New.. With Concerns/Questions

This section is for discussions with other women who have probably been through the same signs/symptoms that you may be experiencing. Please note, we cannot offer medical advice and encourage members to discuss their concerns with their doctors. New members, come on in and introduce yourself!
fiona
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Re : New.. With Concerns/Questions

Postby fiona » Wed Oct 15, 638302 7:18 pm

Kathryn, how are they planning to monitor you on a day-to-day basis as an outpatient?

Have you been given a BP that, should you hit it on complete bedrest, they expect you to head straight in? When's your next appointment?

I would be very vigilant about any new symptom or apparent worsening - even if you just start to feel crappy. Just feeling 'off' is sometimes a flag that you're getting into trouble.

Bedrest has helped some of our members buy more time - stick to it, and try and spend as much time on your left side as you can.

Keep us posted (from a laptop in bed, of course!).

pusheangel
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Re : New.. With Concerns/Questions

Postby pusheangel » Wed Oct 15, 638302 4:37 pm

Thanks for all of your responses. I appreciate you taking the time to encourage and help me.

The appt. with MFM went okay. He wanted some more labs done and for me to be monitored because BP was 145/100 when I went in. After getting to the hospital BP seemed to stabilize and labs came back good. After talking with my regular OB they decided to release me. They are talking about giving me steroids in case I can't make it to 37 weeks. My bedrest which had been modified bedrest has been changed to full bedrest.

The high risk OB said that with this illness it is a wait and see type of thing. Both he and my regular OB are concerned, but he said we will have to take it one day at a time. The high risk OB did seem impressed that I have had this illness for 3 weeks now and am still on outpatient basis.

I did, however, gain 3 pounds in about 4 days. But, all in all I feel like my docs are keeping a close eye on me and although there are no guarantees I will make it to 37 weeks I know they are looking out for our best interest.

Thanks again for all of your responses. I'm sure I will be posting more as I develop more questions.

Kathryn

rachelc
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Re : New.. With Concerns/Questions

Postby rachelc » Tue Oct 14, 638302 1:34 pm

One thing that you might want to ask about at your appointment is steroid shots to develop the babies lungs. I know that you are shooting for 37 weeks but honestly, I think the odds are against you. It may be wise to have them "just in case". Let us know how your appointment goes today.

rebeccac
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Re : New.. With Concerns/Questions

Postby rebeccac » Tue Oct 14, 638302 10:55 am

Alanna (above) summed up everything great.

I was induced at 35 weeks and ended up with an ER section because I got very sick, very fast. DS spent 2 weeks in the NICU and I spent 1 week in the hospital. He is now a VERY active 2 years old!

37 weeks would be great but with what you are describing, might not be possible. 33 weeks is a good place to be given the circustances.

My advice is not to have any preconceived ideas about your labor and delivery (easier said than done). Things may change fast for you and you will have to take things one at a time as they come up.

Take care.

cheer34
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Re : New.. With Concerns/Questions

Postby cheer34 » Tue Oct 14, 638302 5:09 am

You have already gotten a lot of good answers, but wanted to add. With severe Pre-e, I believe I read that the guidelines for delivery are that if you are between 33 and 34 weeks WITH steroid shots, the recommendation is to induce. The survival rate is very high and the possibility of long term complications are low enough that it is not worth jeopardizing your (and consequently your baby's health).

My son was born at 33 weeks and spent 17 days in the NICU...no breathing problems at all, he just couldn't take a bottle (poor suck reflex). He has NO long term repercussions and is smart as a whip!!

I was induced and was told that because my body was not ready to be in labor, the induction could take several days. I started contractions within the hour of receiving the cervadril and they started pitocin a few hours later. From start to finish it only took 12 hours and it was a vaginal birth...so it CAN be done!

You are in a good place, being seen by a specialist and 33+ weeks is a good place to be.....

aundapenner
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Re : New.. With Concerns/Questions

Postby aundapenner » Mon Oct 13, 638302 3:46 pm

(((Hugs)))

Oh, I am so sorry that you are having to face this horrible disease. But have faith and courage my friend. From what you've written, it sounds as though your care is being proactively managed and that is a great thing!

