Amniotic fluid questions

[ellairiesmom]

As part of a condition of my VBAC pursuit, I had to do a 35 week U/S yesterday to check the baby's weight & my fluids. (I have GD & DD was almost 10lbs & that weight check U/S was dead on 2 years ago)

Our baby is in the 42% so I was really, really excited about that. I can't see how my OB could be concerned about size if I continue to keep my glucose #s in check.

But, the U/S did show what the tech said was slightly low amniotic fluid...not something I expected at all. She said they like to see an 8 at 35 weeks & it was 6.5. She said it wasn't that bad & asked if maybe I wasn't drinking enough water recently. I realized that I absolutely had not been drinking enough water since Christmas...we have been running non stop with the holidays & then we hosted some friends for NYE & I was so busy cleaning, cooking etc I wasn't drinking like I normally would.

Anyone know anything about the levels & if in fact I need to be prepared for any surprises at my weekly appt Thurs because of a 6.5 out of 8??? The U/S Dr asked me to come back in a week to check the fluids again & they did throw me on the NST for 20 mins but were very pleased with those results.

I have had a discharge the whole pregnancy-same as last time. I wasn't thinking I was leaking fluid-any way I can confirm that myself???

[MaerynPearl]

I think they are right and that you do need to just get more fluids... that can make a huge difference!

I do not think you are leaking or anything... just a bit dehydrated (I got the same problem with DS because my U/S was done in August and I still had some morning sickness so I was quite dehydrated)

2 weeks later when I went back (better hydrated) it was a fine level again

[AustinMom]

You have a lot of options..

There is a lot of huff and puff about fluid levels. First off, the baby is constantly making fluid, fluid is really just the baby's pee. Yes, hydration does have a direct effect of fluid levels, so I would, if I were you, be drinking at LEAST 2 quarts of water a day.

Since the baby makes the fluid, if the test says it's low, wait about an hr and retest, the baby may have peed and upped the fluid.

stay away from caffine as it can cause you to have less fluid (I don't know how well this is proven)

You can get a second opinion on the test. Ask around for for a good sonographer referral.

I am having a VBAC and we are not going to have any u/s unless a concern comes up with the baby. You can always refuse the test. An OB can't tell you "you can't have a vbac unless you have an u/s" That's ridiculous, if that is what he is saying, i'd get another dr. I have found through my experience a lot of Dr. will find ways to refuse to do a VBAC because of the malpractice issues they face.

Switch OBs or go through a midwife is you are low risk. A previous cesarean does NOT NOT NOT NOT make you high risk. That's bologna!!!!! Since you are trying a VBAC, the studies show that you should NOT be induced or augmented with ANT stimulants. Pitocin is most commonly used, and it's linked to up to a 6-7 time increase in the occurance of uterine rupture. Cytotec is not FDA approved for any pregnant women, and with VBAC it should not even be considered. If you Dr. is telling you that you have to be induced because of fluid levels, I would switch Dr. for sure. It's not worth it.

[ellairiesmom]

I should have been more clear...I have no issues with my OB. She has been extremely supportive, we have done Bradley & hired our instructor as our Doula. We are prepared & she is on board. My OB is someone I trust & I have no interest in switching. I am actually high risk anyway-I am GD & stayed on my Metformin for this pregnancy to hopefully avoid Insulin in the end (fingers crossed). It has nothing to do with a VBAC-that is how it works with GD and any medication for it. In NJ, a midwife probably would not have accepted me as a patient because I am a VBAC on medication for GD. And if they did, chances are, they would be dumping me to a back up OB by the end if I went past my due date because of the GD & Metformin.

I do not have issues with doing an U/S or NST at this point in the pregnancy because I would rather be safe knowing the GD isn't impacting my baby at all. Yes-I could refuse the test but I don't see it as the devil. And the fact that the baby is showing small will only help my case to go past 40-41 weeks which is tough to get with GD.

I went to one of the top GD U/S places to go so I wasn't questioning accuracy. I also recognize that in going along with these less invasive techniques, I am allowing her to feel confident as my caregiver that everything is looking good.

I did not mean to suggest that she might surprise me with talk of an induction...I was more wondering about bed rest or checking fluids every 48 hrs or something along those lines. Or maybe something I wasn't even aware of...just trying to prepare myself since her & I discuss every detail very openly & honestly.

I didn't mention anything about Pit or Cytotec etc. My practice & hospital doesn't even use Cytotec-never have.

You did mention the caffeine which is interesting because I have had more caffeine in the past week than normal...I had treated myself to diet coke over the holidays a few times & also a few Chai Teas I made at home...

[AustinMom]

Good to hear. I'm glad you have an OB that is wonderful. you are right, if you are high risk, you do not need to be going through a midwife. Also, I'm not sure what GD is. Gestational Diabetes?

It's good that they don't use Cytotec. One of my friends was induced with it and it causes tetanic contractions and she went in for a cs

As far as the fluid goes, and talk of induction, the reason I say that is because another friend of mine went in for 37 wk US and they said she had "no" amniotic fluid. The had her schedule a CS right then, and it turns out, her fluid was fine.

It may not hurt if you want more info, to call an area midwife and ask her what she would suggest for potential low amnitoc fluid. Or ask your Doula if you have one.

[ellairiesmom]

I did send an email to our doula updating her on the U/S...she knew I was really hoping the baby "looked" on the smaller side to them. Of course we all know these size U/S can be off 1-2 lbs BUT since this one worked out in my favor , I will be sure to make a big deal out of being below the 50% since the U/S tech & GD (yes-Gest Diab) Specialist there were really happy with that & thought it was great news. If the baby had shown big, I was fully prepared with stats on lack of accuracy etc.

I think I did well today getting back on track with H20...hopefully a week of that will show it was just about me not drinking enough.


On the whole VBAC thing...
I read TONS on here about induction for VBAC & increased risk of rupture...it's a tough call. Some stats showed that if the Pit was kept short & sweet, the rupture rate only went to 2% or so???? When I brought it up as a possibility to my OB for the "after 41 weeks" thing, she said she would consider it ONLY if my cervix showed signs of progress on it's own & even then she wasn't sure. I still think it sounds better than a repeat section at 41-42 weeks but I guess I need to read more on the rupture risk.

I wasn't comfortable with trying a VBAC homebirth because of the GD. And in NJ, it would have had to be UC because Midwives aren't technically allowed to do HBs for VBACs without risking losing their lic. BUT, any Midwife Group or OB/GYN gets a little antsy if you start to get past 41 weeks with GD/VBAC...I had called around to some of the more popular Midwives & all said they would transfer to backup OB at 41 weeks with a VBAC & GD.