Pre-Eclampsia Watch Dog on the loose. - Page 11 - Mothering Forums
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#301 of 601 Old 10-04-2005, 03:27 AM
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Quote:
Originally Posted by kir

But if you DO have pre-e or HELLP, then using relaxation or supplements or whatever to bring down BP isn't really the issue because the REAL problem is that your liver/kidneys are getting messed up? Is this right?



Kiran
Well, once you GET pre-e - it doesn't go away with suppliments - but per my OBGYN - it can be prevented with Calcium, Omega 3&6, Vit C, and a high protein diet. And so far, it's working for me!

He also said for me personally not to be alarmed at BP that is in the 130's in the final stages of pregnancy as BP tends to increase twords the end.

Also - I had to go to the hospital to get checked (early labor symptoms) and the nurse checked my BP and whatnot. My BP was 140/90 and she said not to worry - very normal (she saw I was nervous.) I was 7 months pregnant and this was 2 months ago.

I dunno about you - but my BP is normally in the high 130's. Now if my BP were normally 100/75, then I think 140/85 would be a cause for concern. It's not the BP itself - it's how much the BP goes up vs your normal BP as well as protein in the urine and swelling in face and hands (pointing to kidney issues.) Pre-e is a combo of these symtoms. And HELLP is Pre-e gone NASTY, when your organs start to fail - and trust me, you'd know if you had it.
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#302 of 601 Old 10-04-2005, 10:18 AM
 
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Actually you wouldn't necessarily know you had HELLP. It can come on incredibly fast--as in everything can be completely normal in the morning and by afternoon you can be in very serious trouble. This is what happened to my mom when she was pregnant with me. She'd been at work that morning with a nagging headache--but not bad and her BP was only very slightly elevated. She worked in a hospital and was told to go home and put her feet up. By early that evening my mother was in a coma and my father was being told that neither of us would survive. She had had blood work done the day before that was basically normal.
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#303 of 601 Old 10-04-2005, 12:39 PM - Thread Starter
 
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HIgh blood p ressure is a symptom that can lead to pre-e in the same way high bp can lead to heart disease. If your high bloodpressure is managed appropriately and you don't have a genetic blood clotting disorder, pre-e can possibly be prevented.

Quote:
Originally Posted by kir
So if your BP goes up a little, but the underlying causes of pre-e/HELLP are not there (my liver function, bleeding and clotting, etc. are fine), then it's ok for now, right?
Kiran
High blood pressure is the cause of pre-e/HELLP. Liver function, kidney failure, falling platelets etc are symptoms of pre-e not the cause.

One abnormal reading of blood pressure is not cause for immediate concern. But it is a reason to keep an eye out. You want to keep your blood pressure under control. The numbers themselves are not as important as the rise in pressure. If your normal bp is 120/80, then one abnormal reading of 130 over 90 is not that big a deal.

Quote:
Originally Posted by mrsmoe
but per my OBGYN - it can be prevented with Calcium, Omega 3&6, Vit C, and a high protein diet.
WHile a healthy diet is the best for every pregnancy, there are several genetic factors that can contribute to pre-eclampsia including blood clotting disorders, autoimmune diseases etc...

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#304 of 601 Old 10-04-2005, 04:56 PM
 
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Originally Posted by kir
But if you DO have pre-e or HELLP, then using relaxation or supplements or whatever to bring down BP isn't really the issue because the REAL problem is that your liver/kidneys are getting messed up? Is this right?
Kiran
BP is like a symptom, not the underlying cause, as Gossamer pointed out - BP is a symptom of heart disease, but you have to treat the underlying issue. (Right? or am I confused?)

It is, as MrsMoe pointed out, easier to prevent than to fix after the fact. But ultimately, who really knows how to prevent it? Many of us are trying lots of tricks, supplements, aspirin, etc, and maybe we should do some sort of poll afterwards (our own MDC completely unscientific anecdotal study) to see how it turns out!
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#305 of 601 Old 10-04-2005, 08:34 PM - Thread Starter
 
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Once you have contracted pre-e it can possibly be managed but the only cure is delivery of the baby. HELLP is life threatening once contracted and cannot be managed and requires immediate delivery of the baby. Once you have contracted pre-e, your blood pressure will not go down. You can have elevated blood pressure during pregnancy without it ever progressing into pre-eclampsia. And remember that high blood pressure is not always the first sign of pre-eclampsia. Again, I suggest www.preeclampsia.org for the best information on pre-e.
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#306 of 601 Old 10-07-2005, 02:05 PM
 
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Ok, you tell me if I'm just being paranoid (because I'm rather used to the label)...

