BP and antenatal care

[sjs40]

I have been thinking about my antenatal checks at the first hospital, and wonder if they should have taken more care. As briefly as possible....I have pcos, high bmi, father had type II diabetes, mother has high bp, and Im 40yrs old, it was my first pregnancy. I had 1 in 29 risk of Downs syndrome (Trisomy 21), I developed gestational diabetes around 20wks and was on insulin from 23wks. My bp from the start was 140/90. By 26 wks I had only put on 4lb in weight. Had a scan at 24wks because they wanted to check on size of baby due to diabetes. Fundal height was measured 24/25/26 wks. At the 26wk check (my last before I transferred) I was told everything was 'normal' and there was no need for them to pass any info on to the new hospital.
At 26+4 I registered with new dr, bp was 185/125, 4+ protein. Admitted to hosp and Ellie was delivered at 27wks due to IUGR and pre eclampsia.
As time goes on I think a lot about things that happened (we lost Ellie when she was 27days old). Surely I was pretty high risk from the start? I can't understand why my bp was not more of a concern, and why nobody noticed that Ellie hadnt grown from 24wk scan to 26wk check. She was actually born at 580g having been estimated at 24wk scan and 27wk scan at 650g.
Maybe these are silly questions....but its bugging me right now.
Thanks for listening, hope somebody has some answers!
Sue

[taras mom]

Not silly questions at all! With that many risk factors, I think they should have paid close attention to your bp, especially if it didn't go down in the second trimester. And if they call no growth between 24 and 26 weeks "normal," it's a good thing you transferred![:(] It sounds as if maybe they were so worried about the GD that they missed everything else.

I had a similar experience with my precious Tara. At 23 weeks she looked about a week behind, but they attributed it to differences in the equipment and technicians since the last ultrasound (different parts of the hospital). Made sense at the time! At 26 weeks, however, she was still 22-week size--definitely IUGR. I know we couldn't have done anything about it, but it still bugs me that she was in trouble for so long and I didn't know.

To make matters worse, they SENT ME HOME after the last ultrasound. They didn't call my OB, didn't send me for observation, didn't even check my bp.[:(!] They didn't even advise me to rest; in fact, I was leaving for the gym when my OB called late the next day and told me to go to the hospital. I don't know where I'm going to go when I get pregnant, but I sure won't trust another ultrasound tech. I was hoping to give you some answers, but I guess I have the same question!

Carol (38)
DH Bill (39)
Tara Mairichi
12/7-12/9, 2002
The Mightiest Little Angel

[akemt]

I am so sorry about both of your experiences.

The only thing I have to add is that my doctor sent me for u/s checks every other week because it was too difficult to gage growth rates (the differences in technician, baby's position, etc) that soon. And, my dd was always about 2 weeks behind in her stomach measurement as compared to her femur and head and what the peri who consulted with my doctor said was if it was a 3 week difference, they would be concerned.

I know that the worst part for me was waiting for that kind of news.
I am inspired by your strength.

Catherine (22)
DH Britton (27)
Emma Margaret (03/02/03) 37 weeks from PIH & oligo

[taras mom]

Yes, waiting definitely makes it worse. I'm hoping I can find an OB who'll see me right after the ultrasounds and who'll schedule me on the same machine with the same tech, but I'm annoyed that they don't do that as a matter of course. Maybe we all need to insist on it!

Carol (38)
DH Bill (39)
Tara Mairichi
12/7-12/9, 2002
The Mightiest Little Angel

[sjs40]

Dear Carol...you have said what I have been thinking...that maybe they got too into sorting out the diabetes and missed the obvious. My actual GP always said that I would have the baby early due to bp, and she turned out right! Shame I had to have hospital antenatal due to gd, rather than seeing her. I now feel she would have picked up more, but you think you can trust the hospital don't you? I didnt put in last post that to add insult to injury, the old hospital actually wrote to me on the day Ellie was born to say that my pregnancy was straightforward with no problems!!!

I can see that different machines and technicians can make for different readings, but it was the same doctor doing the measurements at 24/25/26wks and she was the one who wrote to me!

If it was a case of going back to that hospital I would say never again, but the new hospital totally filled me with confidence when I made my unexpected visit. As it happens it was the best NICU in the area...the old hospital didnt have NICU beds. I am confident that the high risk care provided by the new hospital will be the best I can get, but trying again is going to be soooo scary.

Sue

[taras mom]

It's scary for me, too, but I have a lot more information this time, and that makes a huge difference.[8D]

Carol (38)
DH Bill (39)
Tara Mairichi
12/7-12/9, 2002
The Mightiest Little Angel