Pregnancy and placenta insufficiency
Discussion
Posting here to see what the PH health experts may have to say. As the wife's post on mumsnet has elicited bugger all comment!
My wife went for a consultant appointment re. her blood levels yesterday at 35wks 4 days. Reassuringly they had improved since her last check but the hospital also performed a growth scan.
This apparently showed "intermittent end diastolic flow" and that growth has slowed (AC down from 57th centile at 20wks to 19th centile now) AC is now 286. HC still looks normal. Weight is 2142g, when i had a private scan at 29+3 it was 1410g.
It seemed at first that they would keep her in yesterday and perform a cesarean within a day or two. But the baby's heart monitored very well in follow up tests at 3pm and 10pm - all perfect according to the midwives. Movement throughout the day was as normal as it's always been, regular and strong.
She's going for another heart rate monitoring now, and then a scan with a senior consultant to check placental flow again. PI was 1.33 yesterday.
Has anyone else had this sort of thing and what outcomes did you have?
My wife went for a consultant appointment re. her blood levels yesterday at 35wks 4 days. Reassuringly they had improved since her last check but the hospital also performed a growth scan.
This apparently showed "intermittent end diastolic flow" and that growth has slowed (AC down from 57th centile at 20wks to 19th centile now) AC is now 286. HC still looks normal. Weight is 2142g, when i had a private scan at 29+3 it was 1410g.
It seemed at first that they would keep her in yesterday and perform a cesarean within a day or two. But the baby's heart monitored very well in follow up tests at 3pm and 10pm - all perfect according to the midwives. Movement throughout the day was as normal as it's always been, regular and strong.
She's going for another heart rate monitoring now, and then a scan with a senior consultant to check placental flow again. PI was 1.33 yesterday.
Has anyone else had this sort of thing and what outcomes did you have?
Edited by Equilibrium25 on Wednesday 22 March 15:21
Thank you Griffwick, what a helpful post. It brought a smile and a tear to both our faces.
What a beautiful little girl and such a cute picture. So glad that she is healthy and grew so much well.
We're having the scan this afternoon, so fingers crossed that they don't force us into an early delivery as we are just 8 days away from being called full term. 4lbs 11 and kicking like a good 'un with a perfect heart trace measured three times over the last 24 hours...
What a beautiful little girl and such a cute picture. So glad that she is healthy and grew so much well.
We're having the scan this afternoon, so fingers crossed that they don't force us into an early delivery as we are just 8 days away from being called full term. 4lbs 11 and kicking like a good 'un with a perfect heart trace measured three times over the last 24 hours...
Just to update this. The scan today showed again that the placenta is not functioning perfectly (too much resistance), but the blood flow didn't show the problem of yesterday. There will be another scan next Monday and they still think an early c-section is likely, but this is a way better outcome than seemed the case yesterday afternoon.
Thanks again Griffwick888 for your post, it's a story and picture that will stick with us in the days and weeks ahead if/when hard times arise.
Thanks again Griffwick888 for your post, it's a story and picture that will stick with us in the days and weeks ahead if/when hard times arise.
Thanks all for your very encouraging replies, every one of them was so good to read and reassuring for my wife as well.
When you're in the situation, you know that other people have been through similar (and others a lot worse, of course), but it's reassuring to read what real people have to say about it.
Thanks again chaps
When you're in the situation, you know that other people have been through similar (and others a lot worse, of course), but it's reassuring to read what real people have to say about it.
Thanks again chaps
Posting updates here as someone may stumble across this thread in the future and find it useful.
We've had further scans on Monday and Thursday this week (so that's four scans in all, over 10 days). The intermittent absent EDF has never resurfaced, so that's looking more and more like a dodgy result in the first scan. Placental resistance has never gone away though, it has been a concern at each scan. Measurement increases and weight gains have been made, now estimated at a few grams short of 2.5kg, but still very short of the curve that was indicated by the 20 weeks scan. Amniotic fluid is normal, which is also a concern as it's not what is expected given the other indicators.
The consultant remains concerned about the placenta and growth restriction (IUGR); we've taken his advice (as you would!) to induce now that the bay is officially term. My wife is 37 weeks pregnant today and she's booked for an induction beginning next Monday. A good time to deliver and not too small if the scans are approximately accurate (I was born at 4lbs 15oz, so it could/should be that she's already ahead of my birthweight), hopefully all is well with her otherwise.