But - previous symptoms of preeclampsia in my last birth, progressed to severe HELLP, induced at 34 weeks. This time at 35 weeks, no symptoms at all (BP very normal to almost low, 112/72 yesterday; no more swelling than any other normal pregnant person; no proteinuria). Is it still possible to become eclamptic suddenly during labor? No signs at all?

I've heard of this happening at a homebirth in my community...I'm having a homebirth. How do they monitor for this issue? Did this MW just drop the ball in ignoring symptoms? My current MW is very laid back, confident (not the same as MW with eclamptic patient), which is cool - but I don't really know what to ask for regarding monitoring for possible problems. BP checks, sure. I guess if I suddenly blow up, that would be weird. But what else? They're not going to be doing panels during a homebirth, nor would I want them to. But I don't want any seizure business either.

Any suggestions? I know many mamas with previous HELLP/Pre-e use the hospital or birth centers, but homebirth has really been my goal in keeping myself really really healthy through these past 8 months. I'm just getting last-minute cold feet! If no suggestions, I'll ask the larger I'm pregnant board?
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#307 of 601 Old 10-07-2005, 02:29 PM - Thread Starter
 
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I am not trying to scare you but the fact of the matter is that most women die of pre-e within the 24 hours after giving birth. It is possible to contract pre-e during labor and after delivery. In fact the workd Eclampsia comes from the greek for lightening becasue it can be so suddenly onset. If you do a hb, I would just make sure your MW knows how to diagnose pre-e in an emergency. Ask her how she plans to monitor you and what would be her red flags for transerring you to a hospital.
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#308 of 601 Old 10-07-2005, 02:46 PM
 
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Yes, I do know her backup hospital, etc...and we live an extremely short distance from the nearest hospital (maybe a 1-minute ambulance ride). Last time, the pre-e onset was steady and predictable, but I didn't know that it could onset so quickly without ANY previous symptoms. I thought the greek word for lightning was for the lightning in your brain during the seizure (ha, just kidding, I have a twisted sense like that). I had a seizure last time, but it was one day before they induced (?!).

The other person I know with a seizure during labor had proteinurea and blood pressure symptoms, some swelling (I dunno, if I was her MW I'd be worried when those two signs popped up). I guess I'm just wondering if there is anything else? Reflexes? I will ask my MW next week. I'd just assumed that the onset would show itself before labor if it were going to show at all...I will have contractions a little on my own at first, so I wanted to know for myself as well.

I've really been the most concerned about it so far - even the perinatologist I met with wasn't so concerned and was supportive of using a midwife - he said to just watch out for symptoms but that I had a low chance of getting it again.
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#309 of 601 Old 10-07-2005, 03:12 PM
 
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Darn my google skills:

"In a prospective study at the author's center, as many as 28% of the women with a diagnosis of eclampsia did not have a diagnosis of preeclampsia prior to seizures."

http://www.emedicine.com/neuro/topic323.htm

Well, I guess we'll have a hearty talk next week.
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#310 of 601 Old 10-07-2005, 03:21 PM
 
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For sure have a good talk and I'd consult with a different peri too because the single biggest risk factor for pre-eclampsia is having had it before, so for him to say your chances are low of getting it again is in my opinion extremely irresponsible.
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#311 of 601 Old 10-07-2005, 03:31 PM
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flyingspaghettimama -

Please be careful and safe and make sure your midwife would take pre-e seriously if your homebirth should happen to go wrong. Hospitals may be nasty places, but your life is precious.
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#312 of 601 Old 10-07-2005, 03:41 PM
 
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Shannon - he was a very good perinatologist, I should have explained... He was more nuanced than I give him credit for here - he said I had a low chance, but higher than someone who'd never had it before, particularly due to the early onset date (27 weeks). He gave some great advice about how to monitor for and hopefully prevent it. He asked lots of questions about my life previous to the first pre-e issue. Apparently, it was his specialty. Pre-e, not my life.

Thank you MrsMoe. I have no doubt that if things get bad, I'm going straight back to the hospital. I have a wonderful family that I need to think of first, before my comfort level in the hospital...I'm even going to write it into my birthplan (also why I was fishing for things to monitor for - I'm putting it into the birthplan so nobody is confused).

That article is scary. Retinal detachment, indeed! Bleh.
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#313 of 601 Old 10-07-2005, 07:30 PM - Thread Starter
 
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Quote:
I guess I'm just wondering if there is anything else? Reflexes?
A symptom of pre-e is hyper reflexology.

