Dream you’re mine

The journey from miscarriage to whatever comes next

The induction–making the decision to induce August 20, 2009

So to quickly recap my previous posts, I went to the hospital for an assessment after calling about having a two day headache.  I ended up being admitted on Wednesday night for additional testing to assess how my body and the baby were doing.  Thursday was pretty uneventful.  I had to be in bed, collect all my pee, have some blood tests and get my blood pressure checked often.  The intent was to do a 24 urine collection to assess for pre-e, but they decided to have the lab run it as a 12 hour test and extrapolate the results from that.  My labs had started coming back with abnormal results–hemoglobin and urich acid (not sure on spelling, but it assesses liver function) stick out in my mind, but there might be others.

My husband left as I was getting ready to go to sleep around 11 or so.  Around midnight, the doc comes in to talk to me about the results and options.  I was in a gray zone.  My various labs were coming back with worsening results, but they weren’t so bad that we had no option but to induce or have a c-section.  I’d been having weekly doctor appointments, so it was great to have a baseline for comparison.  For example, I hadn’t had even trace elements of protein in my urine throughout the pregnancy.  Suddenly last week, there was protein in the urine.  So even though my lab results weren’t coming back as horrible, we-must-get-the-baby-out-now results, we could see the trend of the results continuing to get worse even in the day I had been there.

The doctor explained that I was teetering on the edge of pre-eclampsia and it was a matter of weighing the pros and cons of the situation.  It was obvious that my results were getting worse and what direction they were headed.  The problem was the unpredictable nature of it and nobody could say when that point would be that things would skyrocket.  She felt that at the most, we could hold off a few days, but I would not be pregnant in terms of weeks.  She also explained that at the gestational age I was at (34w5d), I’m far enough along that they do not try to stop labor for patients who are having pre-term labor.  So was it worth waiting each day, running more tests and determining when would be pushing the limit on how long to take this pregnancy?  The downside was that things could escalate very rapidly and either of us could be at risk.

It was a lot to process.  I asked the doc what she would do.  She said she isn’t 100% objective, because she has seen this escalate very quickly and the worst case scenarios, but that she would induce.  She also said she talked to two other docs at the clinic and a perinatologist and they were all drawing similar conclusions about my case.

I couldn’t make this decision without my husband, so he came back to the hospital.  I took a shower just in case we decided to move forward with the induction.  We also talked to our doula about it, who thought it made sense to induce after hearing all the factors.  She recommended getting a good night’s sleep and starting the meds in the morning though.  After all the losses and getting this far, we just couldn’t see pushing the pregnancy further and compromising the baby’s health.  Mine came into play too, probably more for my husband.  But it was a tough decision.  There was no way to know if we were making the right one.

So the process to induce was going to involve pitocin and magnesium sulfate.  The mag is not normally administered for induction, but I was given it to prevent a seizure or stroke given my condition.  Even though the doula recommended waiting until morning to start all meds, we moved forward with the mag immediately because my bp was 198/105.  This was my bp on medication.  Scary stuff.  So the mag started around 1 am, which relaxes the smooth muscles.  From that point on, I was hooked up to an IV.  I was also constantly monitored for my bp and had two monitors on my belly to assess baby’s heartrate and contractions.  We both tried to get some sleep and the pitocin was started around 7 am.  At that time, I was dilated 2 cm and effaced, although I don’t remember if I was still at 50% then or it had increased a little from there.

 

Still in labor and delivery August 13, 2009

Filed under: Uncategorized — agplatters @ 10:43 pm
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Looks like I’m staying until the 24 hour urine test is complete and they will decide from there on next steps.  It is pretty uneventful.  They check my bp multiple times a day and monitor the baby, who is doing great, a couple of times.  Hopefully I’ll get to go home tomorrow.  I’d much prefer that somebody says either I’m here until delivery or I’m going home to bedrest….I deal much better with something concrete than limbo land.  Oh well.  I have even more respect now for women who are stuck on bedrest, both at home or in the hospital, for months at a time.  I cannot imagine!

