High Risk Pregnancy ~ General Discussion and Support

[*Beema*]

Just wondering who on BB is or has gone through or in the future is at risk of going through a high risk pregnancy..... I thought that we can support and travel through what can be a difficult journey together

There are a ranges of reasons that will determine if your pregnancy is considered high risk, which can be from complications arising out of a previous pregnancy and delivery for example IC (Incompentant Cervix) PE (Pre-Eclampsia), C/S (C-Section), PPH (Post Partum Haemorage) or retained placenta, PPROM (Pre Term Premature Rupture of the Membrances) or PTL (Pre Term Labour) it could be maternal issues for example, uterine abnormalities, BMI (Body Mass Index), BP (Blood Pressure), GD (Gestational Diabetes), it could be issues that have arisin during your current pregnancy large or smal baby, low or high amniotic fluid, GBS positive, and many other reasons.

A few questions I guess to get the conversation going... so you can also see who is going through the same or similar to you.

What complications are you having and what is your care provider doing to try to control these complications to prolong your pregnancy? How are you or your conditions being monitored?

Do you feel that you are being monitoired or cared for sufficiently, or are your concerns being fobbed off?

How do you get through week, day or even hour at times, mentally, physically and emotionally?

How was your high risk pregnancy experience and what advice can you give mothers who are travelling along or going to travel along a similar journey?

It is such a different experience going through a high risk pregnancy..... so I guess come in and share your experiences, fears, hopes, grief and concerns and together we get through

[*Beema*]

For me this is my second high risk pregnancy, my first was classed as high risk due to:

Polyhydrominous (high amniotic fluid)
Septate Uterus
Low Platelets

I went through an OB and ended delivering prematurely at 33 weeks, due to a PPROM and Spontaneous Labour quickly followed and wasn't able to be stopped, had a VB with an episiotomy.

This Pregnancy is high risk due to the following....

Previous PPROM (pre-term rupture of the membranes) and PTL (Pre-Term Labour)
Septate Uterus
Multiple Pregnancy, with early loss or twin
Possible IC (In compentant Cervix)
Low Amniotic Fluid (which appears to be settling at the moment !)
Possible Irritable Uterus
Placenta over the septum of the uterus and abnormal appearance to the placenta, with risk of SGA (Small for Gestational Age) or IUGR (In Uterine Growth Restriction)
Low Platelets
Prolapse

I am having fornightly scans on my cervix to monitor it's length and whether it is staying closed, we have had over 2cm of shortening over the past few weeks, and have two more scans with the opportunity to do an emergency stitch if needed, we have just over 6mm left before it become critical, next scan is next week.
I have had my first lot of Uterine Dopplers to monitor blood flow through from the placenta and cord to monitor and changes which could indicate the beginnings of growth restriction.
Keeping track of BH's length and frequency and any cramping to ensure that they aren't increasing in intensity and frequency.
Four weekly BT's to check platelet levels.

I am seeing a Private OB who speicalises in High Risk Pregnancies and I feel that she is doing everything she can to ensure my pregnancy lasts as long as possible, I feel that I am in the best hands and that I am confident that we will get as far as we can and what ever gestation that is I am at peace with what ever the result is. She listens to all of my concerns and is being very proactive.

I am booked into my Private Hospital and the Hospital where I had DD should I not make it to 36 weeks, so I feel comfortable that we won't go through what we did with DD.

If my cervix shortens too much after it is too late to do the stitch she will be starting me on Progesterone to hopefully stabilise it, and Nifedipine to relax the uterus/to stave off contractions, and the steroids would follow incase we got to a point where we were unable to stop everything from progressing, as we need 3 courses over 48 hours to be really effective.

I have good and bad days, I feel that somedays I will easily make it beyond DD's gestation then i have days when I feel that I will struggle to get a few more weeks, it can be such an emotional rollercoaster, and I am focussing on 30 weeks as a big milestone to get past, the smaller milestone of 24 and 28 weeks are in my mind but not at the forefront as I feel that while the baby has a good chance at these times, the journey can be a very rocky one, the longer we can bake the better and I feel that I need to focus further ahead. After 30 weeks I am aiming for DD's Gestation and then 36 weeks and of course full time

I will leave it at that for now, and see if anyone comes in and joins me

[~mamaspice~]

Hi Beema, my pregnancy is classed as "High Risk" but certainly not as high risk as yours.
I'm classed as high risk because of a combination of the following: previous caesarean, I have gestational diabetes, and I have a 50% chance of getting PIH/PE with this pregnancy as I had it with my last pregnancy, resulting in elective cs at 38 weeks. I have also had issues with hypocalcaemia due to damage to parathyroid glands when I had a thyroidectromy 18 months ago.

