Early Induction b/c Pre-eclampsia - Mothering Forums

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#1 of 10 Old 07-16-2008, 02:04 PM - Thread Starter
 
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Here is my background w/my pregnancy. At 24 wks we were diagnosed w/IUGR, and a possible coarctation of the aorta, along w/bilateral uterine notching. The dr has been stumped by our baby. He says for what is going on, she should be doing worse. We have weekly u/s for doppler studies, and
growth scans every 3 wks. THe baby is now measuring in the 3-4% as of
last week (by size not weight). Also, I have been to a ped. cardiologist every 4 wks. for an echocardiogram.
My peri. told me that he would induce me at 38 wks. Now I have "mild pre-eclampsia" and will be induced at 36 wks. I am wondering if
any of you have BTDT? I am worried about the baby. I believe this is best for the baby, but worried. I was holding out hope for her to have a chance of not having to go to the NICU, but now it's inevitable. I am also wondering if any of you were induced this early and had a vaginal birth? or a c-sect (whether or not induced)?
Thank you for your time and stories.
Jen
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#2 of 10 Old 07-16-2008, 03:26 PM
 
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I was diagnosed at 31 weeks with pre-eclampsia/ IUGR this past February. My daughter was in the 1% for her age and was born at 31w5d (Valentine's day) by emergency c-section. 2lbs 8oz. They tried to induce me but her heart rate dropped with each of my first 3 contractions so a c-section was needed. We spent 6.5 weeks in the NICU so she came home about 1.5 weeks before her 4/12 due date. She is doing great now with no lasting complications. I spent about 11 hours a day with her every day she was there. It wasn't easy but it was do-able.
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#3 of 10 Old 07-16-2008, 04:37 PM
 
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I am so sorry this is happening to you, and congratulate you for trying to prepare yourself ahead of time. It sounds like you have really done a great job at getting all of the help you need!

I had an emergency c/s for pre-e at 33 weeks. There was not even a chance for induction. The sad truth is, I know six women who were induced at term(one had pre-e), and only one had a vaginal birth, the rest were varying forms of "emergency" c-section. It's not very optimistic, I know. However, people on this forum have had varying experiences with induction, hopefully someone can share a positive story. There are all sorts of factors that go into a successful induction; preeclampsia and gestational age tend to complicate things a bit. There is a book called "The Thinking Woman's Guide to a Better Birth" that may provide some insight.

Please do your research about induction. Especially cytotec. It may be a good idea to check out the forums at the preeclampsia foundation, where you can ask about pre-e and also talk to moms who had pre-e and NICU babies. http://www.preeclampsia.org/forum/default.asp

Good luck to you. Please try to get lots of rest right now, and focus on a positive, happy future with your babe.

"In the depth of winter, I finally learned that within me there lay an invincible summer"
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#4 of 10 Old 07-21-2008, 03:49 PM
 
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I cant help as far as an early induction goes, as my inductions were both full term, but I might be able to give a little bit of advice. With my first, I was 2 weeks overdue and he decided he was comfy in there So I was induced, I had no dilation, no effacement, cytotec got me to a whopping 1cm, and then I had pit from there. I actually dilated pretty fast (8 hours) and everything went well, except for a failed epidural, until I had started pushing. They were doing that whole count to 10, take a breath, count to 10 thing and it wore me out SO fast. Then his HR dropped and I had an episiotomy to get him out. I feel like between me being stuck flat on my back the whole labor and with the way they were telling me to push, he just couldnt take it anymore.

With my 2nd, I was again induced, but at 39w 4d due to mild pre-e. This time I had researched it, knew there was a possibility of another induction, so I started taking evening primrose oil to help soften my cervix at around 37w. It worked reallllly well, and I was already 4cms before I was started on anything. I also made sure to stay up and not be stuck on my back and when it came time to push, I followed my gut and did it the way I felt was right. I had told my MW before hand that I did NOT want to be counted at or told I was doing it wrong. It worked really well and she was born very quickly.

