advanced maternal age and ultrasound question

[lillymonster]

I am 32 weeks, I just had an ultrasound. Everything looked good. Midwife informs me I need to get another one at 36 weeks. I would have denied the 32 week one had I known I need another in 4 weeks. It seems kind of pointless to do another in so soon. She said to check low amniotic fluid, but I never heard of that with my first baby, and that was only 4 years ago. Isn't fluid something that can change, like if I drink more water? And if it is low, what is my option since I am a vbac - a c-section? They won't induce me as a vbac.  By the way, I am 40. I was 36 with my first. I understand the risk of stillborn for AMA, but can't that be checked with something other than an ultrasound?

[gemasita]

I think you are right to be upset about not knowing that she would suggest ANOTHER u/s.  First of all, maybe you can ask your midwife what happens after the 36 week u/s:  both if everything checks out normal (would she suggest ANOTHER one?) and if it doesn't (what interventions would she be suggesting).

I have definitely heard of checking amniotic fluid levels for prolonged pregnancy (many would define this as beyond 42 weeks but I know that a couple of midwife practices around here encourage an u/s to check fluid levels at 41 weeks - not sure why).  But to do this at 36 weeks seems unnecessary to me.  If you reach 41 weeks though (or maybe before), I'm guessing they'll push another u/s and you have a right to know that in advance.

Here is an article about amniotic fluid levels.  You are right - they fluctuate and there are thing you can do to bring them up if they are low.  Sounds to me like you have good instincts!

Low Amniotic Fluid Levels:  A Cause for Concern?  http://www.themidwifenextdoor.com/?p=1141