Choosing to deliver at 35w6d - second thoughts

MrsMSG

Some history.

DS1 was born at 37w5d, via emergency c-sec, after 20 weeks of bedrest, 5 of them hospitalized, due to partial abruption, maternal renal failure, pre-e, and IUGR.  He was not in the NICU, and while he is still small (>5%), he is healthy and developmentally on track.

DS2 was stillborn at 25w due to a blood clot. It was determined after delivery that he, too, was IUGR, and I was also diagnosed with pp pre-e.

I have been on bedrest with DD's pregnancy since 23w.  She, too, has been diagnosed with IUGR.  My ob and MFM are both confident with delivering her via c-sec on 4/26, which puts me at 35w6d.

I've been fine with this.....I was happy to see 30w. But now...I'm starting to second guess myself.

I know this is a very personal decision, and of course, I realized 36w is great compared to the micropreemies so many of you had....

But I'm still looking for honest opinions.  Would you proceed with delivery pre-term, or try to make it even another 8 days to 37w?

I'm not in the hospital on bedrest, and we live 45 miles from the Nashville hospital I'm delivering at.  I'm just worried that something will happen with her placenta here at home, and we won't make it in time to save her....unlikely, I know, but after a stillbirth....the rational part of your brain stops working.

Any thoughts?  TIA.

At1stsight

Did they say why they want to deliver pre-term? Do the docs think it's safer and what were the reasons it would be safer? I have no advice other than to make sure you're comfortable with the answers to those questions. I would trust my docs if they could answer them with real reasons.

I hope everything goes smoothly with no NICU time regardless when you deliver.

ijack

I would imagine that with your history you're scared of what happened last time, which is completely understandable. Obviously as someone whose had a preemie I would never "choose" to deliver early, but in your case I can understand. Is there any way you can choose to be admitted to the hospital for the remainder of your pregnancy?

TriciaJoy

hey you!

This is a hard one. Ordinarily, I'd absolutely be pushing for 37w. But I know what you want through.. and I'd be horrified, too.

Could you ask for an amnio to make sure her lungs are developed and she can safely come out now?

SWMcFarland

With your history and the IUGR, I wouldn't blame you one bit for wanting to deliver at that time.  Have you had the steroid shots?  I know some doctors/hospitals won't give them after 34 weeks, but I would push for it knowing you are delivering preterm.

I wish you the absolute best and prayers for a non-eventful, stress-free birth.  Hang in there mama!

Sweets2005

First of all, I am so sorry for your loss. If your OB is okay with it, I would go ahead with it. I had severe bleeding from an abruption and if I thought that could happen again, I would want to deliver a little early, too. Congrats on making it this far! Good luck with your decision and delivery!

MrsMSG

Neither my on nor the MFM have brought up the steriod shots.  And the only determining factor, really, in choosing 4/26 is that I have a BPP and growth u/s on Thursday, 4/22, and the plan is just to stop the Lovenox injections over the weekend, and deliver via c-sec on the following Monday.

DH wants me to be admitted to the hospital on Friday, so that I'm there under surveilance while I'm off the Lovenox...but I'm not really sure how to request that.  On paper, I'm "fine."  I'm on so many BP meds that my BP is holding steady and there is no sign of pre-e, and honestly, the baby is doing well.  Because she is still so little, she has plenty of room to manuever, and I feel her constantly.

My nerves and mental stability are really what is driving the early delivery, which is why I feel selfish and am having second thoughts....but if I'm being completely honest, I'm a WRECK right now, despite prozac and anti-anxiety meds.  So, which is the lesser of two evils: early delivery, or me stressing out?

Thanks for your input, ladies. It helps just to be "heard."

Rachel&Joe

I vote to only do it if they will do an amnio to check on her lungs & also consider the steroid shots.  there have been some later term preemies on here that actually had to be intubated for a short while so i would not want to risk it if you had the choice of waiting until 37w.

I also wanted to say, i am so happy for you, thrilled that you have made it this far & so excited that you are having a girl.  Do you still wear the necklace I made you ever?

MrsMSG

Rachel&Joe:

I vote to only do it if they will do an amnio to check on her lungs & also consider the steroid shots.  there have been some later term preemies on here that actually had to be intubated for a short while so i would not want to risk it if you had the choice of waiting until 37w.

I also wanted to say, i am so happy for you, thrilled that you have made it this far & so excited that you are having a girl.  Do you still wear the necklace I made you ever?

Any time it matches my outfit, Rach.   Otherwise, it's the Lisa Leonard necklace the PAL girls got me.  But it's one or the other.

ijack

MrsMSG:

DH wants me to be admitted to the hospital on Friday, so that I'm there under surveilance while I'm off the Lovenox...but I'm not really sure how to request that.  On paper, I'm "fine."  I'm on so many BP meds that my BP is holding steady and there is no sign of pre-e, and honestly, the baby is doing well.  Because she is still so little, she has plenty of room to manuever, and I feel her constantly.

Honestly, just tell your doc that you would feel better if you were being watched once you were off the lovenox and s/he should make it happen.

GL!

gwenypher7

I would trust your doctors. If they suggested the c/s at 35/36 weeks, I would do it. I had an iugr baby as well, and there was no known reason for it - but iugr does mean she's not getting the nutrients she needs for some reason. That's such a scary situation because things can change very quickly. At 35/36 weeks, she may grow better as an outside baby.

At first, I was given the choice of trying to let dd stay in for another week or two - then my platelet level plummeted and I had to be induced - but I do know the agony of this decision. If you aren't sure of your doctors' assessment, ask for a second opinion.

Congratulations - either way, you will be meeting your little girl very soon!

Sweets2005

I totally don't blame you for letting your nerves/emotions make this decision! you have been through a lot and at this point, there is no wrong decision. Can you get the steroid shots? I know you said they haven't brought it up but maybe you can just ask? Can you stay on the Lovenox until the c/s or is that not okay?

I hope after the baby is born that you update us and show us some pics! I will be sending positive thoughts your way every day until baby is here!

*LilaC*

I know where you are coming from. My mom had an abruption with me (I was iugr as well) and then delivered my brother stillborn at 31 weeks due to a blood clot. She ended up losing a few more babies, but had planned c-sections at 36 weeks with both my sisters before anything could go wrong. They did do amnios to check for lung maturity and both my sisters came straight home after 4 days...I know that is not always the case though.  My son was born by c-section at 32 weeks after an ultrasound revealed IUGR and placenta problems. I would definitely trust your doctors on this one. I know how scary having a preemie can be, but I also know how quickly things can go wrong. 

 Hang in there   

lstaylor73

My boys were IUGR babies, with Cameron being 2lbs 15oz and Evan being 1lb 7oz at 28wks 6days.  You can read our story in my blog:

 https://taylo2babies.blogspot.com/2008/06/introducing-cameron-evan.html

 Our peri knew it was a matter of being at the exact right place and time to catch when Evan would surely go into distress.  They put me on modified bedrest and admitted me for 24 monitoring with the doplar three times a day because our peri knew that there would be nothing I could feel to know something was going wrong and only constant doplar u/s would be the way to know when it was time.  And they caught it just in time and had the boys out in under 45min.  Evan had gone into full reversal of blood flow and would have surely died had they not been monitoring so closely. 

With your history I would demand that they do something similar if it's at all possible.  I would want to bake the baby as long as possible under the closest of observation, but I also understand that you are anxious to get this baby out so they can help her.  I wish you the best of luck, please let us know what happens.  ((HUGS))

lemen99

I would trust your doctor.  Depending on the circumstances, consider asking him or her if an amnio makes sense to check lung maturity!