31 weeks with placental abruption - what to expect if baby delivered soon?

[Ice Cold Cube]

Hi everyone

I'm new in this section - usually I'm found hanging around in the toddler forum but I'm 31 weeks pregnant with baby no 2 (pregnancy no 5 as my first 3 ended in mc) and have been suffering placental abruption on and off for 2 weeks now. I've been hospitalised due to the continual bleeding and resulting anemia, and if I have another big bleed we'll definitely be going for emergency section. If things settle down, baby will be delivered by planned section at 36 weeks.

So I'm just waiting and praying that I don't have any further bleeding, but I have no idea what to expect if baby does need to be delivered just now at 31 weeks. I had a growth scan 10 days ago and baby was 50th percentile for weight, which was great news for us as my son was below the 10th when he was born at 39 weeks. I know these scans can be quite unreliable though.

At 31 weeks, will I be able to hold my baby girl after she's born? Is she likely to be able to breathe? I've had the steroid injections to help with that already. Should I invest in some prem baby clothes? Would she even be able to wear clothes at 31 weeks?

I feel so lost when I think of what it will be like when she arrives. It's going to be so different from the birth of my son 2 years ago.

Any advice or insights anyone can offer would be fantastic. Congratulations to you all on your own pregnancies and extra special babies.

Laura x

 

[ShelbyLC]

My girls were born at 29+5, so just a little behind where you are now. They are currently 5 weeks old (almost 35w gestational age).

They were 2lbs 13oz and 2lbs 15oz at birth. T lost 4oz after birth and started regaining at 5 days old. B lost 6oz after birth and started regaining at 6 days old. They hit 3lbs at 2 weeks old and 4lbs at 4 weeks old. They have been gaining approximately 1oz per day, but that has slowed down this past week as they were started on bottles, and that burns more calories.

Both were breathing on their own at birth and put onto CPAP. They were taken off CPAP after 5 days, but B went back onto CPAP for a few days less than a week later, due to having too many apnea/bradychardia spells. They have both been off of CPAP for 2 weeks now. They both still occasionally have apnea/bradychardia spells, but have gotten much better.

They started eating the day after they were born - first 3cc every 3 hours (by tube) and then the amount increased every day or every other day (depending on how well they tolerated) until they reached 21cc. Then the increases stopped for a few days and since then, the girls get their amounts increased about twice a week. They are currently taking 30 and 31cc respectively. They get bottles 1-3 times a day, depending on how tired they are (sometimes they refuse the bottle) and are tube fed the rest of the time.

They are both still in isolettes to help keep them warm, but they will probably go into cribs soon since they have reached 4lbs. I'm guessing/hoping the doctors will wait until the girls start gaining again to transition them.

Some tips and advice, in case you do deliver soon:

1. Don't expect the babies home before their due date. When my girls were born, I told myself they would probably be home by the middle of January/36-37 weeks. With how things are looking now, they will probably come home towards the end of January. (Our due date was Feb. 5) It was pretty disappointing to have their nurse tell me a few days ago to look at 3-4 more weeks. So, as hard as it is, try not to get your hopes up about any specific amount of time or dates.

2. Sometimes, babies take two steps forward and one step back. Expect some setbacks and also some pleasant surprises.

3. Every NICU is different, so make sure you ask what is allowed and what isn't. A lot of NICUs allow stuffed animals in the isolettes. Mine doesn't. They won't even allow them on top of the isolette. They do, however, allow (and encourage) parents to bring blankets for their babies, and clothes when the time comes. (My two started wearing clothes at 3 weeks old.) Receiving blankets are the best and most useful. I have a total of about 20 that I rotate between the girls and I do laundry once or twice a week, depending on what's needed. As for clothes - don't buy preemie clothes yet. You may not ever need them. We have 3 preemie outfits for each girl and they fit perfectly, which means they will only get maybe another week or two of use. It's much easier (IMO) to put them in newborn clothes, especially if you think you'll be nervous of "breaking" them. Their arms are tiny and the preemie clothes are made to fit, so it's a little difficult to get their arms in the sleeves sometimes if you're nervous. Newborn clothes have wider arm holes.

4. The first 3 weeks were really hard, because there wasn't a lot I could do for the girls. I could only hold them once a day and the nurses were constantly reminding me that the girls were getting cold, no matter how tightly they were wrapped up. Then the girls were moved to the "feeders and growers" side of the NICU, which is just what it sounds like - a place where stable babies go to eat and grow until they are big enough to go home. Now I can hold the babies as often as I like, as long as their temps are good and they aren't having any issues. I'm also now allowed to do pretty much everything for them - change their diapers, wrap them up and take them out of their isolettes, feed them, take their temperatures, etc. What I'm trying to say: prepare yourself for the possibility of feeling "useless". I definitely felt like I wasn't able to do anything for them. But just being there for them is great. Sitting with them with your hand on their back, just talking to them, is what they really need.

