No fluid/20 week induction update

Emily wrote in message news:m1t%b.402942$I06.4380323@attbi_s01...

Going through all of the options, it seems that the course
with the least risk to my health and future fertility is
an induction. On Monday and Tuesday I have appointments for
something to soften my cervix (don't know exactly what yet),
and then the induction will be on Wednesday.

I'm so sorry to hear about your loss. You'll be in my thoughts, with
best wishes for an easy induction, a speedy recovery, and a healthy
future pregnancy.

--
C, mama to fifteen month old nursling

I'm confused...

I've known several moms who had extremely premature rupture of
membranes who were kept pregnant for several weeks to bring baby to
viability before allowing baby to be born to increase the chances of
survival for baby...and didn't have problems with lung development.

Is there something else going on with your situation? What I mean
is..is there another problem that is contributing to the
oligohydramnios that reduces survival rate and therefore makes the
situation more drastic...or is it just the oligohydramnios that they
are looking at as a diagnosis?

(I'm sorry you have to experience this...I truly truly am..)

Hi Elfanie,

At 17weeks, the amniotic fluid was moderately decreased. At 19
weeks, it was completely good. In between, I also had a lot of
bleeding. It seems that the placenta is failing -- at the moment,
failing to produce enough amniotic fluid (I know the baby produces
some to). Perhaps related to all this (via some sort of irritation
of the uterus) I am now also leaking what little amniotic fluid
there is. The issue isn't low amniotic fluid, it's *no* amniotic
fluid. Even if I don't spontaneously deliver before 28 weeks or
whatever, without fluid now, the baby's lungs won't develop.

--
Emily
mom to Toby 5/1/02
#2 EDD 7/19/04

Elfanie wrote:
On Fri, 27 Feb 2004 06:14:37 GMT, Emily wrote:
The baby's kidney are there. The problem seems to be with
the placenta. 16-24 weeks is when the baby's lungs are developing,
and without the fluid, they can't develop.

I'm confused...

I've known several moms who had extremely premature rupture of
membranes who were kept pregnant for several weeks to bring baby to
viability before allowing baby to be born to increase the chances of
survival for baby...and didn't have problems with lung development.

Is there something else going on with your situation? What I mean
is..is there another problem that is contributing to the
oligohydramnios that reduces survival rate and therefore makes the
situation more drastic...or is it just the oligohydramnios that they
are looking at as a diagnosis?

I believe the issue with Emily's pregnancy is that her placenta is not
producing amniotic fluid (or so little that it's totally insufficient to the
task). This is very unlike a PROM situation, where the placenta continues to
produce fluid to replace at least some, if not all, of the fluid before it
leaks out. Emily has explained in detail the condition that causes this
elsewhere (MTHsomething, I believe) in earlier posts. A Google search on her
name and "low amniotic fluid" should easily pull up her posts where you can
read the details.
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [23 mos.] mom)

This week's special at the English Language Butcher Shop:
Financing for "5" years -- car dealership sign

Aurora reciting alphabet: S...T...U...V...DW...X....Y...Z

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

Emily wrote in message
news:m1t%b.402942$I06.4380323@attbi_s01...
Hi,

We saw the perinatologist this morning. She was very kind,
and took lots of time with us and answered all of our questions.
We took another look at the baby on the u/s and saw absolutely
no fluid this time. It seems that (on top of everything else,
and probably not unrelatedly) I'm leaking fluid as well.

We confirmed that the chances of carrying this baby to term
and having it be viable and healthy are very, very slim. We
are also optimistic that the cause of the problem is unlikely
to be a recurring one, so that we can hope for an unproblematic
pregnancy in the future.

Going through all of the options, it seems that the course
with the least risk to my health and future fertility is
an induction. On Monday and Tuesday I have appointments for
something to soften my cervix (don't know exactly what yet),
and then the induction will be on Wednesday.

The baby is still wiggling and squirming, even though there's
no room without any fluid. It's pushing on the uterine wall
(which is actually kinda painful). The perinatologist says
that it must be a strong baby to do that -- I guess good muscle
tone tends to run in our family. DS has always been very strong,
practically could handle his own head (strong neck) from birth,
walked at 9.5 months, etc.

I asked about donating milk, and the perinatologist said she
would look into it for me. There's a chance that it could
actually be used in the NICU at the hospital where I will
deliver. Otherwise, there aren't any milk banks in my city,
but I will look into sending it to one.

So, I wish this could be over sooner, so I could get on
with things more quickly. It's very strange to be grieving already
for someone who is still alive. My department has been very
supportive and accommodating, and my class is taken care of
for the rest of the quarter. I should be able to teach next
quarter (starting 3/29) and think that I'll enjoy being able
to throw myself into my work.

DS is, of course, a huge comfort. I can imagine that this would
be 100x harder if it were my first pregnancy, and only harder
still after previous pregnancy loss. I am very much looking
forward to trying again (once my body has had a chance to recover
so that I start off on the best possible footing), and to
seeing lots of fluid on a ultrasound some day soon, and even
more so to cuddling a newborn!

Thanks again to everyone here for being so supportive.
I expect I'll keep posting as I go through this experience
and then fade away again until I'm pg again.

