MY 32 WEEK APPT TODAY!!

Are you pregnant again after having preeclampsia once already in a previous pregnancy? Post your thoughts/concerns here - there are others who share your feelings. This is also the home of our Bedrest Buddies Support group.
miamibunnie
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Re: MY 32 WEEK APPT TODAY!!

Postby miamibunnie » Wed May 04, 639250 10:13 am

Its the blood thinner (lovenox) that makes it an issue, with lda the strength of thinning out blood is not the same. But I work with surgeons and I was so nervous on the spinal block, and the drs told me spinal block is safe and you only get poked once. I am ok with it.
Lisette 37 Hubby 37
Lisette 36 / Luis 36
1996 25 weeker due to Eclampsia with seizures daughter alive today 15 yrs old " Julyzah Caridad"
2010 23 weeker due to severe preeclampsia my angel left us

2011/27/July we beat preeclampsia and made it to 36.5 weeks 6lbs 1oz baby girl "Kendall Lauren " pe-free just bp started acting up.
Thanks to God, my doctor, Lovenox and Lda.

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jean
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Re: MY 32 WEEK APPT TODAY!!

Postby jean » Wed May 04, 639250 9:27 am

I wonder if epidurals are out of the question when the person is using lda? (does lovenox thin the blood more than lda, or would they be about equal in this situation?)
Our first son was born and passed in Feb of 2010. Born at 29 weeks due to HELLP and passed due to NEC. We miss him every day. :~(

Our second son was born at 39 weeks gestation in Nov of 2011. No HELLP or pre-e! Took LDA starting at week 12 and went off of it at week 38!

http://findingtherainbowconnection.blogspot.com/

miamibunnie
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Re: MY 32 WEEK APPT TODAY!!

Postby miamibunnie » Fri Feb 25, 639250 12:26 am

Thats great seattlemom....your that far....I cant wait to meet my little one. This feels like a 1st time delivery for me since I never got to experience going this far.
Lisette 37 Hubby 37
Lisette 36 / Luis 36
1996 25 weeker due to Eclampsia with seizures daughter alive today 15 yrs old " Julyzah Caridad"
2010 23 weeker due to severe preeclampsia my angel left us

2011/27/July we beat preeclampsia and made it to 36.5 weeks 6lbs 1oz baby girl "Kendall Lauren " pe-free just bp started acting up.
Thanks to God, my doctor, Lovenox and Lda.

SeattleMom
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Re: MY 32 WEEK APPT TODAY!!

Postby SeattleMom » Fri Feb 25, 639250 12:00 am

I agree with Caryn, my Doctors have both told me that it is not an option to induce post C/S so the only chance for a VBAC would be to let the pregnancy progress naturally.
For me, it's too risky. I have GD, chronic HD and I'm 36.5 weeks and my BP's have been creeping up. My Dr. thinks we'll need to deliver soon but I have a planned C/S for 39 weeks in case I do make it that far.
I opted just to go for the C/S as I just don't have the risk tolerance if something goes wrong. This is most likely my last pregnancy and it would be devastating if something happened to the baby. My Dr. gave me a 2/100 chance of uterine rupture with a VBAC and said that generally there are devastating effects to mom and baby if that happens. So although the risk is low the problems are bad if it happens. I figure I have so many things going on that generally have low percentage of happening (PE, GD, Chronic HTN) that my odds would place me at greater risk. Also, I had a 2lb 9oz baby at 31 weeks.

miamibunnie
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Re: MY 32 WEEK APPT TODAY!!

Postby miamibunnie » Sun Feb 13, 639250 9:54 pm

Thx Caryn....you made me feel a little better... I was worried that I would stay paralyzed for a whole day. Thats my biggest fear...I ususally go to bed early but since yesterdays appt I just can' sleep thinking and thinking. I am grateful that I will have a full term baby if I deliver at
37 weeks.

So far my bps are great just the gestational diabetes that just was diagnosed 2 wks ago but its controled....I just pray...I know that once I deliver her and I hear her little cry I will be so emotional....because god knows how much I been through. Just the thought of it makes me cry.
Lisette 37 Hubby 37
Lisette 36 / Luis 36
1996 25 weeker due to Eclampsia with seizures daughter alive today 15 yrs old " Julyzah Caridad"
2010 23 weeker due to severe preeclampsia my angel left us

2011/27/July we beat preeclampsia and made it to 36.5 weeks 6lbs 1oz baby girl "Kendall Lauren " pe-free just bp started acting up.
Thanks to God, my doctor, Lovenox and Lda.

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caryn
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Re: MY 32 WEEK APPT TODAY!!

Postby caryn » Sun Feb 13, 639250 9:35 pm

I don't know *why* I flipped around which birth was the Caesarean and which the vaginal, sorry!

I had a spinal with Oscar, in what was an "emergent" delivery, where it didn't have to happen quite quickly enough to need a general. It wore off pretty quickly, within an hour or so in the recovery room, so the paralysis thing didn't last long, I could still meet him for a bit before he went off to NICU (delivery at 34 weeks on the nose), and there was really no pain postpartum whatsoever. I gather there's residual effect from something the anaesthesiologist does?

