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Preemies
IF/Preemie Case Studies...you responded, I need a little more help
Awhile back, I posted a request for your stories to use as case studies in my Human Growth and Development class. Here is the link:
https://community.thenest.com/cs/ks/forums/27091705/ShowThread.aspx#27091705
I have been simply amazed by all of the stories..thank you so much for sharing them with me to use in my class. I can only imagine what sharing these stories will do to help educate my students who are largely future nurses and teachers. I am composing the case studies and am totally engrossed in all of the amazing experiences, complications and just plain miracles your babies are!
While I have walked the HR pregnancy road and rode the NICU roller coaster, every story is different. Some of you mentioned the procedures, conditions or complications by name, others mentioned them by symptoms, so I could use a little help, if you would by answering these questions so I can put a history with each case. I guess what I am trying to show the students is that it can happen to anyone regardless of demographical stats. If you want to copy and paste that would be great!
Mom?s age, Dad?s age:
IF issues:
IF treatments/procedures:
Pregnancy Complications/Issues:
Baby?s GA:
Reason for Prematurity:
NICU Experience/Prematurity Issues:
TIA!!
This discussion has been closed.
Re: IF/Preemie Case Studies...you responded, I need a little more help
Mom?s age, Dad?s age: 24 and 26
IF issues: PCOS,Ovarian cysts, and no ovulation
IF treatments/procedures: None
Pregnancy Complications/Issues: Severe Pre-Eclampsia and Toxemia
Baby?s GA: 26 weeks
Reason for Prematurity: Baby went into distress, Heartrate dropped from 160's to low 90's
NICU Experience/Prematurity Issues: Born weighing 1lb 4oz (due to IUGR), she had a PDA that closed after 2 doses of ibeprofen, she had 2 suspected cases of sepsis both requiring spinal cultures to be taken, 1 case of suspected pneumonia, she was exposed to enterobacter which they believed to have contributed to her pneumonia and required her to be in isolation, she received at least 4 blood transfusion due to her small size, she spent 6 weeks on the conventional vent because of vent dependance, she developed a non-occlusive blood clot in her Aorta from the umbilical lines a week after birth that just cleared up last month. She developed ROP due to prolonged exposure to oxygen, which cleared up 2 weeks after she was released from the hospital. She spent 114 days in the NICU total and left the hospital breathing on her own and weighing 7lbs 4oz .
Mom?s age, Dad?s age: 34, 37
IF issues: none
IF treatments/procedures: none
Pregnancy Complications/Issues: no problems/issues at ALL until premature rupture at 23w1d. Still unexplained.
Baby?s GA: 27w3d
Reason for Prematurity: pPROM
NICU Experience/Prematurity Issues: Aside from reflux, our big NICU issues were more "hospital" related than prematurity related - MRSA (twice), H1N1. We were also exposed to Pertussis. We had a NEC scare with invisible blood in DDs stools, but it turned out to be stomach irritation related to her o/g tube. No IVH, no ROP, off O2 by her original due date.
Mom?s age, Dad?s age: 27, 29
IF issues: None
IF treatments/procedures: N/A
Pregnancy Complications/Issues: Severe Hyperemesis
Baby?s GA: 34 weeks 1 day
Reason for Prematurity: Decreased fetal movement which escalated to fetal distress. When they got my placenta out, it was almost completely dead.
NICU Experience/Prematurity Issues: DS was in the NICU for 22 days. He had breating issues and was on CPAP and a nasal canula. Had an infection in his lungs which cleared up with IV antibiotics over a few days. Problems regulating blood sugar which cleared up after about a week. Typical feeding issues so had NG tube. As & Bs. Failed carseat study due to difficulty breathing and desatting immediately when in car seat. Was in car bed until he was 3 months. Came home without any monitors but was put on a brady monitor at about 3 months because he started having bradys again. Had the monitor for 30 days which determined they were not serious.
Mom?s age, Dad?s age: 31, 33 (started TTCing at 28, 30).
