What would you do?

Discussion in 'Pregnancy - Third Trimester' started by TMonster, Oct 14, 2013.

  1. TMonster

    TMonster Well-Known Member

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    The hospital has my due date as Oct 21st based off LMP. I KNOW the exact date I ovulated, my due date should be Oct 25th and so far the 12 week scan and 20 week scans were both spot on with my date. The hospital refused to change the date since there is less than a 5 day difference and therefore it is deemed insignificant.

    My doctor does not want me to go far over my due date because I have had so many complications during this pregnancy including bleeding early on, and an incidence of slow growth which can both be a sign of the placenta potentially starting to fail.

    The doppler scans are showing a borderline s/d ratio which shows blood flow through the umbilical artery. It should be below 3 and my numbers have been 2.9, 3.1 and 3.0 over the last few weeks. My doctor says my flow is good, my fluid perfect, NSTs look great but I am stressed out.

    On top of all of this there is the heart defect to worry about and truthfully, I would prefer to have Zoe on a Sunday night or Monday morning so that she will end up with less time in the NICU. They are going to wait a few days before doing the surgery and I would prefer having the surgery done on a Wed/Thurs rather than delaying the surgery due to another weekend and if I deliver her on a Thursday or Friday they will just wait until the Monday to start doing the tests anyway.

    If I don't have her by Friday I am going to have to set an induction date. I could set the date for the 21st (the hospitals due date for me but technically 4 days early by my calculations) or give her more of a chance to come out on her own and get a bit larger and induce on the 28th (3 days past my calculated due date.)

    If I wait longer it would mean coming in for more visits (twice a week) to get more scans which is a huge pain as well as potentially risking something going wrong with the cord and needing an EMCS but there is a part of me that feels guilty inducing before her due date and giving her the chance to make an appearance on her own.

    There is also the discomfort factor and I would like her here as soon as possible and so I am making efforts to self induce.

    Given the complications and risks would you choose to get induced on the 21st or give it longer and wait till the 28th?

    Also, one more thing and it is rather selfish but there is a part of me that wants to bring her home by my birthday which is Nov 12th or at least Thanksgiving and if I induce later it means I may not have her home by my birthday (which may not happen either way depending on how well she does after surgery) but its still something I am hoping for.
     
  2. IsabellaJayne

    IsabellaJayne Mum of 2 girls, pregnant with baby GIRL #3

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    Id be induced at the earlier date. Better to have her out and get the tests started. Ift he Drs are happy with that date, why delay?

    Good luck whatever you decide :)
     
  3. bamboo10

    bamboo10 Well-Known Member

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    I think the 4 day due date difference is negligible.

    But my instinct is that once she's out, giving more time between birth and surgery seems safer -- so she can "rest up" and get strong before surgery. But I have no idea if that's actually true, it's just a gut feeling.

    What hospital are you delivering at?

    I'm sorry you have to deal with all this and wishing you all the best outcomes!
     
  4. TMonster

    TMonster Well-Known Member

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    They want her to rest up for a few days anyway before surgery to recover from the trauma of birth.

    Delivering at NY Presbyterian Cornell
     
  5. Bluewings

    Bluewings Blessed Twice

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    I just want to say... you may need to know that the surgery may not go as expected. Our DD had AVSD and we were told we would be able to bring her home and her surgery would depend on when her heart started to fail. She was in NICU 2 weeks then went straight to surgery. That's not something you can plan.
     
  6. TMonster

    TMonster Well-Known Member

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    Unfortunately she is going to need one of two surgeries within a few days of birth because she has no functional pulmonary valve.

    Once she is born she is going to need an echo and possible cardiac catheterization to see what her actual state is. They stopped with my fetal echos at around 32 weeks because it because it became too difficult to get a good picture.

    The surgeon has a strong preference to do the full repair within days of birth which he thinks is possible based off the fetal echos but he will still only know once she is born and can assess the actual state. If he cannot do the full repair he will do a palliative shunt procedure and then the full repair a few months later.

    The shunt repair would lead to significantly less time in the NICU initially but 2 heart surgeries which I would prefer to avoid so hoping for the full repair to be done initially if possible.

    I know I can't take her home until she has one surgery or another done and they can't keep her for too long without surgery because they are artificially keeping the ductus open via drugs which can cause problems if she is on them for too long.

    After the surgery the length of the NICU stay will depend on how quickly she is recovering and mostly feeding. I wont be able to feed her until after surgery so I will pump and freeze and she will be on an IV. The estimate is somewhere between 2-6 weeks in the NICU till I can bring her home after a full repair.
     
  7. Bluewings

    Bluewings Blessed Twice

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    I didn't mean our circumstances were exact, as it sounds as if our children have different heart issues. I just mean I think you can let go of dates and not stress about that since some stressful things will be coming up here shortly enough. We were also given a general recovery time and our daughter ended up in PICU for 2 months.
     
  8. minties

    minties Complete

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    I have no advice on your situation, but didn't want to read and run. That sounds like a very stressful situation to be in.

    I had Sophie at 39+2 due to gestational diabetes, and I was worried about those few days difference, I will admit. But my midwife reassured me that 39 weeks was a fantastic gestation to reach and that the 5 days difference was nothing. Sophie was fine and healthy.

    It's my understanding that inductions çan and often do take a few days anyway, at least from my observations of midwifery shows based in the UK. You're in the USA though right?
     
  9. TMonster

    TMonster Well-Known Member

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    Similar but different conditions. Zoe has Tetralogy of Fallot with pulmonary atresia. So she has a VSD but that VSD is partially what is keeping her alive due to the pulmonary atresia. The blood being able to mix relieves some of the pressure in the right ventricle and allows the blood to flow out of the aorta.

    The full repair patches up the VSD and uses a conduit or a patch to allow blood to flow into the pulmonary artery so that it can reach the lungs.

    Its super scary but fortunately the condition is very correctable and has amazing success rates so I am trying to remain positive.


    Yes, it would be in the US but I suspect the induction procedure is the same. I still would prefer to go into labor naturally. I was going to try acupuncture today but ended up with an acupressure massage because needles still kinda freak me out but I did schedule an acupuncture appointment on Wed. Hopefully I can make some headway with it.
     
  10. bamboo10

    bamboo10 Well-Known Member

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    That's good - great hospital for NICU and neonatal... hoping for the best for you and your little one. xo
     
  11. CountryS2011

    CountryS2011 Well-Known Member

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    Just go with it, it's fine...it's not gonna make TO big of a difference. They are going off ultrasound for me because I never had periods, and they are supposed to go off periods, not ovulation dates
     
  12. TMonster

    TMonster Well-Known Member

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    They wont go off my scan either because its a 4 day difference its still within range. They wont go by ovulation dates because most women have no idea when they ovulate but I ovulate late in my cycle. I suppose its just 4 days and it doesn't matter too much. It just makes me feel guilty like I am not giving her a chance. I know it sounds totally stupid.

    I am leaning towards the earlier induction date. These hormones are driving me mad today.
     

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