Preemies

Prenatal care after a preemie

I'm not ready to TTC yet, but sort of just thinking ahead and trying to gather some information for the future.  

I had PPROM from chorioamnioitis (confirmed by testing after the fact) with my son and he was born at 34w6d.  I was told by my OB afterwards that chorio is a rare and random thing and that since I had no other complications, it was unlikely that I would have a preemie again, but still my prenatal care would be a little different the second time around.  

I know that I will most likely be getting progesterone shots. Are additional prenatal appointments and ultrasounds likely as well?  Pelvic rest?  Bed rest? Those of you who have had another baby after an unexpected preemie, how was your prenatal care different?
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Re: Prenatal care after a preemie

  • I'm currently pregnant with #2, and the only difference so far is that I see an MFM in addition to my OB, and I am getting the P17 shots. They won't do anything more intense or restrictive unless it is needed. As long as everything goes well, I'll continue my regular routine, just with a few extra doctors appointments.
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  • I didn't have a preemie with my first-ever was a full term close to 9 lb baby, however while he was a toddler i was diagnosed with an autoimmune disease. The nature of the disease causes miscarriage, preterm labor and low birth weight so i saw maternal fetal medicine for growth scans. I had a growth scan every 4-5 weeks to check fluid levels, baby's weight gain, placenta, cord ect. It's a good thing I saw mfm because i had a regular OB appointment 2 days before the growth scan and during the growth scan it was determined i needed to be induced due to pre eclampsia...

    i know it's not exactly what you were asking since i didn't have a preemie the first time around but i did see MFM...
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  • I was already high risk with my first due to type 1 diabetes and saw a Mfm last time. This time I have some additional ultrasounds, and p17 shots.
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  • I had my son at 31 weeks due to sudden severe HBP.  my pregnancy was great up until then.  Anyway before we started TTC we went to see the MFM to come up with a plan.  When we got pregnant the plan was ready. I just went for a lot of baseline blood testing as well as a 24 hour urine catch and genetic testing. I will have more growth scans and will start 2 week and 1 week appts earlier than usual.  I will also have to monitor my blood pressure at home. They are hopeful we will go to full term this time.

    To answer your question it often means more appts and scans (but who doesn't want to see their baby??) and potentially shots. but bed rest and pelvic rest don't seem to be common unless your particular condition requires it. 
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  • I had a preemie at 32 weeks when my water broke for unexplained reasons.  I was diagnosed with g.d. in that pregnancy although I never really had high blood sugar when I tested.  For this pregnancy, I met with the high risk doctor before I got pregnant but she said it was fine to TTC.  I met with her when I got pregnant and again at 20 weeks when she did a more extensive ultrasound than I would have normally had, which may have been due to my advanced age as much as my preemie birth.  From about 17-22 weeks, I had cervical length scans with a wand ultrasound.  Around then, I started progesterone shots.  Each week I have to go in to get that, and they do a weight, bp, urine sample, and listen for the baby.  Sometimes it is ridiculous because they don't always line up with regular OB appts so a few times I have to go in two days in a row and do all this.  However, because I was not diagnosed with g.d., I do not have growth scans and I have not seen the high risk doctor since 20 weeks.  I do not see an OB more often and do not seem to be getting any different care at this point--in fact, no one seems particularly concerned compared to last time because I passed the g.d. test this time.
  • My first was 34 weeks ptl/pprom no reason why. Went to Ob the morning I had him and I was told everything was fine. With my 2nd I had p17 shots and some extra monitoring though I was over 35 so that put me up for extra monitoring anyway.
    I had contractions starting at 32 wks with ds2. So I was on modified bed rest and ended up in the hospital 3 times. However I attribute the extra monitoring to catching my contractions early and being able to stop them. It is nerve racking having a 2nd after a premie. Contact your insurance. Mine offered a bunch of extra services since my first was a premie. Good luck and hopefully a uneventful pg.

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