Peri appointment and a ? about notching...

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karoliina
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Re : Peri appointment and a ? about notching...

Postby karoliina » Sat Sep 09, 638609 10:58 am

quote:Originally posted by bcrnjo

Karoliina... I have been following your story too... 38 W, yayayaya for you!!!


Thanks! :)

Karoliina

bcrnjo
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Re : Peri appointment and a ? about notching...

Postby bcrnjo » Wed Aug 30, 638609 3:26 am

Wow... thanks so much for all that info Caryn... one thing the sonographer did say was " well there is notching but it's really not too bad".. what ever that means... lol...

Karoliina... good luck with the study, sounds interesting!PS... I have been following your story too... 38 W, yayayaya for you!!!

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caryn
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Re : Peri appointment and a ? about notching...

Postby caryn » Tue Aug 29, 638609 10:05 pm

You can have a normal pregnancy even with notching. Given your history, it's just another thing to keep an eye on.

As I understand it, notching is when after each beat of the maternal heart, the bloodflow drops below the average flow when the heart isn't beating, and then pops back up. Here's some pretty pictures: http://www.centrus.com.br/DiplomaFMF/Se ... ga_01.html

This means that the placenta isn't as deeply implanted, because the flow isn't as steady -- it pulses, and not just *up*, with each maternal heartbeat, but *down* a little bit, which is the notch. And it's because the spiral arteries aren't as "remodeled", as they put it -- the placental cells haven't replaced as much of the artery, so the placenta's shallowly implanted.

I've posted a bunch of recent studies in News where they've looked at this notching when it happens in pregnancies following preeclamptic pregnancies, and it's only thought to be *an* indicator, and not a terribly useful one, because many women with notching go on to have perfectly normal pregnancies. Absent or reverse diastolic flow are solid indicators for delivery, but notching is very common.

Here are some links to those studies:
http://www.preeclampsia.org/forum/viewtopic.php?t=31603
http://www.preeclampsia.org/forum/viewtopic.php?t=31480

Hope this helps. These subsequent pregnancies are nailbiters.

karoliina
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Re : Peri appointment and a ? about notching...

Postby karoliina » Tue Aug 29, 638609 2:36 pm

Wow, lots of good news - congratulations!

I think it's possible to have a normal pregnancy even with notching. I guess it depends a little on how much notching there is. They found some in my arteries in early pregnancy, but it wasn't considered severe. I think it disappeared later, but I still got PE.

I'm taking part in a research that is trying to find out (among other things) how predictive the notching is.

Good luck with the second half of your pregnancy!

Karoliina

bcrnjo
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Peri appointment and a ? about notching...

Postby bcrnjo » Tue Aug 29, 638609 1:38 pm

Hi there... so I had my peri appointment yesterday. I first had a 45 min detailed u/s. I was 20 W 5 D yesterday. Baby looks great, actually everything measures at 21 W 1 day and the sonographer said that baby measured slightly bigger but it was all good. Baby wriggled around the whole time and did not like to be proded... lol... So, out of the 6 markers they look at, the baby passed all 5 with flying colors... marker 6 is uterine artery notching, and of course I failed that one... I do have notching in the uterine arteries.... they did say that sometimes the notching smooths out by 25 weeks so i get to see them again in a few weeks for another u/s.... but for now it's just a marker towards PE etc... so, my question is ( I didn't think to ask yesterday, but I will next time I go)... just because I have these notches, CHT and previous pre E... is it likely I will develope pre e again or can a woman have a normal pregnancy even with the notches present?

On the plus side... my BP's are still really good ( 130's/ 78-85 )and my meds have not needed adjusting since day 1 ( Labetolol 100 mg 2 x day). I feel fantastic. I hope all stays well for as long as possible... but at least baby & I are getting awesome care!!


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