Thursday, July 19, 2012

31 week update

So, I got it clarified... the perinatologist had only written a recommendation to my OB to "follow up in two weeks" with an ultrasound. She did not specify that growth needed to be checked or that I should have it checked every two weeks, that is just how I understood it.
My OB emphasized that growth measurements are so small that looking at a change any more often than every four weeks will not give you good accurate information. So, we will only measure growth monthly. Looking at placentas and cord flow IS in fact a part of a biophysical profile scan, so we will be checking on that weekly. I was satisfied that at least this would be looked at frequently.
This time both babies were moving around and doing breathing exercises right away and passed their bios within the first minute. Edens placenta doesn't look too bad but Owens is pretty bad. It's a grade 3 now and looks really calcified, but both of their cord flows were 2.6-2.8 this time which is totally normal thanks to my bed rest . I was VERY happy about this! The US tech explained that they would never deliver early based solely on a calcified placenta. She said they look at how well the placenta is functioning to make that decision and the best indicators of that are cord flow (S/D ratio), amniotic fluid level and growth and if all of those things are fine, there is no need to worry. She said she's seen really calcified placentas produce huge healthy babies and seen really perfect looking placentas produce tiny growth restricted babies. She said a calcified placenta by itself is really nothing to worry too much about.
And then I saw my OB and she told me all the same things and said that with the way the babies are looking, we will still plan on going to the full 38 weeks. She said at this point she has no real reason to take them early. We will of course reevaluate on a weekly basis, but for now we're saying 38 weeks. She doesn't think I'll make it that far and thinks I'll go into labor on my own before that. But honestly, I disagree with her.
If I had to guess, I will NOT go on my own despite all this preterm labor/ dilation drama. We did this same thing with Corynn. At 35 weeks I was having regular "contractions" and dilated to 2.5cm and 80% effaced. I lost my mucus plug the next day. I continued to dilate about 1cm a week as well as have regular braxton hicks contractions. My doctor said every week that I would go into labor any day. I NEVER did. I made it to 39 weeks and was induced at 5cm 100%. Who knows how long I would've gone on my own before going into labor!
Of course this time this same thing started to happen at 28 weeks so it was a little more worrisome and we needed to take it seriously and treat it as pre term labor even if it wasn't the real thing. I honestly think that this is just what I do... I have a lot of regular braxton hicks weeks and weeks before I were to go into labor and my cervix dilates easily so these BH cause me to start slowly dilating, but it doesn't mean anything "real" is going to happen. And now I'm on medication to stop my BH contractions so I REALLY don't think I will go into labor on my own. Plus the bed rest I'm sure prevents me from rapidly dilating.
My doctor didn't check my cervix yesterday. She said she'll only check it if I start having more contractions again. No need to stir things up at this point now that everything is calmed down.
Both babies are still breech this week. I think it's getting pretty crowded in there because their movements are pretty small now and my doctor decided to go ahead and schedule me for a csection on September 4th so that we can get a 'good O.R. time" (good for her I think).This is pending the peri's approval because Shawnee mission has a strict policy of not delivering before 38 weeks for twins and 39 weeks for a single. I will be 37wk 6days on Sep 4th, and I asked "would they seriously care about a one day difference?" and she said that yes they are kind of nazis about it and won't allow anything any earlier without an emergent reason or perinatal approval. My doctor ONLY delivers at Shawnee Mission on Tuesdays, so if we don't do it that day, I'll have to wait until Sep 11 when I'll be one day away from 39 weeks. Ugh, pleas NO! My belly will be measuring at 48 weeks by then. Hopefully the peri approves Sep 4th.
As far as CS vs induction she said we can always cancel the csection if they flip head down again but for now she's thinking that may not happen. Oh well, at this point I don't really care how they get here. Of course I would prefer a vaginal delivery but it's not that big of a deal to me. I've accepted the high possibility of a csection.
At 34 weeks I will switch to more of a modified bed rest and at 35 or 36 weeks we will start weaning me off of the pericardia and after that point we just let things happen naturally. But I would be willing to put money on it that NOTHING will happen.
In other news, I have had very little weight gain due to my GD diet. At 24 weeks I had gained 12 lb and then it pretty much came to a halt. At my 29 week appointment I had gained 1 more lb for a total of 13lb. But this past week I had said to Erik that I felt like I was gaining weight. I started getting puffy and swollen an my clothes just felt tighter. Sure enough I gained 6lb in TWO weeks time! This is the biggest most rapid pregnancy weight gain I've ever had. I couldn't believe it because I feel so freaking hungry all the time and never get to eat anything yummy, so I know the weight gain can't be from too many calories. My doctor just said that this is the time for the most rapid growth and weight gain of the babies and in addition to two heavy babies, I'm starting to retain fluid. My lips and nose look puffy and if I stand for more than about 5 minutes or even have my feet dangling instead of elevated, they start to puff up, swell, throb and turn  a blotchy purplish red color and I develop some lovely cankles. I never really had this too bad with Corynn, so this is new for me. My stretch marks are also starting to hurt and itch and burn and my skin is really shiny and stretched looking and starting to crack and flake.
Back to the subject of diabetes, my doctor said that the fact that I have to be so strict with my diet or my sugars will go crazy high is a good sign that the placentas are functioning well. She said that if they start crapping out that they will secrete less hormones (that bind to my insulin receptor sites) and I would notice a change in my sugars. They would start to be much lower and I would be able to eat more carbs without consequence. So this makes me feel pretty comfortable because I can NOT budge with my carbs right now and this info gives me something to work with to feel like I have some way of monitoring them in between appointments.
I never feel like they move enough and have started getting my doppler out again and doing my own home non-stress tests. I did tell my doctor that I don't feel like they move enough, although they do move and she said it's fine as long as they're moving and reminded/ reassured me that they just don't have much space. I'm always amazed that they pass their bios so well because I'm such a worried wreck that I'm always convinced something is wrong, but then every week I'm reassured that they are just fine. I'm so grateful for weekly ultrasounds to take my anxiety down a notch.


No comments:

Post a Comment