Cord accidents - Page 4

[pamamidwife]

Keri, do you mean that frequent hiccups, strong and long BH contractions and frequent movement should all signal a NST?

I don't really know how something like that could be necessarily prevented. Unless, of course, we're doing cesareans on every woman at 35 weeks.

Not to get hostile, please don't take it that way. Was just wondering why that website makes sense to anyone. I think that it gives false hope to people.

[coleslaw]

No, I mean that I had unusual movement for my pregnancy, for my baby. I've been pg before and I know what was typical and not typical for my pregnancy. There is more to my specific story than what I wrote. I was just thanking her for giving me some information because it seemed to have fit what my instincts have been telling me on what killed my baby. I am also feeling very raw, so I don't think I should go any further with this post.

[pamamidwife]

, Keri. I didn't mean to insinuate anything.

and now, not related to you.....



(please don't read)







That website really disgusts me. It symbolizes everything that is wrong with modern childbirth. I really feel physically ill after reading it.

[Full Heart]

Originally Posted by twinangels04

Excessive hiccups (baby), hyperactivity (baby), decreased movement (please do kick counts every day!), fetal heart rate under 100 or more than 150 bpm, fetal shuttering or quivering, localized pain in the uterus (usually happens at night, it will be a sharp pain towards your side and will happen a few times in a row), frequent contractions (The Pregnancy Institute http://www.preginst.com/)

So would these be a sign if there weren't present before in the pg? Like Excessive hiccups and hyperactivity? Because I have had babies who have had hiccups several times a day every day. Like the baby I am carrying now. This pg I also have a very hyperactive baby. One night it felt like someone was inside me doin the jig. I have never experienced that before. I have also had a very very quiet baby who never moved much. In all my pg I have felt the baby quivering or shuttering. And have heard other women mention the same thing. No one seemed to know what it was from. My midwife suggested it couldbe the baby practicing its breathing. I can imagine those symptoms would send women to the drs constantly for nst and u/s.

Also I had a u/s a week before I had ds, no one mentioned anything about his cord. He had it wrapped around his arm, torso and leg. It was so tight he had bruises on his leg and arm for what seemed like forever. Probably only a few weeks, but in nbs that seems like forever. Especially when the normal bruising from birth went away in a few days.

Anyhow, DIdn't read the websites but those symptoms seem more like a normal pg to me than warning signs. Unless its is sudden and unusual.

Michelle

[pfamilygal]

I've seen 4 or 5 true "cord accidents" (that caused stillbirth) in my 6 years as a nurse. Most of the time it is obvious. Once I saw the cord wrapped like a sling around the child and one half of the body was purple and the other half was pale. Other times there is an obvious kink or knot in the cord. The cord is fat and healthy from the kink down and shriveled from the kink up. A dear friend lost her son this way. She noticed at 38 weeks that she was feeling no movement. She had polyhydramnios, so she had difficulty feeling movement at all.

That said, all three of my kids had nuchal cords. My first had it times 3. I was induced for severe PIH and pulmonary edema. When he was beginning to crown his sats dropped very low. The OB cut a huge episiotomy and pulled him out with forceps. She had a a hard time getting the cord untangled even after his head was out. He was black as coal, floppy and not moving or breathing. After a few minutes (the longest of my life!) of resuscitation efforts he started crying. He was fine.

My second only had a nuchal cord x 1. I pushed her head out, the doc slipped it over her head, and out she came. No biggie.

My third was a c/s due to transverse lie after SROM. When they cut me open the doc had a hard time getting her turned to come out because the cord was around her neck twice and around one leg. He said it was a very short cord. I feel like maybe the reason God allowed her to turn was so I'd have the c/s.

I think cords can be a big deal or no big deal at all. Just depends.

[crazy_eights]

Originally Posted by twinangels04

(and yes mom2six, continual Bx hicks was a sign for me, they felt different from regular bx hicks though, it was more of an all day tightness which was sometimes painful):.

I want to start by saying I'm really sorry for your loss. Such a horrible, horrible thing.

In this area, standard care for mono/mono twins is hospitalization at 26 weeks with continuous monitoring until delivery (some will only do it until 34 weeks as the risk of entanglement decreases after that), but that is relatively new. In just this past year I saw one 'crash' c/sec with mono/mono twins that got entangled and luckily the huge decel experienced by one twin was caught on the monitor. This is one case where all that high-risk care really pays off.