IF issues: PCOS (Polycystic Ovarian Syndrome)...lack of ovulation
IF treatments/procedures: HSG, IUI+ Clomid x's 4, then IUI + Injectables and Metformin (drug for blood sugar issues often used to treat diabetics, women with PCOS often have diabeties and will frequently suffere from GD...many women with PCOS take this when tehy are not pg to help control their PCOS symptomos)with a trigger shot (forces you to release the egg)...I had one previous IUI+injectables and metformin cycle that was cancelled due to hyperstimulation....so my cycle that I got pg on was a low and slow cycle...to ensure that I did not produce too many eggs. At trigger I only had one mature follicle....well, obviously I had another one b/c I have fraternal twins.
Pregnancy Complications/Issues: I had a pretty normal multiple's pregnancy, however lots of all day morning sickness until 14 weeks, then at 21.5 weeks, I felt off, and thought I was having contractions on the way to work one Friday, called my cousin and she said, yes, that sounds like contractions, but it's way too early...you should call your OB...so I went to work and went immediately to the school nurse, laid down, timed 'contractions' and called my OB who told me to go to L&D..there it was discovered that I was dialated 4 cm and that Baby A's bag of waters was in my birth canal...I had an Incompentent cervix...so they gave me LOTS of terbultine to stop the contractions, put me in the trundle position (head lower than feet to coax baby A back into my uterus)and scheduled a cerclage for the next afternoon...we were told that there was a 25% chance that the bag of waters could be pierced during the surgery or that the surgery would be unsuccessful...which it wasn't. I was on hospital BR for 3.5 weeks and then home on strict bedrest for IC and PTL
Baby?s GA: 30 weeks (we have twins and twins tend to develop faster in utero than singletons...which I think is odd, but hey, we'll take it!)
Reason for Prematurity: Premature Rupture of Membrances (PPROM)...sadly I'd had my best appointment the day before my water broke. The plan was to keep me on hospitalized BR for as long as possible, BUT I passed too much of Baby A's membranes so they had to let me go into labor naturally....I made it 24 hours, which meant that I got 1 shot for lung development.
NICU Experience/Prematurity Issues: we were in the NICU for 87 days...after the first 3 weeks (biggest issue during this time was that one of my girls had bloody poop which often is indicative of NEC, but it was determined that she did not have it, instead she was allergic to the human milk fortifier that they were giving her to mix my breastmilk to a higher calorie), my girls were mainly feeders and growers...we were so so lucky...however my girls are IUGR (interuterine growth restriction, whcih developed AFTER my cerclage around 23 weeks babies, so they were slow to grow so that kept us in teh NICU for awhile...well, that and the fact that they developed Thrush and HATED to eat after that (it was a very very odd case b/c it was growing on their feeding tubes and so it wasn't going away)..I actually suggested that this could be what was happening..ick. Our biggest current issues are: 1- asthma, 2-slow to gain weight b/c of being IUGR babies, at 18 months they are just now weighing 19 pounds, and thankfully these days LOVE to eat (they just hated their bottles). We've been VERY lucky otherwise, they are very healthy and meeting all their milestones, but it's important to note that MANY people have not been as lucky as we have.
If you need anymore infomration, please page me!
Mom?s age, Dad?s age: I was 31, husband was 38
IF issues: I had a luteal phase defect (low progesterone), my husband has a low sperm count & low motility
IF treatments/procedures:
Clomid/IUI
Pregnancy Complications/Issues:
I had two previous miscarriages. With Robbie, I spotted off and on for almost my entire pregnancy, with no known cause.
Baby?s GA:
26w2d
Reason for Prematurity:
Severe pre-e/Hellp
NICU Experience/Prematurity Issues:
Robbie spent 96 days in the NICU. He was on the vent for 5 weeks, CPAP for another 3, then high flow, low flow until a week before discharge. A PDA which closed with a round of meds, 2 positive cultures in his trach tube cleared with antibiotics, an imbalance in digestive bacteria also treated with antibiotics. Several NEC scares. He had horrible reflux, resulting in an NJ tube for a few weeks, which was what finally got him off the ventilator. He was diagnosed with an malformed diaphragm and hiatal hernia about 37w gestation (not related to his prematurity) which required surgery to repair. He had a fundoplication and a G tube placed at the same time, along with bilateral inguinal hernias repaired.
Post NICU he had other issues. Not sure if you wanted all that. Let me know if you do.