You've gotten excellent information above. I'd like to simply share a bit of my experience with PE.

I had PIH (pregnancy induced hypertension) at 28 weeks. From that point on, I had to stop working, bedrest at home, visit my ob 2x weekly for NSTs etc, constantly monitor my BP, kick counts 2x daily, you name it. I made it to 33 weeks before I began spilling protein and my BP was no longer managed by meds.

Henry was born just at 34 weeks. I was induced. But as my OB said, a 34 week cervix doesn't always want to cooperate. After 20+ hours (with my water breaking and feeling contractions (which BTW was such a beautiful feeling))nothing happened. We agreed to a c/s.

*IF* your doctor recommends a c/s, trust him/her. PE is a dangerous disease in which the outcomes can be horrible.

I was also told that if I were able to deliver vaginally, they preferred me to have an epidural because it was known to help relax the moms and keep BP lower. Not sure how true that is but makes sense to me.

HTH.

And please please please, trust yourself! It's always amazing to me as a mom to realize that I really have this "instinct" from pregnancy on, when something just wasn't right.

(((hugs)))

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caryn
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Re : New.. With Concerns/Questions

Postby caryn » Mon Oct 13, 638302 2:45 pm

Kathryn, welcome to the forums.

I'm sorry you've been hit with this syndrome and that your pregnancy has turned medically complicated, but I'm glad you've found us. Everyone's covered your questions really well; I just wanted to add a few things.

One is that 34 weekers have something like 99% survival odds, and 99% of those have no long-term morbidity. My 34 weeker was discharged from the hospital after a week, and we were given the instruction to "treat him like a normal newborn." He's headed to kindergarten this fall and you'd never guess he'd been born prematurely.

I'd also like to add the caution that if any of your symptoms worsen tonight not to hesitate to head into L&D and have them admit you for another workup. These pregnancies are complicated and can turn on a dime, which is why they're often managed by MFMs who specialize in hypertensive pregnancy. That's why the NIH Working Group Report calls for hospitalization of severely preeclamptic patients at a tertiary hospital with a good NICU; your odds, and your baby's odds, are the best in an environment where they're prepared to provide top-flight emergency medical care at the drop of a hat.

Here's a link about how PE does the damage it does:
http://www.preeclampsia.org/forum/viewtopic.php?t=16607

Here's a link to a bunch of recent research into the syndrome:
http://www.preeclampsia.org/forum/viewtopic.php?t=26469

and here's a link to our Signs and Symptoms page:
http://www.preeclampsia.org/symptoms.asp

Please keep us posted as you're able.

alviarin
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Re : New.. With Concerns/Questions

Postby alviarin » Mon Oct 13, 638302 11:54 am

Katherine, I'm sorry you are having to deal with severe PE, but welcome to the preeclampsia foundation.

*Is it safe for the baby to be induced at 37 weeks?
Most docs consider 37 weeks full term (40 weeks is only an average). Most babies do great at this age.

*What problems or complications are probable if my body/cervix isn't ready for birth at 37 weeks?
If you fail to progress, or things take a turn for the worse due to PE, you may face a c-section.

*Will it be possible to still have an unmedicated (no pain meds) vaginal birth?

It is possible to have an induction with no pain meds. You will probably be put on a magnesium sulfate IV to prevent seizures or eclampsia. Here's a couple threads discussing birth experiences and inductions you may find of interest:
http://www.preeclampsia.org/forum/viewt ... xperiences
http://www.preeclampsia.org/forum/viewt ... xperiences

*It has been mentioned to me that women with severe PE are normally hospitalized. Is this true? With the current symptoms I am having is it probable that the high risk OB will want to admit me?

I'm glad you are going to consult an ob that specializes in high risk pregnancies. Odds are that you will be admitted to the hospital. The NIH Working Group Report on High Blood Pressure in Pregnancy says this:

"Hospitalization for the duration of pregnancy is indicated for preterm onset of severe gestational hypertension or preeclampsia. The decision to prolong the pregnancy in these women is determined day by day. The women should receive intensive maternal and fetal surveillance, usually at a tertiary care facility. Laboratory studies are performed at frequent intervals and include serial determinations of platelet count, serum liver enzyme levels, renal function, and urinary protein. Assiduous attention is given for worsening hypertension; evidence of central nervous system involvement that includes severe headache, disorientation, or visual symptoms; and hepatic involvement indicated by epigastric pain and tenderness."

