Advice please? Notching on placental atery, Placental insufficiency and Pre 30 week p

[MaevesMummy]

Sorry for the rambled title.
Basically I had 1 previous premature birth, at 22 weeks. It was a live birth, but Maeve was very small (300g) I had been bleeding before and test results found a big infarction on one side of the placenta with a clot. It had partially abrupted in my opinion, bleeding caused pPROM.
Since I was found to have APS, very high antibody count. I have been on asprin and clexane.
I am now pregnant again.
At a recent bloodflow scan 24 weeks, I was told I have notches in the distolic placental artery. Has anyone had this?

It can be an early warning sign of IUGR and PE?
I have got this awful feeling about it, Nothing I can put my finger on or anything. Midwife Wednesday and growth scan on Friday. Sorry for the ramble. Is there anything I need to ask for? Going to ask for steroid shots. Will they give these to me even if birth is not aparantly iminent? xxxxx

 

[Marleysgirl]

*wave*

I had placental arterial notching, diagnosed at a research scan at 21 weeks. I had regular doppler scans again at 25 weeks, 27 weeks, 28 weeks (for a TV show). At the 28wk scan they found that the bloodflow was reversing, and walloped steroid jabs into me in the anticipation of birth. Andrew was born at 29+1 weeks, weighing just 1lb 6oz (638g).

Andrew is now 21m actual, 18m corrected. He's still very small, and has hearing loss related to a bleed on his brain; he also has developmental delay but that was exacerbated by developing epilepsy last year. But he's absolutely wonderful ... I have a thread around here somewhere, I'll bump it for you!

I don't think they'll give the steroid jabs unless they think birth is quite soon, I seem to recall reading somewhere that they are only of benefit for a short period - but I could be wrong. My bloodflow improved after the steroid jabs, which is how we managed to last another week before birth. I actually felt reduced movement on the day of birth, so rushed to the hospital and they delivered him - the reduced movement was probably related to the cranial bleed.

Things for you to ask - when they will give you the steroids; how often they will scan you; estimated size of baby now and how that compares with average figures (so you know whether to expect IUGR); who and when you should contact if you are remotely worried. Because my arterial notching had been found earlier, I was referred to a specialist Placenta Clinic; and when I felt the reduced movement, it was them that I called rather than the Triage team - my consultant actually scanned me in his lunch-hour, and then sent me down to the delivery ward.

There is someone else on this forum (I'm hopeless at names) who was diagnosed with arterial notching and it actually went away later in the pregnancy - she'd been worried about a premature birth and instead went 10 days overdue!!! So the diagnosis does not always end in bad news. The really good thing is that it has been spotted, and you will receive a higher level of care to ensure that your baby has the very best chance of survival.

 

[MaevesMummy]

Thank you so much for this information. Thats great info.
Very honest, and I guess from what you are saying it can go either way. I am now 26 weeks, movement reduced the last couple of days and I went to Triage this morning having felt nothing. They eventually found a heart beat on the mobile scanner after a terrible 5 mins of not finding it with a doppler. I should find out more Friday, but having had pPROM with my last baby, I was concerned to see little baby d looked somewhat cramped. Its probebly all in our heads though.

I will make sure I read Andrew's story. He sounds like an amazing little chap.
xxxxxxxxx

 

[Marleysgirl]

I hope you get some answers on Friday to your questions, and that they put in place a monitoring routine & emergency procedures for you to follow whenever worried. I certainly put Andrew's survival down to the high level of care that I got from the specialised clinic.

 

[24/7]

Hello.... It's me marleysgirl was talking about -

We had bilateral notching of the arteries too, and were told at 16 weeks of the liklihood of IUGR and PE. I was put on aspirin as soon as the scan showed the notching and continued to take it until 36 weeks.

We had regular doppler and growth scans and our little boy always measured small and was on roughly the 13th percentile, but all the time he was growing they were happy for him to stay inside.

In the end not only did I make it to term, but in the end gave birth to our little boy at 41 weeks exactly, and he came out a shocking 7lbs8oz!!

The weekend before he was born I was in hospital with high blood pressure, but it never progressed into PE, and I was still allowed to give birth in a birthing centre as my bloods were still clear for PE when I went into labour.

Despite all the worries my pregnancy progressed problem free and I had an absolutely perfect birth in the end.

Good luck, and feel free to PM me any questions.

 

[MaevesMummy]

Thakou so much. Trying desperatly to stay positive, this hasbeen a great help. I am going to ask to double my asprin dose, I am suprised they didnt do it anyway. The clexane I am on doesnt cross the placenta so actually isnt making any difference to the distolic ateries.
I think I will ask to be seen in Day assesment unit once on the weeks where i dont have appointments.
Thanks again both xxxxxxxxxxxxxxx

 

[Marleysgirl]

Hello.... It's me marleysgirl was talking about -

I'm hopeless at names!!!