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Re: IF/Preemie Case Studies...you responded, I need a little more help
Mom?s age: 26 Dad?s age: 27
IF issues: none
IF treatments/procedures:
n/a
Pregnancy Complications/Issues:
Gestational Diabetes
High Blood Pressure/swelling starting at 29 weeks (put on meds)
Baby?s GA:
33w4d (considered 33weeks while in NICU...for example - they wouldn't let him bottle feed until 34 weeks...so rather than wait 2 days, they made him wait an entire week)
Reason for Prematurity:
Severe pre-e/Hellp....discovered due to high BP that wouldn't go down after taking meds - blood tests revealed HELLP - emergency c-section an hour later.
NICU Experience/Prematurity Issues:
Carter was a feeder/grower. Had to learn to maintain his temperature and bottle/breast feed. Born at 3lbs 10oz he spent 20 days in the NICU (discharged at 4lbs 11oz). No real set backs, and no issues since coming home besides losing weight at first (due to EBFing and low supply - which never rebounded)
Mom?s age, Dad?s age: Both 38
IF issues: Hypothyroidism, Diminished ovarian reserve
IF treatments/procedures: IVF
Pregnancy Complications/Issues: Preeclempsia
Baby?s GA: 35 weeks 4 days
Reason for Prematurity: Water broke spontaneously.
NICU Experience/Prematurity Issues: Needed a CPAP after being born with the cord wrapped around his neck (I received steroid shots for lungs due to pre-e). He had issues eating, and needed the bili lights. Also had issues keeping body temp up. He spent 12 days in NICU and is home now and doing wonderfully.
After 7 years trying to concieve, 3 failed IUIs and 2 failed IVFs, my third IVF was a success!
My Christmas baby turned into a turkey bird! Dillon Richard was born at 34 weeks, 5 days on November 28, 2009 after 10 weeks on bedrest for preeclampsia.
<a href="http://smg.photobucket.com/albums/v705/arriinthere/PJ/?action=view
Mom?s age, Dad?s age: 27, 27
IF issues: PCOS w/ no menstrual cycles or ovulation
IF treatments/procedures: Took 1000 mg Metformin to regulate cycles
Pregnancy Complications/Issues: No complications or issues until 24 weeks when I had spotting and severe back pain. The doctors found that my water was bulging out of my cervix and diagnosed me with an incompetent cervix, which was around 1-2 cm dilated. I layed upside down (to prevent my water from breaking) and on medicine to stop the contractions in the hospital. They said I would deliver in 1 or 2 days but I didn't deliver for 2 weeks, thank God.
Baby?s GA: born at 26w2d
Reason for Prematurity: Incompetent cervix
NICU Experience/Prematurity Issues: Andrew was in the NICU for 117 days. He was born at 2 lb 3 oz and just over 13 inches long. He deal with many issues during that time - grade 2 and 4 IVH, PDA closed with 2 rounds of Ibuprofen, pneumothorax requiring using of high frequency ventilator (oscillator), was also on ventilator (2 weeks?), CPAP (long time), and the nasal cannula, had 2 blood transfusions (that I remember), anemia, jaundice. Ultimately, severe reflux is what kept him in the NICU for so long - the problem was unknown and he refused to take a bottle until it was discovered. He came home weighing just over 8 lb, requiring no respiratory support.
Mom?s age 35, Dad?s age N/A Donor 27
IF issues:none
IF treatments/procedures:concieved via un medicated donor sperm iui
Pregnancy Complications/Issues:none until sudden onset pre-e/hellp
Baby?s GA:30 w 4 d
Reason for Prematurity: hellp syndrome
NICU Experience/Prematurity Issues: Birth weight 2lb 5 oz 14 in. 69 day nicu stay. 12 hrs on vent and 3 days on cpap. Nasal canula 14 days to try to help with As and Bs. No oxygen support ever. PDA treated with ibuprofen. Some aspirates with eating and one NEC scare but she just needed to poop! Moved to the intermediate nursery after 20 days. Slow weight gain she did not hit 3lbs until 36 days in nicu. Continued to have As and Bs for entire stay in nicu which were her largest problem. Many were reflux related. She was put on reflux meds after discharge and seems to be growing out of the reflux as she does not need her meds most of the time. She is not having weight gain problems and is was in the 10th percentile for weight (non adujusted) at her 4 month check up. She was 12lb 2 oz at 5 months. She is somewhere between her actual and adjusted milestones (I would say closer to adjusted age) but moving along through at her own pace as usual.