So I guess if you felt comfortable with it, I'd use some EPO for a bit before your induction, try to stay up and about as much as possible (I know they like to limit it when your BP is going up, but even sitting up in bed will help), maybe get into the tub for a bit, and try to avoid having your water broken-at the very least until you are dilating well and baby is well engaged. If the EPO doesnt work on its own or you arnt comfortable trying it, you can ask for something like cervidil (sp?), a gel that will help your cervix BEFORE they start pit. If you arnt dilated at all, the chances of induction being successful are much lower. And yeah, do some research of your own, look into options-its been awhile since I was induced last and things are constantly changing.

Cari-mama to Eriq, Lile, Paikea, Kaidyn, and Mieke is here!! 2/9/10
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#5 of 10 Old 07-22-2008, 06:25 PM
 
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How have the fetal echos gone? Can they tell if a heart defect is present? If so I think inducing with pitocin would be a bad idea. DS2 was born with a heart defect called TAPVR and from the research I've done I've learned that pitocin is linked to potential breathing issues. Heart babies need all the help they can get with startup breathing, even my drug free heart baby went very dusky at birth and needed oxygen. I agree with the others about trying more natural forms of induction first. Do as much as you can to prep your body for birth.

I'm so sorry you are going through this The most important things are keeping you and the baby safe and healthy and if that means a scheduled cesarean then so be it. I know cesareans get a bad rep around here but they are a lifesaving tool when used properly. Pre-e is a case where a cesarean birth can and a lot of times should be used.

Zen doula-mama to my spirited DS1 (2/03), my CHD (TAPVR) warrior DS2 (6/07) & a gentle baby girl (8/09)
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#6 of 10 Old 07-22-2008, 06:39 PM
 
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I had an induction at 36 weeks for serious pre-e with my dd. She also had IUGR. The induction was hard because my body was not ready for labor, and she needed to be born fairly quickly. They started right away with strong doses of pitocin and AROM. I had hoped for a natural birth, but the contractions got too intense for me and I had an epidural, which actually allowed me to progress more quickly (went from 7 cm to pushing in about 20 minutes). My baby was born vaginally almost 15 hours after the pitocin was started. I know that I was lucky it went as well as it did, but it is possible to deliver vaginally w/early induction.

My dd also did not go to the NICU, although I believe that if our hospital had had one, she would have gone as a matter of protocol. We did spend a few extra days in the hospital.

Hugs, mama. It's so hard to be in a position like this.
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#7 of 10 Old 07-23-2008, 03:27 PM
 
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Oh yeah, I have seen that before (I used to work as a doula). It goes against what most at MDC would think, but I've been there for 2 births that were totally stalled and after an epidural, proceeded very quickly. It seems as though if you are seriously tensed because of the pain, it can stall out progression and the epidural helps to relax everything. So yeah, Id keep that in mind if you get stuck for awhile-you'd end up with a spinal for a cesarean anyway so Id try an epidural before going straight for a cesarean, if there was time.

Cari-mama to Eriq, Lile, Paikea, Kaidyn, and Mieke is here!! 2/9/10
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#8 of 10 Old 07-24-2008, 01:23 AM
 
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I have a funny story.

My doctor tried to induce me at 37 weeks for mild pre-ecclampsia. She thought it would be easy because I was dilated to 4 and almost fully effaced. I contracted constantly on the pitocin, but my cervix DID NOT CHANGE! After more than 12 hours on pitocin, my blood pressure had dropped because I was so hungry I was about to pass out. As my bp was not over the 140 mark anymore, my doctor had the wisdom to say go home and rest. Had we continued with the induction I would have probably ended up with a c section. Two days later I went into labor naturally when my water broke and my son was born naturally after a 5 hour labor and less than 20 minutes of pushing. My blood pressure was normal throughout my true labor. Go figure.
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#9 of 10 Old 07-24-2008, 04:15 AM
 
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I was induced at 37 weeks for pre-E and had a vaginal delivery. I was talked into the epidural because it was supposed to lower my insanely high blood pressure (if it did, I don't want to know what my BP would have been without it!). My DD was born 100% healthy, no NICU stay whatsoever.
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#10 of 10 Old 08-03-2008, 02:37 PM
 
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I was induced for pre-e at 36 weeks. I had 24 hours of labor and my daughter was born vaginally. she was 4lbs, 12 oz. She was in the 3% for her gestational age. She spent a week in the NICU to learn how to feed and for jaundice, but she was very healthy.
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