And to answer one of your other questions - I didn't hold them right away because my arms were tied down (I had a C-section), but OH did.


I really, really hope you don't have to deal with the NICU. I hope you make it to 36 weeks and get to take your bub home right away. But, the NICU really isn't as scary as I expected, and the time has honestly flown by. I can't believe it's been 5 weeks already. It feels like it's been only one or two weeks, at the most. That really gives me hope. If the last 5 weeks have passed so quickly, surely the next 3-4 will fly by as well.

Good luck.

 

[Ice Cold Cube]

My girls were born at 29+5, so just a little behind where you are now. They are currently 5 weeks old (almost 35w gestational age).

They were 2lbs 13oz and 2lbs 15oz at birth. T lost 4oz after birth and started regaining at 5 days old. B lost 6oz after birth and started regaining at 6 days old. They hit 3lbs at 2 weeks old and 4lbs at 4 weeks old. They have been gaining approximately 1oz per day, but that has slowed down this past week as they were started on bottles, and that burns more calories.

Both were breathing on their own at birth and put onto CPAP. They were taken off CPAP after 5 days, but B went back onto CPAP for a few days less than a week later, due to having too many apnea/bradychardia spells. They have both been off of CPAP for 2 weeks now. They both still occasionally have apnea/bradychardia spells, but have gotten much better.

They started eating the day after they were born - first 3cc every 3 hours (by tube) and then the amount increased every day or every other day (depending on how well they tolerated) until they reached 21cc. Then the increases stopped for a few days and since then, the girls get their amounts increased about twice a week. They are currently taking 30 and 31cc respectively. They get bottles 1-3 times a day, depending on how tired they are (sometimes they refuse the bottle) and are tube fed the rest of the time.

They are both still in isolettes to help keep them warm, but they will probably go into cribs soon since they have reached 4lbs. I'm guessing/hoping the doctors will wait until the girls start gaining again to transition them.

Some tips and advice, in case you do deliver soon:

1. Don't expect the babies home before their due date. When my girls were born, I told myself they would probably be home by the middle of January/36-37 weeks. With how things are looking now, they will probably come home towards the end of January. (Our due date was Feb. 5) It was pretty disappointing to have their nurse tell me a few days ago to look at 3-4 more weeks. So, as hard as it is, try not to get your hopes up about any specific amount of time or dates.

2. Sometimes, babies take two steps forward and one step back. Expect some setbacks and also some pleasant surprises.

3. Every NICU is different, so make sure you ask what is allowed and what isn't. A lot of NICUs allow stuffed animals in the isolettes. Mine doesn't. They won't even allow them on top of the isolette. They do, however, allow (and encourage) parents to bring blankets for their babies, and clothes when the time comes. (My two started wearing clothes at 3 weeks old.) Receiving blankets are the best and most useful. I have a total of about 20 that I rotate between the girls and I do laundry once or twice a week, depending on what's needed. As for clothes - don't buy preemie clothes yet. You may not ever need them. We have 3 preemie outfits for each girl and they fit perfectly, which means they will only get maybe another week or two of use. It's much easier (IMO) to put them in newborn clothes, especially if you think you'll be nervous of "breaking" them. Their arms are tiny and the preemie clothes are made to fit, so it's a little difficult to get their arms in the sleeves sometimes if you're nervous. Newborn clothes have wider arm holes.

4. The first 3 weeks were really hard, because there wasn't a lot I could do for the girls. I could only hold them once a day and the nurses were constantly reminding me that the girls were getting cold, no matter how tightly they were wrapped up. Then the girls were moved to the "feeders and growers" side of the NICU, which is just what it sounds like - a place where stable babies go to eat and grow until they are big enough to go home. Now I can hold the babies as often as I like, as long as their temps are good and they aren't having any issues. I'm also now allowed to do pretty much everything for them - change their diapers, wrap them up and take them out of their isolettes, feed them, take their temperatures, etc. What I'm trying to say: prepare yourself for the possibility of feeling "useless". I definitely felt like I wasn't able to do anything for them. But just being there for them is great. Sitting with them with your hand on their back, just talking to them, is what they really need.

And to answer one of your other questions - I didn't hold them right away because my arms were tied down (I had a C-section), but OH did.


I really, really hope you don't have to deal with the NICU. I hope you make it to 36 weeks and get to take your bub home right away. But, the NICU really isn't as scary as I expected, and the time has honestly flown by. I can't believe it's been 5 weeks already. It feels like it's been only one or two weeks, at the most. That really gives me hope. If the last 5 weeks have passed so quickly, surely the next 3-4 will fly by as well.

Good luck.

Thank you so much for your reply. Your information and advice is really really useful.

Your baby girls are amazing! I hope you're all home soon and going from strength to strength. Good luck!