Did the peri do any dna tests on you to test for blood clotting disorders? Do you have any autoimmune disorders like Lupus or Rheumatoid arthritis etc.?

The earlier you contract pre-e the greater your chances of getting it again.

On the first page of this thread there is a list of symptoms to look for. I hope the information you have found here helps you make your decision that is best for your family. Feel free to ask if you have any more questions. You can also pm or e-mail me.
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Before you were conceived, I wanted you. Before you were born I loved you. Before you were a minute old, I would have died for you. That is the miracle of life. ~Maureen Hawkins~
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#314 of 601 Old 10-07-2005, 07:40 PM - Thread Starter
 
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These are all signs and symptoms of pre-eclampsia.

*None
High blood pressure is a silent killer. Oftentimes, women diagnosed with preeclampsia do not feel sick. Many signs and symptoms of preeclampsia mirror other "normal" effects of pregnancy on your body. Women diagnosed with preeclampsia may feel frustrated when prescribed bedrest because they feel fine. If you feel fine, it may be hard for you or your partner to appreciate that preeclampsia is a serious condition.

*Hypertension
High blood pressure is defined as blood pressure of 140/90 or greater as measured on two separate occasions within six hours. However, a woman who normally has a low baseline blood pressure, such as 90/60, could be considered hypertensive at a blood pressure of less than that - especially if she has other symptoms. A rise in the diastolic (lower number) of 15 degrees or more, or a rise in the systolic (upper number) of 30 degrees or more is cause for concern.

*Swelling or Edema
A certain amount of swelling during pregnancy is normal. Edema is the accumulation of excess fluid. It is particularly concerning when it accumulates in the face (eyes) or hands. It is normal to have trouble wearing rings throughout pregnancy.

*Proteinuria
Proteinuria is the result of proteins, normally confined to the blood, spilling into your urine because the small blood vessels in the kidneys become damaged. A simple dipstick test of your urine at each prenatal check-up can screen for proteinuria.

*Sudden Weight Gain
A gain of more than 2 pounds in a week or 6 pounds in a month could be cause for concern.

*Headache
Dull, throbbing headaches, often described as migraine-like that just won't go away.

*Nausea or Vomiting
Nausea or vomiting is particularly significant when the onset is sudden and in the second or third trimesters.

*Changes in Vision
Vision changes include temporary loss of vision, sensations of flashing lights, auras, light sensitivity, and blurry vision or spots. For some women who are farsighted, vision may actually improve.

*Racing pulse, mental confusion, heightened anxiety, trouble catching your breath
If these symptoms are new to you, they could indicate an elevated blood pressure.

*Stomach or Right Shoulder Pain
This type of stomach pain, called epigastric pain by the medical profession, is usually under the right-side ribs. It can be confused with heartburn, gallbladder problems, flu, indigestion or pain from the baby kicking. Shoulder pain is often called referral pain because it radiates from the liver under the right ribs. Lower back pain is different from muscle strain common to pregnancy. It is usually more acute and specific. All may be a sign of HELLP Syndrome or a related problem in the liver. Shoulder pain can feel like someone is deeply pinching you along the bra strap, or it can be painful to lie on your right side.

*Lower back pain
Lower back pain is a very common complaint of pregnancy. However, sometimes it may indicate a problem with the liver, especially if it accompanies other symptoms or preeclampsia.

*Hyperreflexia
Hyperreflexia is when your reflexes are so strong that when they are checked, your leg bounces back hard.

I hope this is helpful.

Gossamer

Before you were conceived, I wanted you. Before you were born I loved you. Before you were a minute old, I would have died for you. That is the miracle of life. ~Maureen Hawkins~
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#315 of 601 Old 10-10-2005, 01:04 AM
 
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Gossamer, how are you and your baby?
Hope you are both doing fabulously.
How many weeks gestation are you now?
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#316 of 601 Old 10-10-2005, 11:53 AM - Thread Starter
 
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Baby and I are just great. I am 34w 3d and no signs of pre-e anywhere in sight. My last 24 hour urine came back better than the one before. My last liver panel came back perfect. My bp's continue to be in the 120/70's to 130/high 70's which does not have anyone concerned becasue bp usually rises in the third trimester. So we are tentatively planning a scheduled C-Section on Nov. 1. 3 weeks from now. I can't believe it. Thank you so much for asking.
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Before you were conceived, I wanted you. Before you were born I loved you. Before you were a minute old, I would have died for you. That is the miracle of life. ~Maureen Hawkins~
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#317 of 601 Old 10-11-2005, 01:40 AM
 
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Congratulations Gossamer on your great progress! I'm rooting for you!