So after my internal last night, I had a fair amount of bright red blood with clots.  It reminded me of the early stages of miscarriages.  And I had a lot of cramping down low.  I think I’ve dilated further.  Earlier in the week, I was having pressure and similar sensations to when I miscarried in my vaginal area, so I had mentioned to my husband that I thought I was dilating.  I also thought I lost a small amount of mucus plug.  Well, I think I just lost quite a bit more.  My guess is this baby is coming in a week or two.  And that is ok.  Of course I want him to be in there as long as possible and be healthy, but I also trust my body and his.  These signs that things are moving towards him being on the outside are telling me to put my faith in accepting what comes and it will be ok.  Since I’ll be 35 weeks tomorrow, it is much easier to accept it and be at peace with whatever is about to come our way.

 

At the hospital

So I’ve spent the past 15 hours at the hospital.  The original reason was because I had a second day of a headache, even with the meds for high bp.  So they had me come in for an assessment.  The good news is baby looks great–he passed all of his tests fabulously!  The not so good news is that my bp was still high, even with a lot of just lying around, and my headache wasn’t going away.  But my labs came back fine and I still don’t have pre-e.

So after about 5 hrs, they decided to admit me for observations and possibly induction.  They checked my cervix last night and I’m 2 cm dilated, 50% effaced and baby is at station -1.  I think he’s advanced since then, as I had quite a bit of cramping afterwards.  The doc was pretty surprised that he was so low and views that as my body’s way of preparing and knowing what it needs to do.  So it is a little scary that he could show up on the eve of 35w, but I’m at peace with it if it is healthier to have him out than to have him inside my body.  I feel like a ticking time bomb!

If I go home today, I’ll be on bedrest and he’ll probably make his grand entrance within the next two weeks.  I was just telling a work friend yesterday that I feel he’ll be here in August, although my guts say around the 27th-28th.  I was also telling hubby earlier this week that I felt him lower and like I was dilating.  When I reminded him of that last night, he said “that sounds somewhat familiar, but I wasn’t actually listening.”  Hee hee.  He’s been great since I’ve been here.  I hope he’s getting some decent sleep on that pullout bed.

 

Growth u/s July 31, 2009

After the scare of being diagnosed with gestational hypertension and being put on meds, I’m starting to accept my fate.  I’ve had time to process and research and gather all my questions.  I’ve had follow up doctor visits to get answers and a feel for what this all means in the upcoming weeks.  And I’ve started wrapping my brain around a baby who comes early or in a medically invasive way.  Sigh.

The good news is the meds are working great and I’m feeling great from that perspective.  I have weekly appointments where they will do non-stress tests and check amniotic fluid levels starting next week.  My doc said I have a mild case of gestational hypertension and no signs of pre-e.  She doesn’t think it will progress, but she is not going to let me get to my due date.  She said she’d induce during the 39th week and, based on the quick peek at the calendar, it would most likely be 4 days before my due date.  I’ve been looking into non-drug ways to get things moving a bit earlier than that.  I’d really like to avoid pitocin.

We had a growth u/s at 32w3d.  Everything looks perfect, he’s still a boy and he has “lots of hair.”  It is so crazy they can tell that!  They estimated he was 3 lbs 13 oz, give or take a half pound.  With that and the various measurements they took, they put him at the 40th percentile.  Given the fact that hubby and his bros were all 10+ lbs, I’m just fine with him being a little on the smaller side!  And that was approximately 7w before induction date, so even if he grew a half lb per week, he’ll be in the 7 lbs range.  There is the chance that things progress with the hypertension and they will need to pull him earlier.  There is also the possibility that when they do the next growth u/s, he will have dropped down to a lower percentile, which will be a sign that the placenta is breaking down and he’d need to be born then.  So we aren’t out of the woods, but so far things look good.