no delivery unttil 28 weeks???

daisy19782011

I am having momo twins, for those that don't know. Yesterday (17 wks for mobile) I had a check-up with my MFM dr. and everything was fine, but he mentioned that he would not even consider hosptal bed rest and observation for delivery until 27.5 weeks and the earliest he would deliver would be 28 weeks. He said before that just too many things could be wrong. He is still aiming for 30-32 weeks, which I understand, but does waiting until 28 weeks as a minimus seem right?

 

I obviously want them to make it as far as possible, but I would like to be monitored very closely....I asked if he would see me every week after 24 weeks and he said we would decide then.

He keeps telling us we need luck for them to get here safely and he is kind of a downer, but I know he is just trying to be realistic. I just needed other opinions!

Thanks!

Courtneyw04

Holy crap. Is he serious? I would get a second opinion. Yes, a lot can go wrong the earlier you deliver but there have been so many medical advances that have allowed micro preemies to thrive.

Mrs. Alice

Ugh.  That and the lack of monitoring would make me want to seek another opinion.  Viability is 24 weeks.  Obviously no one wants to deliver this early but if it's a life and death situation, you can bet that I would take the chance.  I was hospitalized for monitoring until delivery at 24w1d.  We were preparing for them to be born any time at that point.

10-4LilBuddy

i am on hospital bed rest right now at 25w1d. I was admitted at 24w1d with contractions to be monitored. No one wants to deliver at 24w but with care, babies have a better chance. We met with the NICU neonatologist on Monday to find out more. She was honest and compassionate. We are trying to get every single minute, hour, week that we can and we are able to maximize this by having constant monitoring. I would question your doctor's complacent attitude and get a second opinion. Good luck.

bitsytripmom

Hi there - I have to agree with PPs on getting a second opinion.  My group of six (very) opinionated MFMs basically takes the perspective that they were willing to start monitoring when the patient was willing to accept delivery and gave all the facts and figures so the patient can decide what works for them and with their lifestyle.  If you were willing to accept the not good odds that come with a 24 week delivery (something along the lines of 90 percent chance of lifelong major health issues/defects), did not have a problem with being in the hospital for 8 weeks (no small thing with the psychological strain that comes with extensive HBR) and were extremely anxious about it, they would be willing to admit.  They also said some of their patients have three kids at home and simply cannot make that work - so they dealt with it by coming in for a daily round of outpatient monitoring up until delivery and were never admitted.  Others agree with your doctor and wouldn't want to accept delivery before 28 weeks due to the potential complications - and that's their call.

All that to say - my doctors believe it's the patient's call as to whether there are "too many things that could be wrong" and then they give us the tools we need to make that call.  When he makes that call for you - he's saying it's better for them not to live than to live with the possibility of disability.  That's a valid decision to make and there are many parents who make it - but I don't know that it's his decision to make.  I've been grateful that all along our doctors have provided us with information and then worked with us to develop a plan of care that we can all get behind. (in my case hospitalization at 26 weeks because they can see everything is looking really good cordwise right now and I'm otherwise not suffering any other issues).

bitsytripmom

Oh - and I've seen either an OB or an MFM for cervix check and ultrasound every week since 20 weeks... There's just too much other non-cord related stuff that can go wrong quickly that can be stopped relatively easily (pre-term labor, cervix shortening, etc).  I can't imagine being past 24 and not seeing him every week.

daisy19782011

Thank you for the responses. ..we are meeting with a neonatologist at 24 weeks and am hoping to learn more. I am definitelygoing to revisit this at my next appt.

daisy19782011

bitsytripmom said:

Oh - and I've seen either an OB or an MFM for cervix check and ultrasound every week since 20 weeks... There's just too much other non-cord related stuff that can go wrong quickly that can be stopped relatively easily (pre-term labor, cervix shortening, etc).  I can't imagine being past 24 and not seeing him every week.

Thank you! C an I ask when you say your cord looks good does it have any knotting or loopinh? How can they tell if it is going to be life threatening?

bitsytripmom

There is no real way to tell if it's going to be life threatening for sure.  Keep in mind that there just is not any way to have perfect knowledge of any of this and it's all out of our control.  I think the serenity prayer is the strongest weapon in any momo mom's arsenal .  

In my particular case, because of where the girls are located, they can see that the girls' cords are still hanging largely separately and do not have a big knot in the middle of them, which would not be uncommon at this point.  They check the blood flow through the cords at the MFM appointments with the good ultrasound machine and can see that, as of that particular moment, things are not stopped up anywhere.  That does not mean something bad still could not happen even with loosely hanging cords getting knotted suddenly or cut off.  But it does mean that there's even less there at this moment to be concerned about than there would usually be.  

Does that make sense?  Sorry I can't be more exact - I just definitely don't want to promise that there's any hope that the doctors can know the difference between life threatening cord issues or not... they're always sort of working with the imperfect knowledge they have at a given moment.

1+tripsmom

I agree with everyone else get a second option. You also might want to see if you can find out how many twins your dr has delivered he just might not know much.

PurpleIris30

I'm not sure, but after reading your post, one thing I would clarify is whether the 28 week delivery date he talked about is his policy or the NICU policy at the hospital at which he has admitting privileges.  Not all NICUs are equipped to handle babies born at 24 weeks.  Maybe that's what he meant?

That said, I agree with other posters that a second opinion might be a good idea.  And if your MFM/hospital isn't equipped to deal with babies born before 28 weeks or admit you for monitoring so that you can make it to 28 weeks or longer (if necessary), and that's something you want, then I'd look into what other options you have available.  Good luck!

daisy19782011

bitsytripmom said:

There is no real way to tell if it's going to be life threatening for sure.  Keep in mind that there just is not any way to have perfect knowledge of any of this and it's all out of our control.  I think the serenity prayer is the strongest weapon in any momo mom's arsenal .  

In my particular case, because of where the girls are located, they can see that the girls' cords are still hanging largely separately and do not have a big knot in the middle of them, which would not be uncommon at this point.  They check the blood flow through the cords at the MFM appointments with the good ultrasound machine and can see that, as of that particular moment, things are not stopped up anywhere.  That does not mean something bad still could not happen even with loosely hanging cords getting knotted suddenly or cut off.  But it does mean that there's even less there at this moment to be concerned about than there would usually be.  

Does that make sense?  Sorry I can't be more exact - I just definitely don't want to promise that there's any hope that the doctors can know the difference between life threatening cord issues or not... they're always sort of working with the imperfect knowledge they have at a given moment.

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Great info! Thx

katiebenes

I find it strange that he wouldn't monitor more... and even more strange that he "won't allow" hospital bedrest prior to. if you need it to keep them healthy why would he be against it?