I did have shivering - the anasthesiologist said that was a common side effect and gave me another med to stop it.

I was really grateful, postpartum, that I didn't actually have any time to think about it, because I really, really do not like needles. At a Level III NICU the teams are usually very well-trained and despite some concern about how my pressures might be too high for a spinal, everything went very smoothly. They really knew what they were doing.

I know you're at a good hospital - I hope you're able to talk to the anaesthesiologist ahead of time and get a better feeling for what might happen before you have to have an official opinion about your preferences!
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

miamibunnie
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Re: MY 32 WEEK APPT TODAY!!

Postby miamibunnie » Sun Feb 13, 639250 8:58 pm

Thanks Ladies for all your responses.

My dr said I can have either vaginal or c-section...she was explaining the risks between both procedure. The vaginal delivery there are risk for myself and baby, due to having a c-section in the past. She said while pushing i can rupture my placenta my uterus scar can reopen itself and cause major infection to the point where some women require a hysterectomy. She said the chances of that are slim but just never know.

With the c-section I will only get general anesthia if I was to get sick like bp issues, preeclampsia, etc. So for now she said that a spinal block would be what they would use. The epidural is out of the question because I am on lovenox. I did ask her why not take me off sooner...she said she would once we came up with my decision which is next week. She did mention heparin...but we did not go that far. She did explain that there are no risk for the baby with a c-section, but for a pregnant woman with a repeat c-section there are some risk. Since I had an emergency c-section in 1996 when I was 23 yrs old she does not know what she will encounter herself once she opens me up. She told me everyones anatomy is different...but she did say that if she was me she would choose the c-section...because after everything I been through with delivering at 23-25 weeks in the past is enough. She told me not to be scared but she has to go over these steps with me because that is part of procedure policy. She mentioned that with c-section some women require a blood transfusion sometimes...and slight chance of infections. But that goes for anyone who has had a c-section before.

I will be awake while delivering my baby if Im ok health wise in the next 4 weeks..crossing my fingers.
In addition, I will get an amniocentesis one day prior to surgery just to make sure babys lungs are fully developed at 36 weeks. On friday they told me baby looks really good and is growing very well. I just can't believe it that I have made it this far and now I am so scared since the time is coming up.

@ Cayn thx for the link
@ Alexis no my incision was done in 96 and last yr I delivered vaginal when my baby passed at 23 wks...but my dr told me you can't compare the size of that baby to this baby.
Im just scared of the spinal block...and the whole operation thing!
Lisette 37 Hubby 37
Lisette 36 / Luis 36
1996 25 weeker due to Eclampsia with seizures daughter alive today 15 yrs old " Julyzah Caridad"
2010 23 weeker due to severe preeclampsia my angel left us

2011/27/July we beat preeclampsia and made it to 36.5 weeks 6lbs 1oz baby girl "Kendall Lauren " pe-free just bp started acting up.
Thanks to God, my doctor, Lovenox and Lda.

alexis
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Re: MY 32 WEEK APPT TODAY!!

Postby alexis » Sun Feb 13, 639250 2:23 am

Yeah, I don't think I've ever seen data on women whose CS was performed preterm. The studies that get quoted pretty much lump everything in together. I know of a few VBACs that came after a 30-33 week delivery, but the plural of anecdote is not data; about all that shows is that their OBs considered it "safe enough."

Just to be clear, I don't think VBAC is invariably the right or even a good choice, but those particular reasons strike me as odd and hew towards the scare tactic. Like Caryn, I would be much more concerned about the timing issue. Was there anything unusual about your incision, though, miamibunnie? I ask because I just looked back and saw how early your CS was done. That definitely affects the safety of VBAC.
Chronic hypertension
Aliza - 01/05/2007 - Severe preeclampsia, emergency CS 37 weeks
Isaac - 09/26/2011 - controlled on 150mg Toprol, NO PE, 39 weeks!

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caryn
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Re: MY 32 WEEK APPT TODAY!!

Postby caryn » Sun Feb 13, 639250 1:29 am

I'm not sure about that .5% applying here, because that's the set of all VBACs, and scars from earlier deliveries go into different areas of the uterus than the scars from term deliveries, particularly into the different muscle structure above the bit directly above cervix that you'd be cutting at term. But I don't know that there's good data on that either; it's something I remember hearing at some conference or other!
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

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caryn
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Re: MY 32 WEEK APPT TODAY!!

Postby caryn » Sun Feb 13, 639250 1:23 am

AHA. Here's the practice guideline: http://www.guideline.gov/content.aspx?id=23853

(overhauled August 2010. So it is a recent change.)

It says "those at high risk for complications... are not usually candidates", but I have the impression it intends to restrict those complications to risk of rupture rather than including preeclampsia under the umbrella, because it then says "induction... for maternal or fetal indications remains an option..." and also says that both of those recommendations are made from a crappy evidence base. In other words, they're mostly guessing about whether or not these recommendations are reasonable because there are no large trials, which mostly leaves it up to you and your doc.

It does agree with my recollection that you can't have misoprostol, but doesn't say anything about oxytocin.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy


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