Baby Elliott - Days 28 & 29 (April 9&10)(long-ish post)
Apr 10, 2015 18:48:54 GMT -5
Post by santoki77 on Apr 10, 2015 18:48:54 GMT -5
Here's more info about what happened leading up to going to L&D yesterday afternoon - this will be long-ish so sorry for those that view this on the app
Day 28/April 9 : NST #1 was quick and easy. Elliott did well. Met with MFMs - they are increasing the short acting insulin and they reminded me that this is a good thing and means my placenta is still working.
Had a GREAT doppler (checking blood flow and size). Elliott is now 2lbs8oz!! Basically grew about 12oz in 3 weeks
He is slowly catching up to his due date. He went from the 15th percentile to 25th. The doppler expert advised that the percentiles were based on Caucasian rates (Northern European). However, asian babies are, on average, at birth are at least 1lb less. Since Elliott is a mix (I'm Korean; DH is a European mutt and (very small) part Native American Indian) maybe 25th percentile isn't too bad. I really have my FX that Elliott is just genetically disposed to be a small baby (which does not have any real indication on how much he will grow as a child/teenager/adult). Also, his head/abdomen proportions are catching up to each other, i.e. becoming more proportional which is also good (apparently his head was a little bigger than his abdomen on previous scans). With oxygen therapy, there was NO evidence of absent or reversed flow. However, after I was taken off of oxygen, there became intermittent evidence of absent/reversed flow. Finally, he went from being about 3+ weeks behind in growth to about 2 weeks behind so maybe my placenta is starting to work (one of the MFMs believes in delayed profusion of the uterine vessels). So...overall pretty encouraging results although because of the evidence of intermittent evidence of absent/reversed flow. I met with one of the MFM fellow who confirmed that the results were promising and that my case was a quandary. Typically, mothers with placental insufficiency/umbilical resistance have babies with IUGR. She confirmed that umbilical resistance typically does not improve over time and, in fact, usually worsens. So...the mere fact that my resistance level has fluctuated and not completely worsened is yet another quandary. Add on my high BP and GD and it's an interesting situation. She finally confirmed that I'll be in the hospital for another week but that's ok.
DAY 28-29 (APRIL 9-10): LESS THAN 1 HOUR LATER....during NST #2, when the 20 minutes were almost done, Elliott had a sustained decreased heartbeat (HB)(deceleration) which lasted longer than a minute. After he perked up, he had 3 other decelarations (which went back to baseline relatively quickly) within 30 minutes so an IV was put in and I was taken back to L&D. Once in L&D, an IV was put in and I was given the regular fluids AND a magnesium sulfate (mag). They also started me on my second round of steroids (another set of 2 shots, 24h apart). Anesthesiology came by again and was concerned that I had recently finished lunch (increased risk of aspirating my lunch if I had to be intubated for an emergency C-section). The mag was very uncomfortable. The area around the IV felt like it was burning and I felt flush all around. I almost wanted to strip all of my clothing! I had them turn down the air as low as possible and had multiple ice packs and cold cloths on me. The initial dosage was pretty strong and then they mellowed it out. I was not allowed to eat as the word "delivery" was mentioned A LOT and they wanted time for the food to clear from my stomach (the anesthesiologist wanted at least 8 hours from my last meal but advised of precautions that could be placed to avoid aspiration, etc.). All-in-all, Elliott's HB started to do better (i.e. variability that they like with accelerations (and few decelerations with quick return to baseline)) and I was in L&D from approx. 4 PM through 10 AM the following day (today)(about 18hours of constant monitoring (NST)).
I later learned, upon returning to my room, mag is administered if they think I was going to deliver within 24 hours!!! I guess I'm glad I didn't know about this because I would have been freaking out a lot more! The plan now is get my 2d steroid shot and wait and see. If I am sent downstairs again, they could administer mag to me again, up to gestational age of 31w6d. After 32w, it's IV and then NST evaluation to determine delivery.
This afternoon's NST (#2) went pretty uneventfully. He had one deceleration during the 40min strip but it quickly returned to baseline. From what I've read, steroids and mag help the baby so I'm hoping, at a minimum, we can get through this week as 31w is tomorrow. I'll be even happier if we can make it to next Saturday (32w).
I am sooooo tired. I didn't get much sleep while in L&D because they had to check my vitals every few hours because of the mag. So far, during my 29 day stay, I have had to go down to L&D every two weeks, maybe Elliott is trying to keep us on our toes. I'm back to completely being back on edge, nervous and anxious again...hopefully this will resolve in a day or so. DH is sleeping over tomorrow night and since I couldn't eat last night's non-hospital dinner, he wants us to do a 'diner-type' breakfast Sunday morning!!