My main complication so far is the GD, as my BP so far has been good but it didn't start rising until post 30 weeks with my first pregnancy so the Dr's are expecting it to start playing up again soon.

I'm doing shared care between my local public hospital and a private Ob. The reason I initially chose public care is that I wanted vbac this time. And although the public hospital have been good, I hated the fact that I was seeing a diferent OB registrar each time and it was very impersonal. So now I also periodically see a private Ob who happens to be a senior Ob at the public hospital but has a private practice also.
Our plan is if things are looking good for VBAC I will have it at the public hospital but if I end up needing a caesarean then he will do it for me privately.
I also see an endocrinologist fortnightly for my diabetes/thyroid issues.

So far emotionally, so good. But I know that if I get PIH/PE again I will start to get a bit nervous. Especially having that coupled with GD. And I'm sure that having the two will mean more monitoring of bubs.

The GD so far I've been able to manage with diet but I may need to srat insulin injections soon. I also have to have another scan at 34 weeks to measure bubs size.

Oh and bub is currently breech so. Not a complication in itself, but if he stays this way, then it's definately a caesarean for me.

I've got my that you get to 36 weeks beema!

[black_rose]

I am classed as high risk because of PPROM, and PTL with dd1 she was born at 34 weeks by c sect. I was also measuring two weeks behind.

With dd2 I had GD and PTL at 35 weeks but I made it to 37 weeks with meds, bed rest and CTG monitoring. I managed a VBAC with just the gas, had a very short labour only 45 minutes after my waters were broken.

I had a check up today, so far I have had an easy pregnancy unlike last time when I had spd as well as the GD. I am measuring behind but I have all three times so it's not a concern yet. My biggest worry is going into PTL again, had very strong BH on the weekend, and an achy belly.

I want to get to 33/ 34 weeks too any earlier and bubs can't be at the hospital we are booked into. Bed rest would be tougher this time, with two girls and dh isn't working from home anymore. I am hoping for a vbac but will talk to my ob at 34 weeks after he checks how far behind I am.

I am lucky enough to also do shared care, my gp delivered until a few years ago so I alternate between him and my ob. I am going to the same private hospital who were fantastic with both the girls.

Great thread Beema! Although I don't feel so high risk knowing what you are going through.

[*Beema*]

Hi Mama Spice and black_rose !!

Don't feel in anyway that your pregnancies are less risky just because of the complications I have , I am hoping that we might be able to take some of the things off my list as we go through all the monitoring etc.

It is great that your BP is doing the right thing so far mama spice, I hope it stays that way, is the risk of PE higher for you as you have GD as well? Youa re doing a great job keeping the GD undercontrol with diet, hopeuflly you can avoid the injections for as long as is safe.

I hope that bubs turns for you soon, my OB wanted Flicker to turn asap due to the low fluid levels and it was going to be harder for bubs to turn as I got bigger, I had been doing inversions and using Moxa Sticks and managed to get Flicker to turn last week, hopefully he/she stays like that now

It is great to see how many options you have for delivery as well, I think it has made me more confident knowing what the plan of attack is.

I would love to get to 36 weeks, to prove all the odds wrong

I worry about being put on bed rest as well black_rose, I am such an active person, and have already had to limit everything so much it is driving me nuts I think I would go insane on bed rest, but if it what I have to do then I guess we just have to suck it and up...

It sounds as though you have quick progressing labours as well, our babies just want to get out in a hurry, it is fabulous to hear you got an extra couple of weeks with DD2 with the monitoring bed rest etc.

Take care and no labour vibes !!!!

[black_rose]

Its reassuring to know that there are other mums to be who have the same kind of fears, its not something people want to talk about IRL. I don't think I could do the whole bed rest again, but I know I may not have a lot of say in the matter. I know I struggled at the end which probably contributed to the meds stopping their effectiveness, the contractions never stopped though so who knows.

MamaSpice, its good that you are being monitored closely. Fingers crossed you can stay off the insulin I hated the injections last time, I had a reaction and had to come off them in the end. I hope bubba turns soon so you have a chance at a VBAC.

