An interesting appt today.

Mrs.Reem

Hmm well my RE, OB, and perinatologist wanted to call a meeting today to discuss how we'll proceed with my pregnancy. I didn't get a lot of details ahead of time so I went into it thinking it was pretty routine.

Apparently they're concerned my water will break early again. There's a 33% chance of reoccurance in those who've already had it happen once with a typical pregnancy. I'm thinking the 77% chance of it not happening are pretty great!... but they seem all serious about it.

They're putting me on progesterone for the entire pregnancy! (um yuck) It was either that or weekly p17(I think) shots. No thanks. I have enough poke marks from the injectables. High protein diet. I'll have weekly appts after 20wks alternating between peri and ob. No lifting more than Katen's weight. Weekly ffn tests at 20wks on also. Here's the kicker, possible bedrest to be evaluated as we go. That just seems like total overkill to me. Total overkill.

What do you think?

I mean seriously? Katen was born at 36wks. It's not like she was a micropreemie or anything. And 77% chance that I'll go full term just fine sounds really positive to me. Don't you think? So what's the big ol' deal? Do you think there's something I'm missing? I did have a tear in my uterus from  fast/forceful contractions and I have thyroid issues and diabetes but other than the tear nothing is different from last pregnancy.

Holy cow! If you got this far you are amazing. I'd have stopped ready already. lol

LisaMarisa

That does seem interesting since she was only 4 weeks early... hmm... I guess just wait and see how it goes.  On one hand it will be nice to be monitored so closely, just in case, but I can see how it seems like overkill on the other. 

Can I ask why you're seeing a peri?  I went into PTL at 31 weeks and am wondering if I should be considered high risk with my next pregnancy.

Christakim

This seems so extreme.  I don't understand why they would put you on bedrest if Katen was only 4 weeks early and only 1 week shy of full term.  I would ASK if there is something you are missing!  77% chance seems good to me!

TheSkimmy

hmmm that does seem like overkill to me. Technically it was only 1 week before full term at 37 weeks. Maybe they will back off a little bit once they see how you are doing?? Did you get an u/s today?? (are you far enough along for an u/s?)

Mrs.Reem

LisaMarisa:

Can I ask why you're seeing a peri?  I went into PTL at 31 weeks and am wondering if I should be considered high risk with my next pregnancy.

I saw a peri with my last pregnancy too because I'm diabetic. I also started off with twins last time but once the other twin passed he wanted to keep me to keep tabs on the diabetes.

I would think (but don't know for sure) that if you went into ptl at 31wks that they'd want to be even more extreme than my Dr.s are with your care. It would be a good question to ask ahead of time maybe. I was kind of caught off guard with all of this myself. lol

cmw&tdm

Yeah, I don't know why they are making such a big deal about someone who prematurely delivered at 36 wks, which is only a week away from full term.  Maybe it's the tear in the uterus, the thyroid issues, or the diabetes they are worried about?  Although they should have expressed that to you.  At least they are doing what they can to get you to FT next time.  Sounds like you have good doctors!

JGirl2005

I think it is great that they are monitoring you that closely.  36wk is still not full term, so there is a chance she/he could come sooner than that.  2nd pregnancies go faster during labor, so maybe that is their concern too.

I think the progesterone is great at keepign PTL at bay.  Great about ffn tests.  My peri did ZERO of those for me - so I think that is a bit of an overkill, but maybe they are concerned that your water could have a slow leak.  My peri didn't want to even talk steroids until 24wks so there is no way they would do ffn on me sooner than that.  Mainly I've heard those starting at 24 wks. 

Mrs.Reem

Ya know I was so surprised at this meeting that I just didn't ask a lot of questions. Now I have a ton. Do you think it would be totally annoying if I called and asked questions now? Maybe I should wait until my next appt. They're going to think I'm nuts.

JGirl2005

I don't think there is much concern - they are just so good at their job.  That's great!  Maybe write stuff down and ask at the next appt. 

Your water broke without contx right?  The FFN is what I would have the most questions on because maybe they are concerned about a slow leak like I said.  I'm not sure what could cause a slow leak -i mean what problems come with it- not sure if you could get an infection from it - and that would be the most concerning.  (well the baby infection).  I guess the baby not having enough amniotic fluid too, which diabetes can cause (or too much fluid).  That is what the extra u/s would be for to monitor fluid too. 