That being said, the website said 'BH contractions less than every 10 minutes'. That fits just about all women as they near term. I honestly can't believe that every woman in her 9th month of pregnancy needs daily NST's for B'H ctx. What you decribed as 'contant B'H', does not seem to be what they were describing. They seemed to indicate the frequent B'H ctx. were a risk in and of themselves to the baby, not that it was necessarily an indication of a problem. I've seen women on continuous monitoring, esp. those pregnant with twins that will contract every few minutes for days to weeks with no apparent harm to their baby.

[mwherbs]

Originally Posted by pamamidwife

, Keri. I didn't mean to insinuate anything.

and now, not related to you.....



(please don't read)







That website really disgusts me. It symbolizes everything that is wrong with modern childbirth. I really feel physically ill after reading it.

I agree with you pam, a few years ago we saw this web site and wrote and complained to no avail. Where is the art in this kind of care? every woman in pregnancy may experience one or more of the things he suggests including the heart rate-- he gives too little information and too broad a swipe at what might be dangerous-- as he would have it all women would be under constant monitior and NSTs and I have certainly seen a trent toward this in the local hospitals- docs no longer have a mom come to the office for anything, they go to the in-hopsital testing area/triage and are given NSTs or what ever other testing....
to note that Sister Angela had instuted using kick counts starting at 28 weeks in her high risk population and that she decreased her still birth rate to 0 by using them- the change she used was in reduced movement noted by mom she did an in office NST where she listened and felt for movement with a fetal scope and charted it by hand if still questionable she would send a mom in for an ultrasound or further testing--

[MoonStarFalling]

Greaseball - I suspect I was denied an autopsy because I was on Medicaid and because the hospital was afraid they would be found at fault. Even though I offered to pay for it myself, I was blown off. I believe they were scared because I sat in the ER in preterm labor for 4 hours before they agreed to check me. When they finally checked me they got a hb (mine) and told me all was well I could go home. I demanded an u/s, which I finally got, that revealed our daughters had died.

To everyone else who has mentioned that these particular "symptoms" are present in any pregnancy: It's all about instinct as you mentioned coleslaw. My instincts told me something was wrong, thus is why I went to the ER. When they talk about hiccups being abnormal, they're talking about the baby having hiccups for hours. When they talk about BH, well it's just unmistakable. The BH I had were constant and didn't feel normal to me, I new something was wrong. The hyperactivity/inactivity mentioned is in reference to a baby that is normally docile but suddenly becomes frantic or an active baby that suddenly cannot be motivated to move.


Mom2six, that is the standard of care for momo twins here also. However, since I declined the routine u/s we had no idea we were having momo twins. Even daily NSTs or constant EFM doesn't guarantee a live baby in some cases. I definitely don't agree with everything Dr. Collins recommends. However, his research is an asset because he is one of only a few researching stillbirth. I don't think NSTs are the absolute answer. I think the mother's instinct is most important. In my circle, I know too many mothers (myself included) that knew something was wrong but were denied monitoring. Too many times we're treated as nothing more than an overly nervous pregnant woman. That's why I believe UP and midwife care is so essential. It's important to be connected to your baby not just relying on a machine to tell you everything is okay.

[mwherbs]

twinangels04 I am sorry for your losses and agree that if you felt something wasn't right you should have been listened to.
I also think that there are many docs and researchers out there looking at stillbirth- I recommend looking at and searching web sites like Pub Med that will net you many abstracts reflecting published articles from around the world.
there are also some very specific web sites out there that deal with momo twin issues- and cord entanglement is a big problem for these babies as is twin-to-twin transfusion syndrome , because these babies share the same bag and the same placenta-- the estimates are 40-70% will have a problem but the frequency of momo twins is pretty small 1 in 25,000 to 1 in 60,000 pregnancies. I agree that these pregnancies should be closely monitored and followed ----

[mandalamama]

i was going for natural childbirth with my daughter, even though we were in a hospital things were going really well (having 2 doulas and a pro-natural labor nurse helped of course). we needed a c-birth because i kept going in and out of transition, the baby never dropped below -3 yet i'd be nearly fully dilated and then go back down to 6cm, 4cm, confusing! turned out she has a *short* cord wrapped twice around her neck. i had no labor interventions, except at 26 hours *i* requested AROM to see if i could help the baby move downwards by getting on my hands and knees, or squatting and rocking. we went for "slow" AROM with careful positioning to avoid prolapse. the baby didn't move down any further.