*What are the chances that our son will have to be born even earlier than 37 weeks, and if sooner what are survival chances. How long would he have to be hospitalized?

The average time from diagnosis to delivery with PE is two weeks. However that includes women who limp along with mild symptoms for weeks and even months, and women who deliver in a day due to rapidly progressing disease. Unfortunately it is a day by day waiting game. That's why more frequent monitoring and testing is important, to catch problems developing before it turns in to an emergency situation.

Thirty three weeks is not a bad place to be- great in terms of survival rates- but the baby may have to spend some time in the NICU. The high risk ob will have more detailed stats at hand.

I hope this answers some of your questions. You might want to write them down or print them out to discuss at your doctor's appointment tomorrow. Also please take a look at our Signs & Symptoms page if you haven't already: http://www.preeclampsia.org/symptoms.asp

Good luck with your appointment tomorrow. Let us know how it goes.

melly
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Re : New.. With Concerns/Questions

Postby melly » Mon Oct 13, 638302 7:26 am

I am really happy that you are seeing a specialist tomorrow. I can only give you answers based on my experience. My first born was induced at 36 weeks due to sudden on-set pe. I was considered mild pe from what I gathered after the fact. I went in for my 36 week appt and was wheeled into L&D with a 10 lb weight gain due to swelling, high bps and protien. I was kept overnight for observation and was started on pitocin the next morning due to the fact that my bps weren't going down, my sons growth had slowed and I was contracting. My cervix was fused shut with scar tissue due to a lasar surgery I'd had years before. I was put on mag and I opted for the epidural. It was 24 hours to delivery from the time I started the pitocin. My son was born kicking and screaming at 5lbs and he aced his apgar. He went home with us after I was released.

My dd was induced 3 months ago at 37 weeks due to PIH and after 3 weeks of bedrest. She also did great and went home with me two days later. No complications. Again I was on Pitocin and had an epidural. No mag this time. It was about 5-6 hours labor this time.

I hope that they admit you with your symptoms. I think I would feel more secure in the hospital. I'm sure it wouldn't be fun, but I hate to think what could happen if you were alone and things took a turn for the worse. 33 weeks is considered a good place to be, 37 weeks full term. As I mentioned earlier, my cervix was fused shut and I still delivered vaginally. But I was a mild pe case and it all depends on how stable you and the baby are. If it looks like either of you are going into distress they will give you a c-section. I would count on being on Mag as well. As far as no pain meds, that is up to you but the induction makes the contractions much more painful and harder than it would be naturally. Also from what I understand, your bps can go down with pain meds. I hope this helps, sorry so long, just trying to answer all your questions and kind of rambling, keep us updated. I want to hear how your appt goes tomorrow. Hugs and wishing you the best!

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Re : New.. With Concerns/Questions

Postby msjboof » Mon Oct 13, 638302 7:19 am

also i know you may want a med free delivery, but you have to do what is best for you and the baby, I had emergency C section.. mom was told oen of us wouldn't make it but maybe both.. i was adimant before about natural birth.. now i love my scar cause it reminds me jsut how short life can be.. PE can be super serious.. this is because it can change from kinda bad to HORRIBLE in minutes.. literally!

I just had a friend who delievered at 23 weeks.. baby was 1.3 pounds, they thought she would die, she has been in NICU for 2 weeks now and is doing great.. has a long road ahead, in medical field, anything past 25 is viable, the longer the better.. your chance of survival goes up each day!

Placenta abruptio is a major thing with PE, I have seen it int he field, but it doesn't happen overnight, so your dr's should be watching for it with the hypertension (high bp). it's when the placenta begins to tear away from the uterus, and the baby doesn't get what it needs.. in those cases.. they do C section usually to save the baby!


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