Amnio before delivery or not..

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angieb
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Re: Amnio before delivery or not..

Postby angieb » Wed Apr 30, 638949 6:25 pm

Thanks Rebecca!

My OB already told me I can come in every week, or every day, if I need to. (Luckily we already have a doppler so that will save us the trip, but it's nice to have that back up if we are having trouble finding/hearing the baby on the doppler. And I've been pretty good about using it only a couple times a week.)

Unfortunately, there isn't a group for subsequent pregnancies but there are a few people in the support group that have had them and have kids now, so I usually stick around after the group adjourns to talk to them about that aspect of it a bit. I'm starting to show more so December will be my last meeting until the baby is here (and I'm really only going to that because I have 2 bags full of blankets to donate to them, and hoping I can hide my obvious baby bump with hubby's huge hoodie and by getting there early so I'm sitting instead of walking in with an obvious baby bump.) But, I have kind of gotten to the point where even with the new people, I'm not really hearing new horror stories, it's just different versions of horror stories I've already heard, so it doesn't really bother me as much. But I still want this baby out as soon as safely possible, and I don't think I will make it through an extra week of baby baking time, if that even ends up being an option. I don't think my MFM really wants to chance it with the risks of labor and then how quickly and severely I got sick the first time, either, but we'll see.
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/

rebecca2
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Re: Amnio before delivery or not..

Postby rebecca2 » Fri Mar 28, 638949 1:02 am

If you have to decide now, I would go ahead and schedule one, because like you said, you can always cancel later.

I also had a classical c-section with my daughter and had to have a c-section with my son. Our original plan was to do an amnio at 36 weeks & deliver if lungs were mature. If they weren't matue, we would deliver at 37 weeks. (Like you, no matter how great the pregnancy, my doctors would not risk me going into labor so I would have a c-section at 37 weeks.). In my case, I didn't make it that far. I was having some contractions at 35 weeks and made several trips that week in to L&D for monitoring because we were afraid I would go into labor. I delivered due to low amniotic fluid at 35w6d. My son had some respiratory distress and was in the NICU for a little over 2 weeks but came home healthy.

You might as well accept that you will drive yourself, your husband, your dr, and everyone else a little crazy during this pregnancy, but that is OK! A subsequent pregnancy after a loss is SCARY! And you will likely require extra support from your doctors. Don't be afraid to ask. There was at least one time I remember calling my OB, because I hadn't felt movement. When the nurse tried to blow me off telling me it was too early (around 20-22weeks), I started crying & insisted she speak with my OB. He let me come in within the hour and of course my son was wiggling away when we got there. We could hear the movement on the Doppler, but he did an u/s anyway. He was really good about treating the emotional side of things.

As for the support group....do they offer a subsequent pregnancy after loss group? The support group I attended has one. You still hear of other ways something can go wrong, but the meeting is focused more on dealing with the stress associated with pregnancy rather than the losses. It really helped me.

Becky
Becky
Mom to...
baby girl Addison 3/11/09-3/11/09 (severe preeclampsia 26w5d)
baby boy Aden 5/25/10 (35w6d low amniotic fluid)
baby boy #2 due 7/4/11

jenmatt1
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Re: Amnio before delivery or not..

Postby jenmatt1 » Sat Mar 15, 638949 3:35 pm

Angie I am surprised we are not all crazy by the time we get through all of this more than once. Don't you feel like you have to think about everything so much more now. After you mentioned they would take you by 37 weeks no matter what- I started worrying that maybe I should be asking more questions. That is my fear too- that I will go into labor before the c-section even though I don't have the same risks with classical c-section. Be prepared to overthink everything you do during this pregnancy - but try to enjoy it as much as you can too. Here's to an uneventful pregnancy and a healthy baby and mommy.
Mom to Olivia 4/4/2008 born at 34 1/2 weeks due to class I HELLP
Declan born 1/4/2011- no HELLP or PE- YEAH

angieb
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Re: Amnio before delivery or not..

