Maybe you can save me from asking my OB these questions this week

ladyteach0505

I feel like a crazy person as it is, but I genuinely have FTM questions that I can't find obvious answers for on the Internet. My OB's office gave me a print out of what to expect at each month's appointment but they aren't detailed in terms of how they check on the baby in the short weeks before delivery. Aside from the growth of your stomach and listening to heartbeat with doppler, do "typical" pregnancies usually involve any ultrasounds for monitoring the baby? Also, as stupid as this sounds, how do they know if everything is going well with amniotic fluid? (Aside from obvious leaking, of course)

Unfortunately I am an only child of an only child and my SIL lives in Florida so it's hard to ask many IRL people these questions. Any info is helpful.

stephaniesee

I think "typical" is 12 weeks, 16 weeks, and 20 weeks. I could be wrong... I've had to go every other week for cervix measurements

pblge

I had all these questions, too! The answer I got is that for most pregnancies they won't do anything but the doppler and the fundal height measurements after the big scans at 12 and 20 weeks. The doctor did say that a fair % of women end up getting a growth ultrasound later on if the fundal height seems off, or perhaps because of GD or similar. Apparently they just assume that baby, cervix, and amniotic fluid are all A-OK unless there's indication of a problem. I do think they'll start cervix checks at the very end, but I'm not sure what week.

I'm sure there are practices that differ, however, and I know they do different things for higher risk pregnancies. I'll be curious to hear what others say.

AMShark

I can't really say, since I'm having twins, and things have been not so normal recently - however, I can say that every time I've had a question that I thought was stupid, my OB or MFM assured me that there are no stupid questions.

I do better if I write out my questions before my appointment. I have a little notebook for my pregnancy, and before an appointment, I'll talk with DH about what questions we have, & then I'll jot them down in my notebook so I can make sure I ask them.

*** eta - fixing rogue punctuation ***

Steph1673

In my experience, you don't get any other ultrasounds after the anatomy scan, unless there is some sort of issue to monitor. For example, I got one in my late second or early third tri last time because they found placenta previa at my a/s and wanted to monitor it. Usually you go in for weekly appointments starting at 36weeks and that is when they will check your cervix.

But as PP said, every practice is different and these are not silly questions, so make sure to ask your OB their standard procedures, too.

southernyankeegirl

Nope, most don't seem to do ultrasounds routinely after the anatomy scan. We had fundal height measured each week and my weight taken and blood pressure. If anything seems significantly off, they sometimes do a growth scan or two to see if baby is growing big. If you suspect an amniotic leak, they will swab you to test to see if there's amniotic fluid, but barring that they tend to assume fluid is fine.

We started cervix checks at 36 weeks. Honestly, I will probably skip them next time. They aren't so comfortable and don't really mean anything (someone with no progress can go into labor later that day, and someone like me who has been dilating and effacing early can just hang out at 2-3 cm dilated and 75% effaced for weeks without anything starting).

wreckitsmommy

My OB did an ultrasound every visit. I had monthly ultrasounds aside from my any other scans necessary. I know not many OBs do this but it was nice to see the baby every time I went in for a check-up.

hopeby2015

Aside from what was previously stated, it seems like my office does growth scans at the 30w mark and the 36w mark. Cervical checks started at 36w for me.

AmCheri

Your question about amniotic fluid is a good one. I lost over 50% of my amniotic fluid between a late Friday and a Monday afternoon appointment. I had no leaking or any other reason to believe my AF had become a problem. I wonder if they assume all is well so long as you're reporting good fetal movement? Can't help with the other questions because my primary doc was an MFM so I ended up getting a fair number of u/s and we were doing NSTs by week 32 I think.

iheartsippycups2

I had ultrasounds with OB @ 12 weeks & 20 weeks. Monthly visits are pee in a cup, weight, blood pressure, belly measurement, doppler, and general "how are you feeling/doing". Last month starts weekly appts where it is the same I just listed, and now he checks cervix (vaginally obviously) to check for dilation. With my first child, I was induced because I never went into labor, and I ended up with a c-section. This time around, we will schedule the c-section ahead of time. After the 20 week scan, the only other major thing they did was the dreaded glucose test around 28 weeks. You drink this nasty sugar water, wait 1 hour, then they draw your blood to check for gestational diabetes. If you fail, you get to do it again, but I believe you wait 3 hours before blood drawn. If you fail that one, my Dr would then would send me to a high risk OB.

ladyteach0505

AmCheri said:

Your question about amniotic fluid is a good one. I lost over 50% of my amniotic fluid between a late Friday and a Monday afternoon appointment. I had no leaking or any other reason to believe my AF had become a problem. I wonder if they assume all is well so long as you're reporting good fetal movement? Can't help with the other questions because my primary doc was an MFM so I ended up getting a fair number of u/s and we were doing NSTs by week 32 I think.

I just posted about this on my BMB. I know discharge happens but at what point do you notice it's a problem? Did you have obvious signs like gushing @AmCheri

AmCheri

@ladyteach0505‌, I had absolutely no signs, not even the slightest leaking. We were shocked at the Monday appointment to find out my fluid had gotten so low over the weekend. I was admitted there on the spot. I saw my doctor today, but didn't ask him about this. I will remember to next time.

ETA: The only reason we knew about the AF level was because I had had a growth scan that Friday and a repeat the following Monday. I was being watched closely due to growth restriction detected at 35w.

ladyteach0505

AmCheri said:

@ladyteach0505‌, I had absolutely no signs, not even the slightest leaking. We were shocked at the Monday appointment to find out my fluid had gotten so low over the weekend. I was admitted there on the spot. I saw my doctor today, but didn't ask him about this. I will remember to next time.




ETA: The only reason we knew about the AF level was because I had had a growth scan that Friday and a repeat the following Monday. I was being watched closely due to growth restriction detected at 35w.

@AmCheri Ah that scares me so much! Being only 23 weeks I feel like I have to predict things I don't know about. And while that's crazy it's also logical to me. I've had increased discharge-watery ish- so I automatically assume the worst. I hope I'm being crazy.

AmCheri

@ladyteach0505‌, I certainly don't mean to scare you. The question you've asked is a good one. I guess the bottom line is that it does none of us any good to worry about situations that are unlikely to happen. I was with an MFM my entire pregnancy, so please take my story with a grain of salt. Just something to be aware of, but pack it away now that you know. I am going to ask my doc next time about this. I've had one sonographer tell me that pumping water is good for keeping up your AF level. If I learn more, I'll update. As for your discharge, I think that's totally normal. It's going to happen on and off the entire pregnancy. Just keep in touch with your doctor. Call when you have questions. That's what your doc and the nurses are there for. Take it easy!

Ecarabeo217

Most of the time, after the anatomy scan, ultrasounds are done on an "as needed" basis. The assumption is that if all is well, your fundal height should equal your gestational age in cm. so if things measure big or small, then an ultrasound will get orderd to check why there's a significant difference. Of course, if you're diabetic, or have high blood pressure or anything else out of the norm, then there will be more imaging involved.
@AmCheri‌ , @ladyteach0505‌ -- fluid gets low when the placenta isn't working, not just from leakage or rupturing membranes. If they were monitoring for growth restriction, that goes along with the placenta pooping out early, so it would make sense that if they were monitoring for growth, the fluid levels could drop so drastically with no "leak". Again, the fundal height measurements would have been off, so a scan would have been indicated.
Hope that helps!