Mom's age, Dad's age: 32, 31
IF issues: low count and motility
IF treatments/ procedures: IVF- they put two in and both took
Pregnancy complications/ issues: I was pregnant with twins. At 9 weeks I started to bleed and went to the ER where they found I had subchorionic bleeding which stopped a few days later. Other than that I had a relatively easy pregnancy except for constant morning sickness. At 18 weeks I found out I was having a girl and a boy. 1 1/2 weeks later, at 19 1/2 weeks, my sac on my girl ruptured. I was put on hospital bedrest and the doctors didn't know if I would lose one baby, both babies, or none of the babies. A week and a day after my sac ruptured I started to have contractions. I delivered my daughter 16 hours later. I was then given a shot of breathane to stop contractions and my cervix closed. 5 days later I had a cerclage put in and then the next day went home to do bedrest. All was okay until 26 weeks when I started to bleed. I went to the hospital and had one steroid shot and was told I would be at the hospital until I delivered. The next morning the baby's heartrate dropped so I was rushed in for an emergency c-section. It turns out the bleeding was from the other baby's placenta which they had to leave in me after I delivered her and if they hadn't taken Brandon when they did I would have lost him too.
Baby's GA: 26 weeks, 1 day
Reason for Prematurity: pProm from Brandon's twin sister at 19 1/2 weeks caused him to go into distress at 26 weeks
NICU experience/ prematurity issues: Brandon was in the NICU for 12 weeks. He came home 2 weeks before his due date. He had a PDA that closed on its own after one round of neoprofin. He had 4 blood transfusions. He was septic several times. He developed ROP and was transferred to CHOP for 2 weeks because they thought he would need laser surgery and our NICU didn't do it. Thankfully he didn't need it and it corrected on its own several months after he was discharged. He was on a vent, CPAP, and cannula. He came off the cannula 4 days before he was discharged. When he was 2 months old he developed a stomach infection and we almost lost him. He had reflux. He just came off of the reflux medicine a few weeks ago at 17 months.
Thanks for doing this, I hope your students can really get a good grasp of what actually happens to preemies and their families.
Mom?s age, Dad?s age: Mom- turned 35 one week before the boys were born at 28wks 6days, Dad - turned 34 the begining of the month the boys were born in March.
IF issues: None
IF treatments/procedures: None
Pregnancy Complications/Issues: Twins (which is considered automatic high risk), Baby B was severe IUGR through whole p/g, Baby A was moderate IUGR. Delivered early due to full end diastolic reversal of blood flow in Baby B's placenta. No other complications.
Baby?s GA: 28wks 6days
Reason for Prematurity: Severe IUGR with full end diastolic reversal of blood flow to Baby B's placenta.
NICU Experience/Prematurity Issues: baby A weighed 2lbs 15oz and 15" long at birth, Baby B weighed 1lb 7oz and 12" long at birth with APGAR of 6 and 9, spent 67 and 68 days in a level III NICU, two weeks on CPAP, long term nasal cannula at 100% O2 causing chronic lung disease in Baby A, Baby B had one very mild Level 1 brain bleed hematoma, Baby A had significant hole in heart diaphragm which luckily closed on it's own with meds, several blood transfusions - about 5 for each baby - because the amount of blood required on a daily basis to check and monitor health depletes the baby's blood supply faster than the liver can create more blood (and the liver does not begin this process significantly until after 32 weeks), possible NEC in Baby B with unexplained severe abdominal swelling, severe constipation, several staph infections, severe jaundice and under lamps for two weeks for each baby, Baby A came home on 1/4ltr of O2 until 5mos actual age. Baby A came home weighing 6lbs 2oz on O2 and required 5mos of puls ox, Apnea & Brady monitoring, Baby B came home weighing 3lbs 8oz. Both babies suffer from EXTREMELY severe reflux/GERD causing a dx of Failiur to Thrive by 10mos of age and began to refuse to eat by mouth. This required GJ feeding tubes. As of 21mos old today they are still on G feeding tubes, still suffer horrid reflux (very, very common in preemies) and still refuse to eat by mouth.