total, i labored for 30 hours, and i have no idea if she was already wrapped up when i went into labor, or if something i did during labor caused her to wrap i was moving around a LOT, getting comfy in any position i could, it didn't feel like she was twisting but who knows. her head was dipping down and dilating my cervix during contractions but then bouncing back up again. we are very, very, very lucky she didn't drop past -3, because that short cord could have become an issue, i believe.

another weird thing ... she started showing major signs of distress at 29 hours and my fluid began to show a LOT of meconium (that's when we rushed to surgery) ... yet when born, she didn't have a drop of it in her lungs! the dr. and my labor/surgical nurse both said they think the cord prevented her from swallowing meconium in utero. *shrug* i'm just really glad i had the chance to labor normally, but also had the option to go for the surgery when things went wrong so quickly. i still feel sad i didn't get the vaginal birth i wanted, and especially sad we didn't get to leave the cord attached as long as possible (which the hospital had agreed to, if it had been a normal birth).

[MoonStarFalling]

Originally Posted by mwherbs

I also think that there are many docs and researchers out there looking at stillbirth- I recommend looking at and searching web sites like Pub Med that will net you many abstracts reflecting published articles from around the world.
----

As I stated before, I've written several articles and done hundreds of hours of research on stillbirth and it's causes. Occasionally a survery will be put out for parents, looking at stillbirth experiences. However, there just plain isn't any real scientific research! That's what's so astounding. Everyone just assumes there's research being done. But it's not.

Originally Posted by mwherbs

there are also some very specific web sites out there that deal with momo twin issues- and cord entanglement is a big problem for these babies as is twin-to-twin transfusion syndrome , because these babies share the same bag and the same placenta-- the estimates are 40-70% will have a problem but the frequency of momo twins is pretty small 1 in 25,000 to 1 in 60,000 pregnancies. I agree that these pregnancies should be closely monitored and followed----

Yes, one of those websites is mine.

Originally Posted by mwherbs

I agree that these pregnancies should be closely monitored and followed
----

I chose not to and would do the same again.

[Galatea]

I know this is late but I just saw the thread.

Ds had a true knot that we didn't know about until I delivered the placenta. Ds was fine and had no decels so I guess he had enough jelly to keep it flowing.

My sister's 1st son didn't move hardly at all in the last trimester. He was always high up on the right side. She went into labor at 41+ weeks and never progressed very far. The baby simply wouldn't descend. They did a section and discovered his cord was nuchal x 4 and there was no slack for him to descend. He had aspirated a lot of meconium by this time and was in the NICU for awhile. He is fine now. He truly would have died without the section.

[mwherbs]

Originally Posted by twinangels04

As I stated before, I've written several articles and done hundreds of hours of research on stillbirth and it's causes. Occasionally a survery will be put out for parents, looking at stillbirth experiences. However, there just plain isn't any real scientific research! That's what's so astounding. Everyone just assumes there's research being done. But it's not.

So the web site you recommend the doc doesn't do much research himself he collects info written by other care providers and has written his own interpretation of that research that is why the paper has about 600 references-- I say read the references--- and come to your own conclusions... I haven't read all of them but much of the info I have read and come to different conclusions.

[eilonwy]

My daughter was born by emergency c-section for cord prolapse; she turned breech at 39 weeks, broke the water and the cord slid down first, followed by her feet. It was all very sudden; I wasn't having any contractions at all, hadn't had a particularly stressful day, nothing extraordinary happened at all until she turned. My waters don't break in the usual way, they seem to just dribble out a teensy bit at a time until there's nothing much left. I think that may have played a role in the cord staying where it had dropped, but there was nothing I could have done about that. It was just a freak accident, there was no way to know in advance that it might happen, and there was nothing that anyone could have done to prevent it. She's fine today, and I have reasons to believe that she might not be fine if I hadn't had the section when I did.

I had an *extremely* long cord when I was born (about 8 feet). It was wrapped around my neck twice, and around my body several times. I shot out like a watermelon seed and was caught by a terrified third-year medical student by one foot. :LOL No brain damage (I don't think so, anyway) but I did have blue extremities. My mom says that it was because the room was freezing and she was ravenously hungry at the time (lunchtime). The nuchal cord wasn't a big deal, because it was freakishly long and I was born very quickly.