Here everything is A-OK so far, in week 23 tho, so still early.
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#318 of 601 Old 10-11-2005, 04:31 AM
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Quote:
Originally Posted by gossamer
Baby and I are just great. I am 34w 3d and no signs of pre-e anywhere in sight. My last 24 hour urine came back better than the one before. My last liver panel came back perfect. My bp's continue to be in the 120/70's to 130/high 70's which does not have anyone concerned becasue bp usually rises in the third trimester. So we are tentatively planning a scheduled C-Section on Nov. 1. 3 weeks from now. I can't believe it. Thank you so much for asking.
Gossamer

Glad to hear it!
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#319 of 601 Old 10-11-2005, 10:33 PM
 
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Gossamer, that is wonderful news.

Hope the next three weeks are comfortable for you.
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#320 of 601 Old 10-15-2005, 04:46 PM
 
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i had severe per-ecclampsia. my pregnancy was fabuolus, but 36w4d i had severe headache, edema everywhere and 180/110 Hgmm BP. And of course, proteinuria. it was terrible, i had natural birth, which was awesome by the way (ebrantyl infusion was administered).

dd is 11 wks old now, i still have the proteinuria, so i have to take ACE inhibitors.
my kidneys will never be healthy again.

i think, pre-e IS a big deal. it was my first pregnancy. i am 25, normal-sized, european woman, my BMI is 22, i am healthy (i mean i was).
i just hope i could have more children...

just wanted to share.

Liv, SAHM of 3 kiddos 

 

 

 

 

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#321 of 601 Old 10-17-2005, 02:10 AM
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I have some slight hypertension (140/90 was the highest ever), and am taking some meds that control it well. So I really shouldn't be getting TOO scared about pre-e....But I'm now almost 32 weeks, with twins, so i know it's a risky situation for developing pre-e. My doctor says if ANY weird stuff develops in my blood work she'll deliver the twins. Has anyone had experience being on hospital bedrest to postpone delivery? Is this something I should bring up, or is it foolish to wait if pre-eclampsia develops?

Thanks for your thoughts. And please send good wishes that nothing turns up in my tests tomorrow!

Kiran
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#322 of 601 Old 10-17-2005, 02:26 AM
 
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Well, if full out pre-e develops, I'm guessing she won't give you that choice-kwim? It sounds like she's on top of it and that's great. I was on hospital bed rest for 10 days before I delivered. My bp had shot up and I was scared--however, my hospital can't deliver until 36 weeks--I DID NOT want to change hospitals, my hospital and my OB were so awesome. So I was on hospital bedrest to take her to 36.5 weeks. Blood work was done twice a day, NST's were done 3 times a day and a machine was left in my room in case I got worried about her. I was controlled until the night before, my bp shot up, bloodwork was still basically normal, I was told that night that I would be a mom the next day.
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#323 of 601 Old 10-17-2005, 02:27 AM
 
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Oh and mega good vibes coming your way
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#324 of 601 Old 10-18-2005, 11:40 AM
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Thanks for sharing your experience. I need to take this one day at a time. I never would have thought I'd feel this way, but I'm so eager to give these babies a good start that I think I'd be totally motivated to stay on the kind of bedrest/testing you describe if it would give them another week!

But let's see....I feel fine, but I get nervous every time I give blood for tests.

Kiran
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#325 of 601 Old 10-18-2005, 11:58 AM - Thread Starter
 
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Kir, it sounds like your doctor is ontop of things. Bedrest is usually used to control BP, so if your BP is under control via medication, I am not sure bedrest is a viable option. As much as you want to give your babies every opportunity, sometimes, being in utero is more dangerous than being born. 32 weeks is 98% viable and pre-e is very deadly. So it is a tightrope we walk. Keep an eye on your bp's, take it easy and keep us updated.
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Before you were conceived, I wanted you. Before you were born I loved you. Before you were a minute old, I would have died for you. That is the miracle of life. ~Maureen Hawkins~
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#326 of 601 Old 10-22-2005, 03:31 AM - Thread Starter
 
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I am 36 weeks today. An official take home baby. I saw my Perinatologist on Monday and the baby is doing great. He is still in the 70% and weighs between 5.5 and 6 pounds. I got an 8 out of 8 on my biophysical profile.

