next appointment. 2 Quote
Eos Posted October 21, 2021 Posted October 21, 2021 On 10/20/2021 at 6:19 PM, Condessa said: I know it is not logical, but I am terrified that if E is premature, he will get cancer, too. I'm so sorry this is so stressful. Is this baby measuring small for dates? 1 Quote
Anne Posted October 22, 2021 Posted October 22, 2021 Praying for you, Condessa - you have a lot on your plate! Anne 1 Quote
Condessa Posted October 22, 2021 Author Posted October 22, 2021 (edited) On 10/21/2021 at 5:59 PM, Eos said: I'm so sorry this is so stressful. Is this baby measuring small for dates? No, he's actually looking big. But so was ds7. He was 7 lbs. 14 oz. at birth, but he still struggled to breathe and digest, couldn't maintain his body temperature, and had no urge to eat at all. Edited October 25, 2021 by Condessa 2 Quote
Condessa Posted October 25, 2021 Author Posted October 25, 2021 My mom is here now, and that is helping a lot. They have me lying down and resting a lot, and coming in twice a week to see the doctor and check labs and fluid and non stress tests. Baby is very active. My bp is creeping up, but slowly, mostly in the mid 140s over 90s (though yesterday it was 145/107). I have to go in if I get over 160 systolic or over 110 diastolic. Just trying to hold off a few more weeks. We hit 35 weeks tomorrow. 14 Quote
Starr Posted October 26, 2021 Posted October 26, 2021 How nice your mom is with you! I spent months on bedrest and know how that goes. It's hard. And then they want you to get up and get to the doctors office to be checked. haha. I pray you and your babe stay healthy and all goes well. 1 Quote
Condessa Posted November 7, 2021 Author Posted November 7, 2021 36 weeks 5 days today. Almost there. One way or another, I'm having this baby within a week. (They will induce me next Sunday if my bp doesn't require it sooner.) I spent several hours in L&D again on Thursday. I was having sharp pains just under my ribs on the right side of my abdomen and nausea, and my bp was up at my appointment with some of the floating lights in my vision. Also I gained as much weight last week as I had my entire pregnancy up to that point. My blood pressure came down in L&D and the lights went away. We were very concerned about liver problems, but my lab work came back fine on that, so the doctor's theory is that the pain is from baby's growth putting strain on scar tissue from my gall bladder removal surgery a few years ago. I had some protein in my urine, but again not enough to call preeclampsia. My platelets were at the bottom of the normal range. So they sent me home again, and my mom is back again to stay until Thanksgiving. It is a huge weight off to have her here. The last few days my bd readings have consistently been up but not to the point where they said I needed to go in. (That is if I sit breathing deeply for 5 minutes beforehand, like I am supposed to.) But I am having more bp symptoms whenever I am up and doing things for any length of time. The constant lower-level headache starts to ramp up to a real pressure headache and I get those firefly lights, and yesterday I started seeing moving shadows in my peripheral vision. So mostly I am just being a lump and lying down on the couch all day long to keep the bp down. As long as lying down works, I figure we can wait a little longer. 24 Quote
Catwoman Posted November 7, 2021 Posted November 7, 2021 Thanks for the update — I’m so sorry things have been so stressful for you! 1 Quote
Junie Posted November 7, 2021 Posted November 7, 2021 I've been thinking of you and your baby! Hang in there! Only a few more days! :) 1 Quote
math teacher Posted November 7, 2021 Posted November 7, 2021 Just wanted to let you know I am praying for you and baby!! My son was born at 37 weeks and the only issue he had breathing was the first 24 hours his breathing was shallow, so they put him on oxygen. I'm sorry that your previous baby had breathing issues! 1 Quote
Ausmumof3 Posted November 7, 2021 Posted November 7, 2021 I am glad your Mum is there to support you and hope all goes well 1 Quote
Popular Post Condessa Posted November 16, 2021 Author Popular Post Posted November 16, 2021 After 23 hours of labor, Ephraim was born just before 7:00 am this morning, at 37 weeks 6 days. He weighs 7 lbs. 8 oz. They took him to the NICU very quickly for respiratory distress, and he is still there, but he is making good progress as they gradually remove the supports and see how he handles it. He had a chest x-ray shortly after birth that showed fluid in his lungs and was on a cpap for about 8 hours, but his breathing is much better now and they have taken him off that. They were also able to turn of the heat light a couple of hours ago and he has maintained his body temperature since then. They are going to let me try breastfeeding in a little while. We are hopeful that he will only have to stay in the NICU for a day or two. 67 Quote
Condessa Posted November 16, 2021 Author Posted November 16, 2021 Trying to add pictures, but the technology is having issues. Quote
Drama Llama Posted November 16, 2021 Posted November 16, 2021 Thank you for the wonderful update!!! Congratulations. Quote
Eos Posted November 16, 2021 Posted November 16, 2021 7 minutes ago, Condessa said: He weighs 7 lbs. 8 oz. Great job, Mom! Quote
MooCow Posted November 16, 2021 Posted November 16, 2021 Congratulations! You did amazing! Prayers for little man that he doesn't have to there for long! Quote
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