Postby angieb » Sat Mar 15, 638949 1:50 am

Yes, because of the classic c-section, the risk of uterine rupture is a lot higher than for women who had a regular c-section. They don't want me to go into labor at all. (Contractions put stress on the uterus, which is at risk to rupture.) So the reason to deliver will be mostly to get the baby out before labor has the possibility of starting. If we don't do the amnio, they'll just wait until 37 weeks and I hope I don't go into labor or start having contractions, but that is the very latest they will let things go, regardless of if I get sick or not.

(And definitely if I get sick sooner, the baby's growth starts falling behind, or go into labor sooner, they will deliver earlier without the amnio.-For some time early, they might try to stop labor but I haven't really talked with them about how that will work, I would imagine they won't be that crazy about stopping labor after 32 wks or so, unless they are keeping me in the hospital so they can deliver right away if it starts again- But I guess they want to know now if we are going to do the amnio or just wait until 37 wks.)
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/

milesymommy
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Re: Amnio before delivery or not..

Postby milesymommy » Sat Mar 15, 638949 1:38 am

Like you wrote, you can always schedule it and cancel later.
If you have no signs of PE/HELLP, I advocate baking as long as possible. It's hard - you'll be so worried and paranoid.
I'm honestly not even sure an amnio is needed at 36 weeks. Unless there's IUGR, which can be noted on an u/s, by 36 weeks the baby's lungs should be fine. 33 weeks is the 'norm' for not needing assistance with breathing, but some doctors like to be sure and will do the amnio or steroids if its before 34 or 35 weeks. 36 weeks is borderline full term and unless there are growth issues, the lungs should be fine.
Good luck!

jenmatt1
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Re: Amnio before delivery or not..

Postby jenmatt1 » Sat Mar 15, 638949 12:19 am

Angie- I agree that I would schedule it now and then see what happens. That way you are planning for it but the option to cancel is still open to you. What if you have no issues- will they still try to do a c-section at 36 weeks? My doc originally said we would schedule this c-section at 36 or 37 weeks, but now has pushed it to 39 since there have been no other issues with this pregnancy. Is this because of your classical c-section? Just wondering if there is something else I should be asking her questions about.

Also by moot point is that the baby may decide to come out earlier. I didn't have time to get steroid shots or do an amnio- they had to deliver her either way right away. So I am hoping you get to 36 weeks but you never know.
Mom to Olivia 4/4/2008 born at 34 1/2 weeks due to class I HELLP
Declan born 1/4/2011- no HELLP or PE- YEAH

angieb
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Re: Amnio before delivery or not..

Postby angieb » Fri Mar 14, 638949 11:57 pm

Unfortunately, we can't really wait because they want to schedule it now, if we're doing it. (Although I suppose I could just have them schedule it and then cancel later if we change our minds.)

It won't really be a moot point if I make it to 36 weeks without PE/HELLP, because the reason for the amnio is not really to prevent me from getting sick, but to get the baby out before I go into labor, because there is a higher risk of my uterus rupturing because of the type of c-section I had the first time. They don't want me to go into labor or have any (real) contractions, at all.

I'm leaning towards letting them schedule it and we can change our minds later. I'm still liking the idea of getting the baby out sooner than later, once we hit the 36 weeks mark, if we hit the 36 week mark.
Last edited by angieb on Sat Mar 15, 638949 1:35 am, edited 1 time in total.
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/

jenmatt1
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Posts: 566
Joined: Mon Jul 20, 638635 11:16 am
Location: Florida

Re: Amnio before delivery or not..

Postby jenmatt1 » Fri Mar 14, 638949 6:08 pm

You may not ever get chance to worry about this. My HELLP came on quickly and baby quickly became in distress with her heart racing and then slowing down. So I didn't get steroid shots or amnio. Luckily at 34 1/2 weeks- her lungs were miraculously ok and she only spent 5 days in the nicu for monitoring of her heart. She is a perfect healthy 2 1/2 year old now.