[crumpet]

i dont know if i full belong here, im probably classed more as medium risk.....

What complications are you having and what is your care provider doing to try to control these complications to prolong your pregnancy? How are you or your conditions being monitored?

my main compliation is incompetant cervix, diagnosed when i delivered at 22weeks last pregnancy...
so far im being monitored and am om 2 progesterone pessaries a day...
om friday i have my 12w appt and find out when ill be having my cervial stitch done.

Do you feel that you are being monitoired or cared for sufficiently, or are your concerns being fobbed off?

yes definatly, my OB is amazing and is right on the ball with everything, u could see is was upset when he delivered our DS and i can tell he doesnt want us to go down that track again

How do you get through week, day or even hour at times, mentally, physically and emotionally?

mentally i just pretend everything is fine
physically i rest a lot so i dont raz up my cervix
emotionally well we are getting a lot better there

How was your high risk pregnancy experience and what advice can you give mothers who are travelling along or going to travel along a similar journey?
i can only go by last time but if ur worried make sure u speak to ur care provider becasue if i didnt i would have delivered my baby at home at 21weeks not in hospy at 22weeks with my OB by my side fighting for me.....

[~mamaspice~]

Beema, I hope you're able to strike some of the things off your list as you go along too! Hopefully your amniotic fluid and platelet levels stay high enough and that cervix of yours behaves itself. Oh and that the septum doesn't get in the way of yor placenta function.
I think that because I have the GD it probably does slightly increase my risk of high Bp again. I've got a 50% chance of getting it again i think.
Thats good that flicker has turned for you. I can defiantely still feel the pressure of bubs head under my ribs and I'm getting kicks really low so I know he's still breach. I've been telling him he's got a few weeks to get his act in to gear. At the end of the day though if he stays breach then I know it's just mean't to be.

Black_rose, hopefully you get to at least 34 weeks this time. And how awesome that you've managed to avoid getting GD and SPD again. Do you mind if I ask if there is a reason why you seem to go into PTL? I've read that both GD and PE can increase the chances of PTL and I've kinda got this feeling that my bubba isn't going to quite make it to 38 weeks this time.

Hi Crumpet, I'm so sorry for the loss of your DS. Good luck for your appointment on Friday. I hope your cervix is behaving nicely.

[black_rose]

Beema when I had gd my blood sugar levels were back to normal straight away, so I could bf ok, dd's levels were all fine we just had to wait an hour to bf feed her and she was in the scn for a few days, she had jaundice as well.

I have had the 2 hour gtt test twice this time and got the all clear on them.

IKWYM when people say they want their babies out now, they have no idea of how much of a struggle it is with a premmie. Wouldn't wish it on anybody. I would love to get to 40 weeks!

Hi crumpet, you are in the right place, thank god for decent ob's out there. Sounds like we have all been blessed to find one to help us through our journey.

[crumpet]

Beema, I hope you're able to strike some of the things off your list as you go along too! Hopefully your amniotic fluid and platelet levels stay high enough and that cervix of yours behaves itself. Oh and that the septum doesn't get in the way of yor placenta function.
I think that because I have the GD it probably does slightly increase my risk of high Bp again. I've got a 50% chance of getting it again i think.
Thats good that flicker has turned for you. I can defiantely still feel the pressure of bubs head under my ribs and I'm getting kicks really low so I know he's still breach. I've been telling him he's got a few weeks to get his act in to gear. At the end of the day though if he stays breach then I know it's just mean't to be.

Black_rose, hopefully you get to at least 34 weeks this time. And how awesome that you've managed to avoid getting GD and SPD again. Do you mind if I ask if there is a reason why you seem to go into PTL? I've read that both GD and PE can increase the chances of PTL and I've kinda got this feeling that my bubba isn't going to quite make it to 38 weeks this time.

Hi Crumpet, I'm so sorry for the loss of your DS. Good luck for your appointment on Friday. I hope your cervix is behaving nicely.

thanks mamaspice..... id like to think it is but i dare say its doing its usual thing!

hope bub turns for u soon!!!

im assuming GD is gestational diabeties? whats SPD?

