question for former high-risk moms...

amd1982 · January 2014

so my last pregnancy with the twins was very different obviously because i was considered more "high-risk." i originally started to see the OB in the nearest city to me, and then had an encounter with one of the doctors (who has since retired) who basically refused me an ultrasound after i hadn't had one since 19 weeks (i was 26 weeks at the time). long story short, i demanded one and circumvented him - that's when i was admitted to the hospital because one twin's cord flow was almost absent and she also had IUGR. i was followed in boston after that point and had 1-2 ultrasounds per week up until delivery.

anyway, i'm back at my original OB's office now with this pregnancy. i like my doctor quite a bit - i was so shocked at my last appt that i really didn't ask about ultrasounds during this pregnancy. however, i had my t/v us at 6.5 weeks and now my next appt is scheduled for 1/28, however i do not believe it is an ultrasound. my question is: is it once high risk, always high risk? it's not like i want to have a u/s per week, but i'm a little leary at only having one at 6.5 weeks and then another one who knows when (12 weeks?). i'm just scared that something similar is going to happen. and i'm also concerned that if i raise any concern to my doctor he's going to say that bc i had twins, it was more high risk and this is just a regular pregnancy. any ideas or thoughts? am i just being paranoid or is this a legit thing to ask? thanks!

itsmevkb · January 2014

I wasn't considered high-risk for my first pregnancy and it proceeded pretty normally up until delivery. For my second, I was over 35 and then had some bleeding early on and so that moved me not into a high high risk category but not necessarily just your normal pregnancy either. My doctor is a pretty understanding guy and basically told me that he'd let me get an ultrasound every week if it would make me feel better. My suggestion would be to talk to your doctor. Yes, a twin pregnancy is different than that of a singleton but I'm assuming that having a history of IUGR, even if it was with twins, moves you into a category of needing to be more closely watched. If you doctor isn't sympathetic to what are your legitimate and not overly crazy concerns then I'd suggest finding one who is. There's a big difference between saying hey, I want more monitoring and I want to come in every week.

(although, I will say that many docs don't do a ton of ultrasounds early on simply because there's nothing they can do to help a pregnancy that early on. It's normal to have one check for viability and then have another between 10-12 weeks for maybe a nuchal screening.)

mcgeeva · January 2014

I am high risk again but It depends on what the reason you were high risk before. If it was cervical issues etc they would def make you high risk again to prevent preterm labor etc. Twins are always high risk so unless you had other factors to them you are having a healthy pregnancy this time around unless shown otherwise. I have a partial placenta abruption and went into labor at 31 weeks then had severe pre-e and was on strict bedrest for 5 weeks. So that puts me at high risk this time expecially since I have already been having hight blood pressure on an off through this pregnancy. So I think it really depends on the situation. Insurance wont pay for the extra ultrasounds and monitoring without cause which means the doctors wont get paid so they most likely wont do the extra monitoring when you have no previous reasons for it. Now I did think having IUGR would put you at high risk for this time around but again im no doctor I only know a few things based on my specific situation. Good luck!

IBackBevo · January 2014

I do not think that once high-risk always high-risk. Especially not in the case of twins.

I had severe pre-e and IUGR with my first. I am not considered high risk this time and my OB said so long as my BP is staying low and everything is normal, she will not be referring me to an MFM.

Ruthie04 · January 2014

I do not believe you are automatically high risk unless there was a reason for IUGR that could be carried over into your current pregnancy. Both of my LOs had IUGR and their placentas were maturing way too fast. While I know twins are at higher risk for placental insufficiency, I also have an autoimmune disease that is correlated with low birth weight in babies. Because both of my boys had IUGR, I am suspicious that this disease may have played a role in their growth issues. If I were able to get pregnant again, I'd ask for additional monitoring in the end becuse of that correlation. Otherwise, I think they'd give me the, "IUGR was because of twins" line.

FWIW, I don't believe it is out of the ordinary to get so few ultrasounds in early pregnancy. With my boys, I wasn't supposed to get ultrasounds between weeks 9 (my first OB appt) and 18 (my anatomy scan). I think the issue with your history is more likely to be of concern later and that any additional scans wouldn't be considered until that time.

Congrats again on your pregnancy!

galaxymom830 · January 2014

Like PPs have said, it really depends on the reason you were high risk the first time. My DD had a SUA so that automatically bumped me up on the "watch list" and earned me a referral to MFM and then I developed pre-eclampsia. It got so severe that my daughter had to be delivered 5 weeks early. My OB said that if/when I get pregnant again, she would most likely keep an eye on me from the beginning because of the pre-e, but I wouldn't automatically be labeled high risk unless something warranted it, like the development of pre-e again. HTH. Congrats!

luvboston · January 2014

As pp said it depends on what caused the iugr twins are more prone to it however in the second and third trimester your baby should be checked some places don't do any ultrasounds except 7,12,20.

I was high risk and will always be because the problems were not just with the baby I have several

Saraevh · January 2014

I agree with others who said I think it depends on your issues. I had cervix and preterm labor issues during my first pregnancy and because of that was labeled 'high risk' for my other two as well and saw a MFM during all three of my pregnancies.

I would definitely ask about extra monitoring at your next appointment given your previous issues even though it was a twin pregnancy.

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