As always, thank you for all of your comments and support. After my situation mellowed out, I sent DH husband but with instructions to keep his phone on and LOUD in case anything happened. Fortunately, nothing did. So here's to hitting 31w tomorrow!
Day 28/April 9 : NST #1 was quick and easy. Elliott did well. Met with MFMs - they are increasing the short acting insulin and they reminded me that this is a good thing and means my placenta is still working.
Had a GREAT doppler (checking blood flow and size). Elliott is now 2lbs8oz!! Basically grew about 12oz in 3 weeks
He is slowly catching up to his due date. He went from the 15th percentile to 25th. The doppler expert advised that the percentiles were based on Caucasian rates (Northern European). However, asian babies are, on average, at birth are at least 1lb less. Since Elliott is a mix (I'm Korean; DH is a European mutt and (very small) part Native American Indian) maybe 25th percentile isn't too bad. I really have my FX that Elliott is just genetically disposed to be a small baby (which does not have any real indication on how much he will grow as a child/teenager/adult). Also, his head/abdomen proportions are catching up to each other, i.e. becoming more proportional which is also good (apparently his head was a little bigger than his abdomen on previous scans). With oxygen therapy, there was NO evidence of absent or reversed flow. However, after I was taken off of oxygen, there became intermittent evidence of absent/reversed flow. Finally, he went from being about 3+ weeks behind in growth to about 2 weeks behind so maybe my placenta is starting to work (one of the MFMs believes in delayed profusion of the uterine vessels). So...overall pretty encouraging results although because of the evidence of intermittent evidence of absent/reversed flow. I met with one of the MFM fellow who confirmed that the results were promising and that my case was a quandary. Typically, mothers with placental insufficiency/umbilical resistance have babies with IUGR. She confirmed that umbilical resistance typically does not improve over time and, in fact, usually worsens. So...the mere fact that my resistance level has fluctuated and not completely worsened is yet another quandary. Add on my high BP and GD and it's an interesting situation. She finally confirmed that I'll be in the hospital for another week but that's ok.DAY 28-29 (APRIL 9-10): LESS THAN 1 HOUR LATER....during NST #2, when the 20 minutes were almost done, Elliott had a sustained decreased heartbeat (HB)(deceleration) which lasted longer than a minute. After he perked up, he had 3 other decelarations (which went back to baseline relatively quickly) within 30 minutes so an IV was put in and I was taken back to L&D. Once in L&D, an IV was put in and I was given the regular fluids AND a magnesium sulfate (mag). They also started me on my second round of steroids (another set of 2 shots, 24h apart). Anesthesiology came by again and was concerned that I had recently finished lunch (increased risk of aspirating my lunch if I had to be intubated for an emergency C-section). The mag was very uncomfortable. The area around the IV felt like it was burning and I felt flush all around. I almost wanted to strip all of my clothing! I had them turn down the air as low as possible and had multiple ice packs and cold cloths on me. The initial dosage was pretty strong and then they mellowed it out. I was not allowed to eat as the word "delivery" was mentioned A LOT and they wanted time for the food to clear from my stomach (the anesthesiologist wanted at least 8 hours from my last meal but advised of precautions that could be placed to avoid aspiration, etc.). All-in-all, Elliott's HB started to do better (i.e. variability that they like with accelerations (and few decelerations with quick return to baseline)) and I was in L&D from approx. 4 PM through 10 AM the following day (today)(about 18hours of constant monitoring (NST)).
I later learned, upon returning to my room, mag is administered if they think I was going to deliver within 24 hours!!! I guess I'm glad I didn't know about this because I would have been freaking out a lot more! The plan now is get my 2d steroid shot and wait and see. If I am sent downstairs again, they could administer mag to me again, up to gestational age of 31w6d. After 32w, it's IV and then NST evaluation to determine delivery.
This afternoon's NST (#2) went pretty uneventfully. He had one deceleration during the 40min strip but it quickly returned to baseline. From what I've read, steroids and mag help the baby so I'm hoping, at a minimum, we can get through this week as 31w is tomorrow. I'll be even happier if we can make it to next Saturday (32w).
I am sooooo tired. I didn't get much sleep while in L&D because they had to check my vitals every few hours because of the mag. So far, during my 29 day stay, I have had to go down to L&D every two weeks, maybe Elliott is trying to keep us on our toes. I'm back to completely being back on edge, nervous and anxious again...hopefully this will resolve in a day or so. DH is sleeping over tomorrow night and since I couldn't eat last night's non-hospital dinner, he wants us to do a 'diner-type' breakfast Sunday morning!!
As always, thank you for all of your comments and support. After my situation mellowed out, I sent DH husband but with instructions to keep his phone on and LOUD in case anything happened. Fortunately, nothing did. So here's to hitting 31w tomorrow!
you've been going through much. As always I wish you and Elliott the best. You're doing great!
happy 31 weeks!