Welcome Crumpet you are int he right place hun xxoo
Your OB sounds fabulous!!
I hope that Friday brings you a nice long and closed cervix, is your OB going to do a stitch anyway or just do regular monitoring and see what it does?
Great advice hun I am so sorry of your wee little DS, I am sure he is watching down and protecting you and your little bubba xxoo
I am glad that I started this thread, hopefully we have a different type of understanding what we are all going through, and it can be hard when others seem to have a really smooth pregnancy, and I do struggle a bit when people just want their babies out, especially when they are well before term I would LOVE a Full Term Take home Bubba, without all the medical jargon that goes with it.

thanks beema.....

yep stitch is a definate, my cervix is 2.5cm when im not pregnant so he wont risk it, which is fine by me!! id rather have it done and be safe rather than sorry.....

this thread is a great idea, im learning lots already!!
i still feel like im a novice at this pregnancy caper, i never got far enough to know about all the ins and outs....

Hi crumpet, you are in the right place, thank god for decent ob's out there. Sounds like we have all been blessed to find one to help us through our journey.

thanks blackrose.....

i know, im so thankful to our OB i really wonder what would be happening if we didnt have him.....

its a bit of a exciting day here today.....

ive hit 12 WEEKS!!!!
i didnt expect to get this far thats for sure!!!!

[*Beema*]

That is great black_rose that everything goes back to normal so quickly and fabulous to hear that you could start BF'ing after an hour. DD had very low BLS when she was born of 0.9, so she had an IV for a couple of days and and NGT for nearly two weeks. She also was Jaundiced for 3 months and nearly had to go back in under lights again, so glad her Bili's came in just low enough

Fabulous news of the GTT's as well !! I have to go straight to the GTT this time as well, last time I did because of the excess amniotic fluid and I think my OB has done it this time so we aren't stuffing around with anything.

Yeah the premmie thing is so hard but I guess unless you have been there it is hard to really understand....

im assuming GD is gestational diabeties? whats SPD?

thanks beema.....

yep stitch is a definate, my cervix is 2.5cm when im not pregnant so he wont risk it, which is fine by me!! id rather have it done and be safe rather than sorry.....

this thread is a great idea, im learning lots already!!
i still feel like im a novice at this pregnancy caper, i never got far enough to know about all the ins and outs....

thanks blackrose.....

i know, im so thankful to our OB i really wonder what would be happening if we didnt have him.....

its a bit of a exciting day here today.....

ive hit 12 WEEKS!!!!
i didnt expect to get this far thats for sure!!!!

wooo hooo for 12 weeks, it is a fabulous milestone!! for a short cervix but great that the stitch will be going in soon, when mine was 2.2cm my OB said between 12-14 weeks, but after my MC finished it relengthened again, so we are going with the fortnightly scans, and hopefully we can keep it above 2.5cm, as I am nervous about getting a stitch done so late.

I have added in IC at the top of the page and also what all the acronyms mean, SPD means Symphysis Pubis Dysfunction, my physio referred to it as Pelvic Instability, I just found this description of it:

The two halves of your pelvis are connected at the front by a stiff joint called the symphysis pubis. This joint is strengthened by a dense network of tough, flexible tissues, called ligaments. To help your baby pass through your pelvis as easily as possible, your body produces a hormone called relaxin, which softens the ligaments. As a result, these joints move more during and just after pregnancy (Kristiansson 1997; Bjorkland et al 1999; Bjorkland et al 2000), causing inflammation and pain, known as symphysis pubis dysfunction or SPD.

In other words it hurts, I had it worse with DD, this time I have only had to wear the belt a couple of times, which holds everything together better

[crumpet]

wooo hooo for 12 weeks, it is a fabulous milestone!! for a short cervix but great that the stitch will be going in soon, when mine was 2.2cm my OB said between 12-14 weeks, but after my MC finished it relengthened again, so we are going with the fortnightly scans, and hopefully we can keep it above 2.5cm, as I am nervous about getting a stitch done so late.

I have added in IC at the top of the page and also what all the acronyms mean, SPD means Symphysis Pubis Dysfunction, my physio referred to it as Pelvic Instability, I just found this description of it:

The two halves of your pelvis are connected at the front by a stiff joint called the symphysis pubis. This joint is strengthened by a dense network of tough, flexible tissues, called ligaments. To help your baby pass through your pelvis as easily as possible, your body produces a hormone called relaxin, which softens the ligaments. As a result, these joints move more during and just after pregnancy (Kristiansson 1997; Bjorkland et al 1999; Bjorkland et al 2000), causing inflammation and pain, known as symphysis pubis dysfunction or SPD.