Tuesday I went to my cardiologist and my meds were upped a little bit becasue my bp was creeping up again to the 130's over 80's. But my bp responded immediately and is back down to the 120's over 70's. The next time I see him will be in the hospital after the baby is born.

THursday I went to the OB for another biophysical profile. I did not like the ultrasound technician. SHe asked so many questions. "WHen did you last see the peri. WHy are you here today? Why did you start seeing the peri? It has a cute face, boy or girl?" TOtally pissed me off. I told her I saw the peri on monday, the office called and told us to come in for an NST, I started seeing the peri because my last baby died." Then she said he measured in the 39th% percentile because his leg was short and his head was small. SO the whole time I was waiting for the OB I was terrified that he was suffering from IUGR. BUt everything turned out ok. The OB said I scored an 8 out of 8 on the biophysical profile which is the most important thing right now. We are scheduled to deliver via C-Section on Nov 2nd at 7:30 am.

So all in all, very good news and very exciting news.

Tomorrow we go to the infant care and breastfeeding class at the hospital. Things are really moving but I am still in denial. THe baby's room isn't even close to being ready, I haven't done any laundry, I don't have an outfit picked out for him or anything. As I told my grief counselor, denial is still really working for me.

Gossamer

Before you were conceived, I wanted you. Before you were born I loved you. Before you were a minute old, I would have died for you. That is the miracle of life. ~Maureen Hawkins~
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#327 of 601 Old 10-22-2005, 05:59 AM
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Quote:
Originally Posted by gossamer
I am 36 weeks today. An official take home baby. I saw my Perinatologist on Monday and the baby is doing great. He is still in the 70% and weighs between 5.5 and 6 pounds. I got an 8 out of 8 on my biophysical profile.

Tuesday I went to my cardiologist and my meds were upped a little bit becasue my bp was creeping up again to the 130's over 80's. But my bp responded immediately and is back down to the 120's over 70's. The next time I see him will be in the hospital after the baby is born.

THursday I went to the OB for another biophysical profile. I did not like the ultrasound technician. SHe asked so many questions. "WHen did you last see the peri. WHy are you here today? Why did you start seeing the peri? It has a cute face, boy or girl?" TOtally pissed me off. I told her I saw the peri on monday, the office called and told us to come in for an NST, I started seeing the peri because my last baby died." Then she said he measured in the 39th% percentile because his leg was short and his head was small. SO the whole time I was waiting for the OB I was terrified that he was suffering from IUGR. BUt everything turned out ok. The OB said I scored an 8 out of 8 on the biophysical profile which is the most important thing right now. We are scheduled to deliver via C-Section on Nov 2nd at 7:30 am.

So all in all, very good news and very exciting news.

Tomorrow we go to the infant care and breastfeeding class at the hospital. Things are really moving but I am still in denial. THe baby's room isn't even close to being ready, I haven't done any laundry, I don't have an outfit picked out for him or anything. As I told my grief counselor, denial is still really working for me.

Gossamer

such wonderful news!!!
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#328 of 601 Old 10-22-2005, 06:33 AM
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Originally Posted by gossamer
Kir, it sounds like your doctor is ontop of things. Bedrest is usually used to control BP, so if your BP is under control via medication, I am not sure bedrest is a viable option. As much as you want to give your babies every opportunity, sometimes, being in utero is more dangerous than being born. 32 weeks is 98% viable and pre-e is very deadly. So it is a tightrope we walk. Keep an eye on your bp's, take it easy and keep us updated.
Gossamer
It's good for me to hear you think my doctor's level of vigilance is reasonable! Sometimes I feel that she's out there looking for problems, and it stresses me out.

Everything has been FINE this past week, which is great! My doc has me going once a week for a full liver profile blood test, and in addition I'm getting a color doppler every 15 days to monitor fetal growth. This is reasonable, right? I think that with my awareness of pre-eclampsia in moms of multiples it's actually most important that i don't get too nervous, and stay as relaxed about this pregnancy as I can for now.

Kiran
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#329 of 601 Old 10-22-2005, 12:17 PM
 
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Gossamer Wooo Hoooo!!!!
Kir, sounds totally reasonable.
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#330 of 601 Old 10-22-2005, 03:46 PM
 
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Gossamer - that's a wonderful update!!

As for me, my little one made her appearance Oct 17 via c-section. My bp kept going up despite the meds and bed rest (though no other pre-e symptoms) so my OB scheduled a c-section for 38.3 weeks. Annika Victoria Louise weighed 8.8lbs and was 20.5in. She is doing great. I am feeling good too, but my bp has been slow to come down (same as last time).
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