Because of their prematurity and Baby B's very low muscle tone they are delayed in every area, though finally catching up at 20mos of age in most areas.
Mom?s age, Dad?s age: 27,34
IF issues: None
IF treatments/procedures:None
Pregnancy Complications/Issues: None until the day I had Cooper decreased movement heart deceleration after contraction...so he was in destress//
Baby?s GA: 33 weeks
Reason for Prematurity: What would have lead to IUGR..
NICU Experience/Prematurity Issues: He was a trooper once out only in the hospital 10 days no Oxygen needed took ng tube out after 5 days..
@ 3 months he developed Oral Aversion...
Mom?s age, Dad?s age: 29 and 28. Age at first m/c: 27
IF issues: Unexplained sub-infertility. 3 miscarriages- one missed m/c, one blighted ovum, and one chemical pg
IF treatments/procedures: HSG
Pregnancy Complications/Issues: None until 29w6d. Preterm labor and then put on bedrest. Positive fetal fibronectin, dilated to 2cm, 60% effaced. At 32w3d: 3 cm dilated, 80% effaced, bulging bag of water. Attempted to stop contractions, but meds didn't help. Received beta methazone shots for baby's lungs.
Baby?s GA: 32w4d
Reason for Prematurity: Unexplained.
NICU Experience/Prematurity Issues: 1 week under billi lights, no other major issues. Spent most of time as a feeder/grower. Came home at 36 weeks gestation at 5 pounds, 14 ounces.
BFP #2: 9/25/08; 10/27/08 - Blighted ovum discovered, 11/5/08 - b/o confirmed
BFP #3: 1/19/09 - Chemical Pregnancy
BFP #4: 2/12/09; EDD 10/26/09 - Richie born on 9/4/09 at 4 pounds, 10 ounces
BFP #5: 5/27/11; EDD 2/4/12 - Sylvia is on her way!
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Mom?s age, Dad?s age: 29, 30
IF issues: suspected progesterone deficiency, protein S deficiency (clotting disorder that causes lots of fun things). had 3 prior losses (lost twins, had an ectopic, then lost another)
IF treatments/procedures: HSG, progesterone after ovulation. always got pregnant on the first try but had a hard time getting pg with my sticky baby.
Pregnancy Complications/Issues: huuuuuuge subchorionic hemorrage at 8 weeks (bled until 14 weeks). amnio at 16 weeks (was perfect) due to bad 1st trimester screening results. iugr detected around 24 weeks. pre-e/hellp at 28 weeks.
Baby?s GA: 28 weeks, 2 days (dr. rounded up to 29 weeks for fun i guess)
Reason for Prematurity: pre-e, hellp, iugr
NICU Experience/Prematurity Issues: bad lungs (just came off of o2 like a week ago), pneumonia at a couple of weeks old, As & Bs, reflux, anemia, jaundice.
I didnt answer the first time, so I am not sure if I should respond to this one or not, if you can use it, feel free to use our answers too.
Mom?s age, Dad?s age: At birth, 22 and 23
IF issues: None
IF treatments/procedures: N/a
Pregnancy Complications/Issues: Minor high blood pressure, but not high enough for treatment. I was borderline 2 weeks before delivery.
Baby?s GA: 24w 3d
Reason for Prematurity: Sudden unexplained hemorrhaging.
NICU Experience/Prematurity Issues: 127 day NICU stay. BPD/ Chronic Lung disease. Surgery to close PDA at 3wks actual after 3 failed rounds of indocine. Stage 4 ROP, 1 laser surgery at 3mos 2 vatrectomys (sp?) at 4mos. Poor SSB reflex, and reflux. learned feeder, didn't take all feedings by bottle until day 124! Other than the above, he had a "general 24 week course"
Mom?s age, Dad?s age: 28 & 27
IF issues:PCOS but under control, no probs getting pg
IF treatments/procedures: none just had been on metformin for a few years
Pregnancy Complications/Issues: slighltly elvated blood sugar
Baby?s GA: 28 wks 2 lb 15 oz
Reason for Prematurity: severe UTI
NICU Experience/Prematurity Issues: mainly feeder/grower, but he had grade 3 brain hemmorage, hole in heart hasn't closed yet, had to be on nasal canula twice, came home at 2 days shy of 8 wks