During this pregnancy, I worry about every scenario- like we all do- but I have quickly found out that the things you plan for are not the things you end up having to deal with. The other thing I'veI learned is not to count on your family history of child birth. No one in either mine nor my husband's extended family even had a c-section- never mind these sort of complications. I try not to rely on that since I know how different my experience was. Instead I tried to learn as much as I can about HELLP/PE and have open discussions with my docs about my fears. It will put your mind a lot more at ease that way.

My advice would be to talk through all the things you can with the doc to try to prepare for the worst- but be prepared for the best outcome as well. You still have a long time before you have to exactly decide what might need to be done- and maybe you make it to 36 weeks without any signs of PE/HELLP and it is a moot point. At first my doctor was convinced I would only make it to 36-37 weeks. Now she wants to schedule c-section at 39 weeks exactly. So things change and you just have to try to be prepared for them. So far I am at 33 weeks tomorrow and no signs of PE/HELLP. BP ranges have only been from 90/50s - 120/65 at the most right now. I don't think I'll last until 39 weeks like my doctors would like, but hoping to get to 37.

Best of luck on this pregnancy.
Mom to Olivia 4/4/2008 born at 34 1/2 weeks due to class I HELLP
Declan born 1/4/2011- no HELLP or PE- YEAH

angieb
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Amnio before delivery or not..

Postby angieb » Tue Mar 04, 638949 4:40 pm

I'm not really ready to think about this already- I'm only 14 wks- but my ob brought it up and wants me to discuss with the MFM next time I see her and let her know what we've decided, so that if we are going to do an amnio, we can schedule it now (for April, apparently they get backed up.)

(I had a classical c-section/vertical incision with Olivia at 23 wks, so I will definitely have a repeat c-section no matter what.)

If we do the amnio, it will be at about 36 weeks, and if the baby's lungs are mature, we deliver shortly after.

If we don't do the amnio, we wait until 37 wks and deliver exactly then, pretty much.

Of course, if I get sick at any time (which is a major possibility), if the baby's growth starts falling behind (so far measuring 2-4 days ahead, so hopefully this won't happen this time), or if I go into labor, we'll just deliver. (I'm not sure if they'll bother trying to stop labor or not, it probably depends how far along I am and what else is going on. But I don't really think it's that likely that I'll go into labor before 36 weeks, given that my mom has never delivered before her due date and in fact I was 2 full weeks late, and I've never been in labor before.)

I'm really torn on this! Of course I'll listen to what my MFM thinks, but she's pretty open and is probably going to want to know our decision after we discuss it. (DH is pretty torn too but more of the "whatever you want to do honey" opinion.) On one hand, I've heard enough horror stories and lived through a horror story, I want this baby out of my body the minute it is safely possible because there are hundreds of things that can go wrong while he or she is inside of me. (Probably should stop going to our infant loss support group soon. We have new people and new stories every month. :( ) . On the other hand, if everything is going well, giving the baby one more week to "bake", and not messing with an amnio, seems like a nice idea (at least in theory), also.

From what I understand about amnios at 36 weeks, pretty much the worst case scenario if something goes wrong is that they just deliver the baby then before they have the results. Are there other risks I'm not realizing?

Any thoughts on this would be greatly appreciated, or if you've been in this boat too, which did you/your doctors decide and are you happy with that decision in hindsight?

Thanks!
Me (29) DH (30)
#1-Olivia Caetlyn-9-28-09-9-28-09, 23+2 wks, emergency classic c-section, class I HELLP, IUGR
#2- Lucas Oliver (rainbow baby)- April 2011, 36+2 wks, HELLP and pre-e free! (lovenox and LDA pregnancy)
#3-Matthew, late October 2012...mostly normal, 37 wks, (lovenox and LDA again)
My blog: http://www.butterflies-and-rainbows.blogspot.com/


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