We've had further scans on Monday and Thursday this week (so that's four scans in all, over 10 days). The intermittent absent EDF has never resurfaced, so that's looking more and more like a dodgy result in the first scan. Placental resistance has never gone away though, it has been a concern at each scan. Measurement increases and weight gains have been made, now estimated at a few grams short of 2.5kg, but still very short of the curve that was indicated by the 20 weeks scan. Amniotic fluid is normal, which is also a concern as it's not what is expected given the other indicators.
The consultant remains concerned about the placenta and growth restriction (IUGR); we've taken his advice (as you would!) to induce now that the bay is officially term. My wife is 37 weeks pregnant today and she's booked for an induction beginning next Monday. A good time to deliver and not too small if the scans are approximately accurate (I was born at 4lbs 15oz, so it could/should be that she's already ahead of my birthweight), hopefully all is well with her otherwise.
sjj84 said:
Hope it all goes well for you, do you know what you're having yet? Is it your first baby? We had our first in October, my only advice is get some sleep whilst you still can!
Yes, we're having a little girl. Very excited (and full of trepidation of course!). Doing our best to catch-up on sleep as we know that luxury will be gone after tonight!Apologies for the slow update...a very busy week last week and then my laptop wouldn't boot once we got home.
Everything went well! My wife was induced last Monday and gave birth in the early hours of Wednesday. Our little girl was beautiful and (as expected) on the small side at 2.4kg. Initially she was fine, but then had problems with glucose levels and a suspected infection. She was admitted to the hospital's specialist NICU unit for a few days, but took well to breast feeding from Thursday PM onwards. On Sunday, she was allowed home a day ahead of schedule.
We had to complete a course of oral antibiotics for her, and her weight was a little down when checked by the midwfie on Wednesday, but I suspect this was down to the drugs affected her digestion. Since she finished the drug on Tuesday evening, she's been doing well and seems more settled in her digestion.
Her only awkwardness is an insistence on being wide awake and cluster feeding from 10pm to 2am every night!!
Apart from being a little skinny, no ill affects at all from the placental issues.
Everything went well! My wife was induced last Monday and gave birth in the early hours of Wednesday. Our little girl was beautiful and (as expected) on the small side at 2.4kg. Initially she was fine, but then had problems with glucose levels and a suspected infection. She was admitted to the hospital's specialist NICU unit for a few days, but took well to breast feeding from Thursday PM onwards. On Sunday, she was allowed home a day ahead of schedule.
We had to complete a course of oral antibiotics for her, and her weight was a little down when checked by the midwfie on Wednesday, but I suspect this was down to the drugs affected her digestion. Since she finished the drug on Tuesday evening, she's been doing well and seems more settled in her digestion.
Her only awkwardness is an insistence on being wide awake and cluster feeding from 10pm to 2am every night!!
Apart from being a little skinny, no ill affects at all from the placental issues.
Huntsman said:
Great news.
I kept a spreadsheet, how many minutes feeding, what time started, an weekly weight, so I could see all was going ok on a sets of charts.
Thanks for the kind words everyone.I kept a spreadsheet, how many minutes feeding, what time started, an weekly weight, so I could see all was going ok on a sets of charts.
Good idea Huntsman, I've just started a weight spreadsheet now and we've been writing down the feed times exactly as you say.
She was re-weighed by the midwife this PM and is back up to birthweight now, an increase of 120 grams in 2 days, so all good.
I've been thinking long and hard about coming back and updating this thread for several weeks now. Here goes and sorry in advance for the tough read.
I'm posting this in case anyone with a pregnant wife ever comes across this thread by searching for IUGR, inter uterine growth restriction or any other kind of possible placenta abnormality.
First, Sophie, the original topic of this thread is bouncing along nicely, the centre of our universe at 2yrs 7mths.
The tragic story is that Sophie should now be enjoying her baby sister Isla, but due to another placental issue she did not join us. We lost baby Isla at 39+2, six weeks back on Monday, she was born sleeping.
Almost our entire 2019 had been built around Isla's impending arrival. It was a joyous first 9 months of the year and we were over the moon to be having another girl with (in our view) a perfect age gap.
Due to late complications in the 2017 pregnancy, this one was supposedly closely monitored. Extra growth scans at 28, 34, 38 weeks. As well as several other consultant appointments for my wife's underlying blood condition which results in a Hb of mid-70s in pregnancy.
