Blood Flow Not Good????

[mommy2maddie]

So yesterday was the first time I have seen the MFM during this pregnancy, at 29 weeks 3 days. My BP was good for me on labetolol 100mg twice a day and no protein, and my latest 24 hr urine came back at 126. So everything is going okay for the most part but when he came in to see me, he said on the ultrasound that the blood flow was not good. He told me I had this with my son in 2009 (which I was never told about) and that I needed to rest and come back every week to see him and get an ultrasound to keep an eye on it, he also pretty much told me I would deliver early and that last time I made it to 35 weeks but that was a stretch. He wasnt very optimistic. So what does this mean for me and my baby that the blood flow is not good? I thought this causes IUGR but my baby weighs 3lbs. 8oz., more than a pound more than my DD who was born at 29 weeks and my baby is in the 67th percentile. I am so confused about all of this! Anyone that has been through this, please help!

[caryn]

Oddly, this is *exactly* what the theory says you should be seeing. Let me back up a bit and explain...

They think PE is a genetic conflict between mother and father over how big the baby can grow, since the dad wants a big kid with good survival odds after delivery, and we want it both to live after delivery *and* to fit out. So we "modulate" the depth of the implantation of the paternal cells that develop the placenta, so that the placenta cannot draw down quite so many maternal resources, so that we can restrict the rate of growth of the fetus. And probably we only do this if our genes detect the presence of paternal genes that will result in a big baby.

So first pregnancy - shallow implantation - compromised blood flow and small baby.

In the second and later pregnancies, the uterine spiral arteries have persistent remodeling from the first placenta which the second placenta can use. So it can dig in more deeply, even if we argue with it. Second/third pregnancy - implantation is still shallow but is better - blood flow is still compromised but better - bigger baby, 'cause it has the genes for it.

Does that make sense?

[MomTimesThree]

I'm sorry I haven't, but it's worrisome how many questions you left the appointment with. I know when given news that isn't what you expect it can take a while to sink in... usually just about the point when the doctor leaves the room and then you think of all your questions. Maybe consider giving him or your regular OB a call to explain everything a bit more clearly- understanding what is going on can take away at least some of the fear and unknown.