NSTs

[expert@preeclampsia.org]

I had preeclampsia at 38 weeks with my first and dropping platelets (they went from 145 to 120 overnight) . This led to a failed induction and c-section. My second pregnancy I did not have any preeclampsia and had a successful VBAC. I am currently in my third pregnancy and my 24 hour urine has been between 400-600, but I have never had elevated blood pressure. A growth u/s was done at 33-34 weeks, and was normal. I have had weekly NST's/AFI's and CBC's. My platelets continue to be slightly above 150. My NST/AFI has always been great. I am now 38 weeks.

Two days ago my AFI went from 16 cm down to 7, but the NST was great. I had another test today, the fluid is the same (7) and the NST looked great. I was sent home and told to do daily fetal kick counts and I will return again in three days. I know that low fluid is classified at less than 5. But I am so worried that something is going to go wrong between now and Monday. I am tempted to just beg for an induction before anything happens.

My doctor said if any of the lab results came back poorly this week or next then she would go ahead and attempt an induction, because my cervix is ripe and is mid-position, and I am dilated 1+, but says these conditions aren't ideal for the induction. When my AFI had dropped, I thought she would surely tell me stay at the hospital and try to deliver the baby.

Between these last two AFI tests, I drank 4 Liters of water every day and rested as much as I could just in case the fluid dropped because I was dehydrated. I have not had any increase in vaginal discharge. Two weeks ago I was tested for amniotic leakage, and it came back negative. For these reasons, it makes me think it is my placenta that is having problems.

Could my placenta stop working over night and thus I would lose my baby before morning? I am looking for reassurance because every time I have the NST/AFI I only get my doctor's message via the nurse. I don't get to talk to the doctor directly. I have to wait until this Wednesday when I see her next. I am trying to ease my mind and not worry so much. I am petrified I will lose this baby.

Thanks so much for your time!

[expert@preeclampsia.org]

When one is doing surveillance for placental insufficiency (IUGR, postdates) an NST will usually predict 3-4 days. Therefore, when there is serious concern, we do them twice a week.

Placental abruptions are not predicted by an NST. Yes, one can have a reactive NST and an abruption that night.