[CarrieMF]

My youngest dd just about died due to a knot in the cord. I don't know when it all started. I had the routine US at 18weeks and they talked about doing another one later because they suspected IUGR(caused by the knot???). She was measuring 2 weeks behind my dates(had bt's at the beginning of the pregnancy) I fell at 30weeks due to my stupidity, though I wonder now if it was my subconscious. I went into preterm labour, they did a NST, and an US(again measuring 2 weeks behind), all seemed fine. She went from normal movement to frantic movement. At 34 1/2weeks we had sex(wasn't supposed to until 35weeks) and I immediatly started bleeding and she stopped moving. I did my usual things to get her to move and nothing worked, convinced I'd killed her(I'm normally not a paranoid person) we went to the hospital. They never found a cause for the bleeding, she seemed fine and I started NST's twice a week. They were still talking about doing another US later. Her movements went from frantic to barely there. At my 36week NST I purposely went after I had finished my big shopping day because I knew I'd have the most contractions and after weeks of this I wanted someone to take notice that this wasn't normal. As soon as I was hooked up and had the first contraction her heartrate went down to 80. Same thing with the next one and then it seemed to correct itself. The nurse came in and left me on for longer because they(late decels) were still there just not as noticeable. The dr scheduled a biophysical for in 3 days. At this US she was now measuring 3 weeks behind. To pass that the tech had me move from side to side for 15minutes to get enough movement out of her. Because I passed that they stopped the NSTs. AT 40weeks(in reality I was 42weeks but that's a different issue) my water broke, in spite of all my contractions I didn't go into labour but the decels were there with every contractions. The next day they hooked me up to pit to augment and the first 2 contractions the hr went down to 50. They called a surgeon in but he wanted to leave it for a while. At 3 I was finally kicked into labour. At 3:50 I felt like I was in transition but there was no change. They turned everything off and called the surgeon back to do a c-section, while they were gone her heartrate went down to 13. At 4:30 he arrived I was 2-3cm, 60% effaced and he could push her head out of my cervix. She was born at 4:47 vaginally. I was laying there while they were shaving me and the nurse handed me a drink for the anesthesia, I waved it off because I had a contraction. I breathed the gas in and started pushing. I didn't know I had to push. She ended up getting stuck adn the dr pulled her out with his hands, then left with her. My dr had never done that before. When I started pushing I had convinced myself she was dead, it took me 3 weeks to accept she was alive. Her apgars were 5 & 9, she was on O2 and monitoring for the first 24hours. I have pics fo the knot around here somewhere.

The drs said her cord was long and that's probably was caused the knot(twisting and such) but also what saved her. Had it been shorter it would have pulled tighter.

There was nothing I could have done to prevent it and with the technology available here there was no way to see it on any of the US's I had.

The drs and nurses in the room at delivery all said "Lucky Baby, Lucky Parents". IMO they should have added "Lucky Dr", even though they couldn't have predicted the knot according to tests done at the beginning of the pregnancy I was 2 weeks further along than they thought. when I went into preterm labour the 2nd time they put me on bedrest to stop it because they don't deliver here before 35 weeks, in reality I was 36 1/2weeks. All the little things alone didn't suggest any problems, but together I knew there was something wrong. I believe even dh could tell, he didn't want anyone knowing I was pg until I was over 20weeks.

She was 6lbs 5oz & 19.25" at what was really 42weeks. She is 3 now and is 27lbs, 32". She has had developmental delays her entire life, she had an immature intestinal tract and is now waiting testing for possible behaviour issues. She is OCD and most likely has some SID, she probably has Speech Apraxia too. She does some very weird things. I finally have someone who thinks that her lack of O2 in utero and during labour is probably the cause of her issues.

[mandib50]

first to the mamas who lost their precious babies, i am so so sorry!!

secondly, wow, i'm surprised. i never even really considered cords to be an issue unless it was prolapsed. one of my son's (homebirth) had a cord around his neck and was fine. my other son was born with the cord wrapped around his body and he did have some decels during pushing but nothing i felt intuitively concerned about. i just wanted to pull him close to me as soon as he was born but couldn't until he was unwrapped from his cord.
thanks for the food for thought.
mandi

[crazy_eights]

One of my neighbors has a similar story - her son had a true knot, but all they could see was the IUGR. She was admitted to the hospital and monitored daily. At some point they decided the baby was not growing at all and delivered him. I believe he weighed 3 lbs. at 35 weeks or so? Tiny. They found 2 tight true knots at delivery. Anyway, he is 8 today and about the size of a 4 or 5 year old and is being treated with growth hormones.