In other words it hurts, I had it worse with DD, this time I have only had to wear the belt a couple of times, which holds everything together better

thanks hun, it was a bit exciting!!!!

when i was preg with Gus we were on fortnightly scans, then i had my 20w one all look ok, as it can with a 2.5cm cervix then a week later the ***** hit the fan, my poor OB he was stunned i felt sorry for him... u coukd see how shocked he was when it happened so quick, hence his reason to go straght for a stitch this time


oh yep i have herd of that..... i had a fewe issues with my hips with Gus and my osteo thought i might have been heading down that path but nothing seemed to happen....
it sounds sooo painful! i hope it doesnt get to bad for u girls, just what u need one more big ache!

[black_rose]

I think my biggest hurdle will be these next few weeks, if I get to 36 weeks I will be happy. A big one I am facing this week is my ob and gp are both away, and it would be just my luck to go into labour when they aren't around. I know I the midwives would be great, but the ob who takes over from mine is against VBAC's and he may push for a c sect. Not that anything will happen but its just another one of those things to overcome.

It doesn't help that the BH are increasing again. It seems to happen at the end of each week, they kept me awake last night.

Hope everyone else is ok.

[black_rose]

Crumpet I was in hospital two days last time and then going in for ctg monitoring three times a week and that was bad enough!

Good luck today Beema, would be hard to decide whether to wait a week or two or go ahead with a stitch now. I guess you can only trust your instincts and talk it through with your ob.

AFM the BH have eased again so they are following a pattern, so I am waiting for them to pick up again at the end of the week. I have lost some of my mucous plug every day since Saturday, but I remember reading that it reforms (I think that was you Beema). My next checkup is in a week, but at the moment I am not overly concerned about it, I don't think I will be making it to term though! I had all these same signs with dd2 for a few weeks too. With dd1 I have no idea, I was clueless as to what was happening, ignorance was bliss with her!

[crumpet]

Crumpet I was in hospital two days last time and then going in for ctg monitoring three times a week and that was bad enough!

Good luck today Beema, would be hard to decide whether to wait a week or two or go ahead with a stitch now. I guess you can only trust your instincts and talk it through with your ob.

AFM the BH have eased again so they are following a pattern, so I am waiting for them to pick up again at the end of the week. I have lost some of my mucous plug every day since Saturday, but I remember reading that it reforms (I think that was you Beema). My next checkup is in a week, but at the moment I am not overly concerned about it, I don't think I will be making it to term though! I had all these same signs with dd2 for a few weeks too. With dd1 I have no idea, I was clueless as to what was happening, ignorance was bliss with her!

oh i know 7 days of hanging by my feet nearly killed me, and the thought of being there for what could have been 8 weeks nearly killed me!!!
thankfully for my stitch ill be in 2-3 days for the op and then monitoring at my OBs request and then all going to plan that will be the only admission......knowing my luck ill be in and out, things seem to happen that way for me!!!

so glad ur BH have settled hun!!! just saw ur ticker, nearly 33 weeks!! ur doing so so well!!!! not long to go now!!!! i to have herd that ur plug can re-grow! it was on here i read it but im not sure where!!

[black_rose]

Hi glamachic, I am overweight but it's not the reason I have been classed as high risk, my ob never takes my weight as my blood work and blood pressure is perfect. Last time with the gestational diabetes I was watched to make sure I wasn't losing too much weight because of the restricted diet. I am a private patient so that could be why my bmi has never been an issue? I know there are few threads about public hospitals turning away woman with a bmi over 30.

[glamachic]

public hospitals turning patients away....no wonder i hate them!

i have no private health and even if i did i wouldnt want to see an OB, they do my head in.

i trust my body and i have full faith in my baby and that if i eat healthy my blood pressure will stay down.

i am convinced doctors are idiots.

after seeing "the business of being born" i am opting for home birth!

[black_rose]

Crumpet I have to change my ticker!! It's out by 6 days, so I am 32 weeks tomorrow, my hospital will take me from now on though.

Csab, thinking of you the things we go through to hold our little ones. Hope they can sort out the thyroid.

Sally I have been reading your thread too, was hoping to see a BA this morning. Will they put her back on the nefidipine, or help her along? I was on it for two weeks and it didn't stop the contractions. Hope you will be home with your two boys soon, I feel the same about having a 33 wk baby if I go into pre term labour I would have to seriously think about what to do, having a premmie in scn or stuck at home on bed rest trying to find someone to watch the girls, esp since the meds didn't stop the contractions too well.