when should delivery be considered?

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Re : when should delivery be considered?

Postby samarasmom » Sat Jun 05, 2004 08:01 am

I think all docs are diffrent. for my last 2 sons and this baby I had preterm labor and was told it was safe to deliver and go off meds at 35 wks. I was diagnosed with PE during labor with my second and never with my first. I went into labor at 34 wks with first, 30 wks with second and am already dilated to almost 2 with this one at 28 wks. I have beginning symptoms of PE with this baby and was told that shed be lucky to make it to 35 wks.
I hope all works out with you and though I dont understand alot about this condition, I hope they dont wait until you get very sick.

Sandra 23
EDD 08/24/04
elijah 05/06/99
isaiah 03/25/02

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Re : when should delivery be considered?

Postby laura » Fri Jun 04, 2004 10:38 pm

Here are the guidelines for delivery as indicated by the NIH's Working group report and reported by the National Guideline Clearinghouse:

Table 3. Indications for Delivery in Preeclampsia*

Maternal indicators
Gestational age >38 weeks
Platelet count <100,000 cells/mm3
Progressive deterioration in hepatic function
Progressive deterioration in renal function

Suspected abruptio placentae

Persistent severe headaches or visual changes
Persistent severe epigastric pain, nausea, or vomiting

Fetal indicators:
Severe fetal growth restriction
Nonreassuring fetal testing results

http://www.guideline.gov/summary/summar ... oc_id=1478

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Re : when should delivery be considered?

Postby dja » Fri Jun 04, 2004 10:11 pm

I'd be very disinclined to let things go too long to the point of getting sick again - it is such a risk to your own health, as well as baby's health, esp. if baby is doing so well. I have seen a perintalogist who told me that if I have another pregnancy, I should consider 34 weeks the goal considering my protein S deficiency, antiphospholipid antibody level, and that I was very ill with Amelia.

At our next visit, I will address this question up front - if I can make it to 34 weeks, I'll be a wreck every day after that knowing that PE can hit so hard so fast.

Mom to Amelia, b/d 03/19/04 @ 22 weeks due to sever PE

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Re : when should delivery be considered?

Postby deerhart » Fri Jun 04, 2004 09:08 pm

It really depends on the doctor and their philosophy. In my first pregnancy, my doc was lets hold out as long as possible, but she decided to induce at 34 weeks, and then we waited antoher 3 weeks to get more favorable conditions (and to avoid a c section).
In my second pregnancy, the same doctor took a slightly different approach and decided to deliver before I got really sick (since she figured induction would be successful the 2nd time around)

From my personal viewpoint, I would much rather induce before I get really sick then wait until its absolutely necessary to take the baby.


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Re : when should delivery be considered?

Postby isaacsmom » Fri Jun 04, 2004 08:49 pm

My doctor induces pre-eclampsia patients at 37 weeks unless there are complications that make it necessary to induce before. She says that there is no reason to wait around and risk mom becoming even sicker. I think she tends to be really cautious with her pre-eclampsia patients because she had pre-e herself.

I went into PTL at 35 weeks and she said she would not stop labor because it could have been my body's way of saying it couldn't handle being pregnant anymore even though my labs and bp were good from bedrest. My body stopped labor on its own, though.

Isaac - 37 weeks pre-eclampsia

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Re : when should delivery be considered?

Postby jjbeck1 » Fri Jun 04, 2004 08:30 pm

My gosh, I would think since you have had hellp before they would induce you sooner. My peri had told me he would induce me at 39 weeks, i told him I just did not want to wait for another emergancy. After problems kept arising, he finally agreed to induce earlier 35.5
I am glad I was persistant after seeing the shape of placenta and cord.
What is your gut telling you?

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DH Bob 36

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when should delivery be considered?

Postby 3preemiekidz » Fri Jun 04, 2004 08:25 pm

I thought with diagnosed pre-eclampsia they really considered 34 weeks the point to start from. I was admitted to the hospital again for high BP (170/112). They ran a PIH panel, 24hr urine, monitored the baby then sent me home on bedrest. My pressures came down to between 130/80-150/100 with most around 140/90 so they said I was stable and sent me home. I'll be 32 weeks tomorrow and when I asked the Dr. what the plan was for me he said "if your pressures are still high at 38 weeks we'll induce you". WTF??? He said all my labs were normal except my 24hr urine which has gone up to 3800 but it's not 5000 yet so they won't do anything. He says they are waiting for bad labs. Isn't that too late? I'm just so frustrated and tired of this whole thing. The baby is measuring in the 55 percentile and all looks good with her so they are just waiting for me to get really sick. When should delivery be considered? I don't want a sick baby but I feel like crap and don't want to just keep getting worse. How do I get the Dr. to take me seriously if my labs show that I'm fine?

Mom to Audri 4,
Ezra 2 1/2,
Liya 1
and #4 EDD 8/1/04
born at 35, 29 and 31 weeks due to Pre-e/HELLP

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