It's great they are so proactive.  Most likely it won't happen again, but schmoodle is monitored a lot because of previous placental abruption.

alchris

There's definitely something to be said for being cautious, but it seems they're being REALLY cautious.  Is there anything they're thinking they'll be able to see with so many appts?  The no heavy lifting and even bedrest make sense IMO, just in case, but not until much later.  Go ahead and call -- it'll be a long weekend for you otherwise, I think.  Keep us posted -- hugs!

schmoodle

I tend to agree with JGirl that this sounds to me like you have a great medical team. Better to be proactive than to ignore a potential risk, even if it doesn't seem significant.

As an illustration, the MFM we consulted said that if we had twins again we had a 20% chance of losing them both again...so 80% sounds great right? But those odds, to a doctor, are "OH HELL NO" and they pretty much said flat out that we should absolutely not have twins, based on those odds. So while 33% chance of something happening doesn't sound bad to us, to a doctor, they are very risk averse (which is good) and want to do everything they can to minimize any such risks.

As JGirl2005 mentioned, we are being SUPER closely monitored and I've been on modified bedrest since 16 weeks. Now the bedrest is partly of my own volition, but the weekly monitoring and P17 shots the doctors suggested based on my history even though they almost exclusively attribute our prior PTL and loss to carrying twins and said that our chance of recurrence was around 5%. They just prefer to be safe than to miss something, and it sounds like that's all your doctors are doing.

I definitely think if you are concerned or have questions you should call, that's what they are there for! I don't get ffn tests so maybe, as others suggested, you could ask more about that, but otherwise maybe just get some clarification on the rest. Maybe they only are talking bedrest IF something comes up, and not just automatically?

Good luck, sweetie!

crystalgirl

Well, that's actually only a 67% chance that it won't happen again.  Does that make you feel differently?  It sounds like they're being pretty reasonable with what they're saying, to me, but I agree with alchris that most of those things don't seem necessary until you're much farther along.

You know, they're doctors.  There is a precedent here.  They don't want to get sued if things don't work out as well this next time!  It's a bit of CYA, I think.

LilSurferGirl

Ditto alchris - I'm all for being cautious, but that does seem excessive.  I would definitely call and ask your questions, they threw a lot at you in that meeting and of course you're not going to think of questions right away - you needed time to process everything.  I would ask them what they hope to see with all the monitoring, the ffn's, the bedrest, etc.  Let us know how it goes!

crystalgirl

I hope my reply didn't sound too blunt!  My time here is in such little spurts, I don't have time to read and revise!  So I tend to just blurt. 

I'm sorry it's looking like lots of no fun restrictions this time around.  I know things were rough enough last time with dietary issues, etc.  Take care, honey, and let us know how everything goes.  ((((hugs))))

skoorbnibor

ok, so I hate to say it, but what if this time your water breaks at 32 weeks? We don't want that (and hey, maybe MrReem might want to be there this time!) I agree they are being super conservative, but on the other hand, better this than to take a risk that can be controlled. The diabetes alone put you in a high risk category...

Really, the best thing (I think) is to act as if the 33% chance is likely and then be thrilled and relieved when it doesn't.... 

 

 

DavezWife

I smell docs covering their butts with legal ooze.

I'm not an alarmist (well, I say that I'm not, lol) but I wouldn't go that far. Take it easy but it would be hard to get me to stay tied down with a baby at home.

mrspresley

seems a bit like overkill to me too but i guess better to be extra cautious?  i have no personal experience with progesterone but i read a post on TTTC a while back where the overwhelming majority of women said they would rather give themselves the PIO shots than do the progesterone supp's.  just fyi

LucyPevensie

Reems .. I'm laughing at you a little bit.  A history of P-Prom .. a baby who spent time in the NICU .. a tear in your uterus .. thyroid issues .. and diabetes. 

Yeah, I can't imagine why they're having a meeting about you and wanting to monitor you really closely.  

Listen to your doctors!  I know you are a very stoic person who I don't think I have ever seen indulge in self-pity so you may really think "what's the big deal" but the reality is  - you're high risk - and they want you and your baby to have a great outcome.