REALLY starting to get worried

[melissaa]

For those ho havent read my back story.. my daughter was delivered via emergency c-section at 35 weeks due to her HR dropping during contractions (It was only discovered hours before that she had IUGR and was in the 4th percentile and her cord wasnt functioning properly). For 36 hours I laid in the hospital watching her HR drop to 60 over and over again.. terrified that with any given contraction she would pass away. We were told after her delivery that had I not pushed for care when I did, they couldnt guarantee she would have made it another 24 hours. That pregnancy, my bp fluctuated and I never had more than trace protein on a dip (was never given a 24 hour test) but when I switched dr's when I got pregnant with my son, they looked at my records and said it was preeclampsia that I probably had with her.
Last week I went into L&D b/c while listening to the baby's heartbeat on my doppler at home, I had two contractions in a row and her HR dropped to 80 both times. When I got to triage, they told me it was most likely cord compression, I was monitored and had to be given terbutaline for ctx and sent home when they slowed to 4 an hour. Since then, I have bouts of 7-9 contractions an hour in the evenings and they die off by bedtime. Yesterday I was back in L&D per my OB nurse's request for the very same hing (only her HR was in the low 100s). When I got there, I only had 2-3 contractions in that hour and her HR did fine so I was told that what I heard was probably my own heartrate (which isnt possible b/c the baby never moved and the doppler never moved.. I watched her HR slowly go down). Today I felt a pretty strong contraction coming on and grabbed my doppler and I watched her HR drop from 125 down to 90 and it stayed in the 90s the entire 60 seconds. Once the contraction was over it slowly started to climb back up and I stopped listening once it got back up to 135.
Im terrified. I dont know what to do here but im scared that something is wrong. I have a growth scan scheduled for the 10th, but im terrified something is going to happen to her before then. What would you do?

[caryn]

The tricky bit is that home dopplers are notoriously unreliable - which doesn't mean that you're wrong about what's happening! - so care providers might discount your reports simply because they know that you can pick up your heartbeat when the fetus is ailing and be falsely reassured, or not pick one up when the fetus is Just Fine and be falsely concerned. The ACOG Ethics Committee actually has a position paper on this, though it's mostly concerned about keepsake ultrasounds. So Trick One has to be communicating your concern to the providers in a way that they can hear.

The way you reported it here seems very clear to me. You report tracking the same heartbeat from 130 down to 90 and then back up to 130 during a contraction. That would worry me not just because of the potential for cord compression, but also because women with preeclampsia or a hx of preeclampsia are at higher risk of abruption, and decels are correlated with abruption. I don't know if *strictly speaking* what you're reporting there counts as a decel - I'm not sure how the medical term is defined for practice - but I would want to know.

How many weeks are you now? I don't like hearing about all these contractions preterm...

[melissaa]

Its completely uderstandable.. I realize they cant do anything unless they actually SEE whats going on, its just so scary!

Im 31 weeks today. A few days before the first triage visit I was in the office for spotting with a crazy amount of discharge for a few days and they checked me and said that I was "tightly closed" but when they checked me in triage last week (when the ctx had to be stopped with terb), they said I was a fingertip dialated. Which makes me wonder if I actually lost my mucus plug and then the contractions have started dialating me. The OB I saw after the triage visit said that a fingertip dialated is no change from being tightly closed and I shouldnt think anything of it. I havent been checked since but have had contractions daily that are pretty intense and now they've changed from feeling tightening up high to feeling tightening and cramping down low with occasional pinching feelings inside. I also have episodes of 6-9 ctx per hour from about 8-10pm almost nightly. What would I need to look out for as far as abruption? My bp in triage the first time was rediculously high for me (170 an 92 were my highest readings) the entire 6 1/2 hours we were there. I had bouts of regular contractions when I was 29 weeks pregnant with DS that never caused cervical change so they told me I had an "irritable uterus" then. I've never dialated before, so I wouldnt have a clue what to look for.