Laura x

 

[colourful20]

Hi Laura

My son was born at 31 weeks and 2 days by emergency cesarean. When he was born he was on the 50th Centile weighing 3lb 14oz. He could breathe on his own and was not put on oxygen initially (we had received only 1 steroid injection).

In our hospital the NICU unit is 1 floor up from the maternity unit so we were separated. I had Lucas at 18.37, at about midnight they brought me a photo of him and I got to see him at 2am. I held him on that day and the next day. Unfortunately he went on to develop a bowel condition and needed an operation so we were transferred to a better NICU facility and I was given a parents room. During the illness and recovery phase he was on a ventilator, then CPAP, during this period he was on a TPN then breast milk was introduced via nasal tube, this was gradually increased. He was in an incubator for 3 weeks. We held him once a day except when he was on full ventilation and the rest of the time I had my hands in the incubator around him. I changed all his nappies, did his mouth cares and tube feeds.

He didn't wear his first set of clothes until he was 3 weeks old. We got a lot of premature baby clothes from car boots and he got his use out of them. At 3 and a half weeks he was moved to a crib and then I could get him out when I wanted. He first started learning to breastfeed at 4 weeks. During his fifth week he roomed in with me at the hospital. He came home from hospital on the 11th November which was nearly a month before his due date. He is now 12 weeks old and weighs 7lb 10oz. He is now on the 9th Centile.

I wish you and your baby the best

 

[Srrme]

I hope your little baby stays cooking for as long as possible.

I had a 28.6 weeker and a 35 weeker, and to my surprise, I was able to hold both of them right away. Neither one of them needed to be intubated, but they were on CPAP and oxygen. They didn't wear clothes right away.

I would definitely invest in a FEW preemie clothes just in case.

Good luck, mama.

 

[Honeybear1976]

My 3rd was born at 31+3 weighing 3lb 4oz id had the jabs and he was only on cpap for only about 36hrs. I didnt see him for 2 days as I was very ill (pre eclampsia). I used a double electric pump from the hospital to express colostrum then milk and he was fed via nasal tube until at about 2 weeks old I started to try him at the breast, it took him a while to master the suck,breathe and swallow! He came home at 35 wks 5 before his due date. Did you bf your first? My 4th and last was born at 34weeks 2weeks after my waters broke! He was 5lb 2 3/4oz, I honestly thought he would come straight home, he bf like a champ for about 24hrs then fell asleep for 2days! Its common at this gestation apparently! He had a few issues with his blood sugars so i had to prick him before and after bf but he came home 7days old, again 5weeks before his due date. I wish you lots of luck and hope baby remains cooking until planned date but if early arrival is her plan then im sure it will be fine. The tiny baby clothes in next and mothercare are great but asda and tesco are huge! X

 

[Ice Cold Cube]

Thank you so much ladies for sharing your stories. Your babies are amazing and so special.

We are 32 weeks today and the bleeding has almost stopped. An ultrasound today showed that the placenta is still doing its job, and baby is 4lb 1oz according to measurements. So pretty positive, I'm just praying that there isn't another big bleed that tips the balance in favour of an emergency section to get her out. I'm still hospitalised, but hopefully getting out on pass for some time at home tomorrow.

I didn't breastfeed Alex, he just wouldn't feed from me no matter how hard we both tried. It was a combination of him being very sleepy from the section, and also very sleepy from a bad case of jaundice. He would latch fine, then fall fast asleep! He lost a lot of his birthweight very quickly so we had to bottle feed him every few hours round the clock to get some goodness into him. I expressed so he had breastmilk exclusively for 10 weeks, then combi fed until he was wholly on formula after a few months. The double pump is sure to become a good friend again this time too! I'm glad I kept it!

Thanks again.

Laura x

 

[rbourre]

I had a placental abruption, as well as many other problems. My daughter was delivered my c-section at 29 weeks 5 days and 2lb 2oz. She's almost 7.5 pounds now. I got to hold my daughter at 4 or 5 days old but only for a very short period of time. My daughter could breathe but not well enough so she had to be on CPAP for a few weeks. She wore clothes for the first time at about 2 and a half weeks old. I would wait on buying preemie clothes until you see the size of her and when she can wear clothes. You might end up buying clothes that are going to be too small.

 

[Ice Cold Cube]

Thank you everyone.

Ella (3lb 13oz) was born last Thur, 10 January, by emergency section after my waters broke and there was meconium present. This time the doctors agreed it really was time to get her out! She's been doing so well - breathing on her own, maintaining her temperature and not requiring any medication. Although we had a set back today in that she was put back on to low flow oxygen and given antibiotics because she's aspirated some milk due to reflux issues. I guess there will be many ups and downs on this journey, and it really helps to hear of positive stories. Your advice and support is really appreciated.

Laura x

 

[ShelbyLC]

Congratulations! It sounds like she's doing really well! There will be a few setbacks but she will get through them and be home soon. My girls also have reflux so if you need any advice on that in the future, feel free to ask.