We had a scan in late September on a Thursday and were told that everything was fine. A simple ultrasound, no dopplers.
Four days later, early on Monday, labour started, a bit of hassle getting to the hospital, but all seemed fine until five minutes before we pulled up. I'm going to spare you the details, but will tell you that I dumped the car where ambulances park as this was an emergency. A midwife took my keys to move it later.
No heartbeat could be found, the room descended into panic (organised from the medical perspective). This was 9am. The immediate diagnosis was that sudden and severe pre-eclampsia resulted in placental abruption, killing Isla instantly.
My wife then had to deliver in the operating theatre, again attended by a huge team and Isla was born sleeping at 11.55. The worst 3 hours of our lives.
My wife lost 2 litres of blood and her blood pressure was through the roof, there was a genuine risk of stroke or worse.
We lost a perfect baby, all through not having an induction. If you've read up-thread, you'll know that Sophie was born at 37+5 after induction. Isla was in the womb for an extra 9 days and was 400g heavier. She was perfect in every way, except the most important one.
Had we insisted on an induction, had the medics suggested an induction, we would have two daughters now.
Our follow up appointment is in a few weeks, but the consultant on duty was the one who ensured that Sophie was induced. In his words, a couple of days later, "it's abundantly clear that both pregnancies were affected by the same problem of poor placentation". Tragically, abundantly clear in hindsight and none of the medical team taking care of the pregnancy identified any heightened risk this time. Our anger about that is off the scale.
To be clear, my wife had none of the risk factors for pre-eclampsia. But a failing placenta is what caused the pre-eclampsia.
My silver lining is i have my wife, with that rate of blood loss and the levels her blood pressure reached in labour, I dread to think what another 30-60 minutes in arrival time at hospital would have meant.
I'm posting this in case anyone with a pregnant wife ever comes across this thread by searching for IUGR, inter uterine growth restriction or any other kind of possible placenta abnormality.
First, Sophie, the original topic of this thread is bouncing along nicely, the centre of our universe at 2yrs 7mths.
The tragic story is that Sophie should now be enjoying her baby sister Isla, but due to another placental issue she did not join us. We lost baby Isla at 39+2, six weeks back on Monday, she was born sleeping.
Almost our entire 2019 had been built around Isla's impending arrival. It was a joyous first 9 months of the year and we were over the moon to be having another girl with (in our view) a perfect age gap.
Due to late complications in the 2017 pregnancy, this one was supposedly closely monitored. Extra growth scans at 28, 34, 38 weeks. As well as several other consultant appointments for my wife's underlying blood condition which results in a Hb of mid-70s in pregnancy.
We had a scan in late September on a Thursday and were told that everything was fine. A simple ultrasound, no dopplers.
Four days later, early on Monday, labour started, a bit of hassle getting to the hospital, but all seemed fine until five minutes before we pulled up. I'm going to spare you the details, but will tell you that I dumped the car where ambulances park as this was an emergency. A midwife took my keys to move it later.
No heartbeat could be found, the room descended into panic (organised from the medical perspective). This was 9am. The immediate diagnosis was that sudden and severe pre-eclampsia resulted in placental abruption, killing Isla instantly.
My wife then had to deliver in the operating theatre, again attended by a huge team and Isla was born sleeping at 11.55. The worst 3 hours of our lives.
My wife lost 2 litres of blood and her blood pressure was through the roof, there was a genuine risk of stroke or worse.
We lost a perfect baby, all through not having an induction. If you've read up-thread, you'll know that Sophie was born at 37+5 after induction. Isla was in the womb for an extra 9 days and was 400g heavier. She was perfect in every way, except the most important one.
Had we insisted on an induction, had the medics suggested an induction, we would have two daughters now.
Our follow up appointment is in a few weeks, but the consultant on duty was the one who ensured that Sophie was induced. In his words, a couple of days later, "it's abundantly clear that both pregnancies were affected by the same problem of poor placentation". Tragically, abundantly clear in hindsight and none of the medical team taking care of the pregnancy identified any heightened risk this time. Our anger about that is off the scale.
To be clear, my wife had none of the risk factors for pre-eclampsia. But a failing placenta is what caused the pre-eclampsia.
My silver lining is i have my wife, with that rate of blood loss and the levels her blood pressure reached in labour, I dread to think what another 30-60 minutes in arrival time at hospital would have meant.
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