 

[MaevesMummy]

Just an update baby is 1lb 14oz roughly in size blood flow still ok but I have had some odd blood tests, reducuction in movement for past 5 days so day assesment twice a week for me and growt scans every 2 weeks. 26 weeks and 1 day now according to them, 26 plus 3 days for me as I know when baby was concieved! Ties in more with the weight too.
Thanks for all your help. xxxxx

 

[MaevesMummy]

Growth scan today! I am so lucky I made it to 28 weeks
Hoping the little tinker has grown. I am waiting for blood tests to come back as my MW thinks I a anaemic, I was worrying I might be getting PE, although my BP has risen it isnt at dangerous levels. Thanks again for all your help and advice. xxxxxx

 

[24/7]

My BP went up too in the last few weeks and I did spend the weekend before LO arrived in hospital but it never developed into PE thankfully!!

I hope the growth scans go well, we always measured small but in the end LO was 7lbs8oz after I went overdue. He did all his growing right at the very end. xx

 

[bob2331]

Hey,

I dont really have any advice as i have never come across this before but just wanted to say, it sounds like your being looked after and dont forget, your gorgeous little Maeve Louise will be watching over you and her little brother or sister and i hope and pray for a healthy 40weeks and a big healthly baby xxx

 

[MaevesMummy]

Thank you, sorry to see of your loss too, I can not imagine how difficult it must be loosing a twin. Your little Harry is just Gorgeous too.
Everything still seems ok, still keeping a close eye.
I dont know if anyone else experienced very random period cramps, in lower stomache and back, not regular maybe several times a day. My consultant said to keep an eye on but I had a fibronectin test and it was negative, I am assured this means labour is unlikley to happen in next 2 weeks.

Thanks again for everyones help and support xxxxxxx

 

[MaevesMummy]

Just updating you, currently preparing for a preemie. Whilst I am lucky enough to be 32 weeks 4 days by their dates and 32 weeks 6 days by mine, baby kind of almost stopped growing the last 2 weeks. Now going for ctg monitoring and blood flows 3 times a week, had my 1st steroid shots today and getting second tommorow.
Feeling positive, hoping the little tinker can put some weight on though. He is 3/4 engaged (i think they said!) so does that mean I will be induced? I forgot to ask, at 33 weeks will they do a c section? I am worried as my boobs are not leaking yet, that my body might not start producing milk. Silly I know but its worries me
xxxxxxx

 

[24/7]

3/5 engaged is good, my LO was there when I went into labour, and dropped instantly as my waters broke.

I didn't leak any milk atall until three days after he was born and had lots of milk, so I wouldn't worry about that.

Good luck. xx

 

[NashiPear]

Hey there Maeve's mummy, thinking of you. I currently have pprom (22 weeks) like in your first pregnancy. I am so sorry you lost Maeve (what a BEAUTIFUL name!). I am still holding strong at 27 weeks and feeling positive. I know you are probably very nervous, but I had to meet with a neonatologist (they expect me to more than likely have a preemie) and the statistics after 30 weeks looked pretty awesome to my husband and I. That is our target!! I know it is still going to be a hard road for you and your little one, I don't want to detract away from situation, but just give you some positives to help you feel strong. As for milk, just make sure you start expressing straight away and get advice if you can. I had low supply with my first daughter and I am hoping to feed (or express) a LOT in the early days to bring in my supply faster and stronger than last time. I hope it works!

Thinking of you.... you have gotten to a great place and done such a great job.... stay positive and believe in you and your bubby!

 

[inperfected]

Hugs. I don't have any experience with this exactly, but had a 29 weeker 2 weeks ago. My milk had leaked once or twice, but only barely, and it came in really. Within one week, I sometimes was pumping 200-300ml every 3-4 hours, so don't worry about that too much at this stage.
As for the c-section, I had one, but they wanted me to have a natural birth unless something happened, and he'd turned breech, which is why I had one.

 

[MaevesMummy]

thanks Ladies, You are all inspirational, I know how lucky we are to get this far! Little one behaved today for Monitoring so back again friday... I have big red cheeks from steroids, and all seems well. Sending you all lots of love, Imperfected your little one is so cute!
Thanks Nashipear, keep up the good work! Stay positive xxxxxx

 

[24/7]

Glad LO is doing well - You are in my thoughts. zx

 

[MaevesMummy]

Ah, I have a naughty one, back for monitoring today. Had a beat to beat variation, problem yesterday morning on ctg, was on it most of the day, the had a deceleration, which isnt good, but hopefully a blip. Back in on ctg today. Hoping today brings good news, although have a feeling it may not.
Will keep you posted. Now 33 weeks 1 day by there dates 33 weeks 4 days by mine. baby under 4lb, and no deteriation in blood flow. x

 

[24/7]

Fingers crossed for today - My growth scan at 37 weeks put LO at 5lbs, and at 34 weeks he was 3lbs9oz. xx