Sorry.
Debbie

Emily wrote:
|| Hi,
||
|| We saw the perinatologist this morning. She was very kind,
|| and took lots of time with us and answered all of our questions.
|| We took another look at the baby on the u/s and saw absolutely
|| no fluid this time. It seems that (on top of everything else,
|| and probably not unrelatedly) I'm leaking fluid as well.
||
|| We confirmed that the chances of carrying this baby to term
|| and having it be viable and healthy are very, very slim. We
|| are also optimistic that the cause of the problem is unlikely
|| to be a recurring one, so that we can hope for an unproblematic
|| pregnancy in the future.
||
|| Going through all of the options, it seems that the course
|| with the least risk to my health and future fertility is
|| an induction. On Monday and Tuesday I have appointments for
|| something to soften my cervix (don't know exactly what yet),
|| and then the induction will be on Wednesday.
||
|| The baby is still wiggling and squirming, even though there's
|| no room without any fluid. It's pushing on the uterine wall
|| (which is actually kinda painful). The perinatologist says
|| that it must be a strong baby to do that -- I guess good muscle
|| tone tends to run in our family. DS has always been very strong,
|| practically could handle his own head (strong neck) from birth,
|| walked at 9.5 months, etc.
||
|| I asked about donating milk, and the perinatologist said she
|| would look into it for me. There's a chance that it could
|| actually be used in the NICU at the hospital where I will
|| deliver. Otherwise, there aren't any milk banks in my city,
|| but I will look into sending it to one.
||
|| So, I wish this could be over sooner, so I could get on
|| with things more quickly. It's very strange to be grieving already
|| for someone who is still alive. My department has been very
|| supportive and accommodating, and my class is taken care of
|| for the rest of the quarter. I should be able to teach next
|| quarter (starting 3/29) and think that I'll enjoy being able
|| to throw myself into my work.
||
|| DS is, of course, a huge comfort. I can imagine that this would
|| be 100x harder if it were my first pregnancy, and only harder
|| still after previous pregnancy loss. I am very much looking
|| forward to trying again (once my body has had a chance to recover
|| so that I start off on the best possible footing), and to
|| seeing lots of fluid on a ultrasound some day soon, and even
|| more so to cuddling a newborn!
||
|| Thanks again to everyone here for being so supportive.
|| I expect I'll keep posting as I go through this experience
|| and then fade away again until I'm pg again.
||
|| --
|| Emily
|| mom to Toby 5/1/02
|| #2 EDD 7/19/04/induction scheduled for 3/2/04

Emily,

As many others have stated it is very difficult for me to convey the pain I
feel for you and your family during this time. I just wanted to let you
know that I am truly sorry for the hurt you are going through.
(((((Emily))))))
Jenn
-WAHM
-DS Feb'92
-DD Feb'97
-Jellyfish due June 25/04

Elfanie wrote:
I'm so sorry....I truly am. Are they thinking that you've had a leak
in the bags for a while now, and that's what's caused the amniotic
fluid to slowly - well, I was going to say 'go down' but from your
description it appears it woudl be more accurate to say "leave"...?
I mean...do they think it was due to a leak, and not due to a fetal
defect? I know you say that the placenta isn't functioning optimally
and you had bleeding...are they concerned at all about an abruption?
And if so...are they concerned about inducing you with a threatened
abruption (if that's what it is)?

Are they able to see the lungs when they've done the ultrasounds
checking for fluid? Have the lungs already been compromised by the
lack of amniotic fluid?
(usually when we have clients 'on the clock' as far as trying to make
it to a delivery stage before having their babies....we shoot for the
latter half of 24 weeks...)

I'm sorry to ask so many questions...I know you're going through SO
MUCH right now..
not long ago I spent 2 weeks at the hospital with a client who was
brought in at 21 weeks with an incompetent cervix...I know how much is
probably being thrown at you right now and I am NOT NOT NOT second
guessing your decisions!! Just trying to understand what you're
facing and what's going on with you and your baby...

*offers warm hugs*

Hi again Elfanie,

Part of why I want to post here is so that others can learn
from my situation, so I'm happy to answer questions (and if
that changes, I'll just stop :-).

We think that the leak is recent, but that the placenta has
been misbehaving for a while. I had a high AFP reading, too,
although u/s show no defects in the baby that would be related
to the high AFP (NTDs) or to the low fluid (the kidneys
are there, the bladder fills up). So, the high AFP is probably
from placental bleeding, and the low fluid has been the placenta
not keeping up for a while. The turn for the worse that we
saw this week is probably a combination of the leak, and the
placenta getting even less effective.

We specifically asked if it's possible to use u/s to measure
the development of the lungs, and the perinatologist said
no, that kind of information doesn't show up. (The lungs are
there, presumably -- it's all the little structures inside
that need the fluid to develop, and are necessary for lung
capacity.)

--
Emily
mom to Toby 5/1/02
#2 EDD 7/19/04

Elfanie wrote:

I'm sorry....I wish there was a way they could say for 100% either way
(ie. if you do X, then Y will happen)....

My heart is just so heavy for you...I can't even express my sorrow
enough for you and your baby. When are you planning to induce? Is
there a risk to YOU of this situation? (from the bleeding..are they
worried about the risk to you of carrying any longer?)

Here's the question that I'm wondering (and yes, if you get tired of
answering my question, then please just forgive me for asking and
don't answer me!)..
We know that if baby is born right now - even if it has a fully
functioning placenta and was 100% healthy, it wouldn't have a chance
of survival...so if born now, your baby absolutely unquestionably will
not survive, 100%..
So is there a risk (other than the intense emotional anguish which
I'm sure would be very difficult) of carrying the baby for another 5
weeks if baby chooses to stay in there for 5 weeks....and delivering
then even if there is a 99% chance that the lungs won't be developed?
In other words...is there even a 1% chance of the lungs developing
properly with your condition? Or - is it 100% certain that the lungs
cannot develop - it's an impossibility? Or - does continuing the
pregnancy pose a risk to you (ie. placental abruptia)?

Hi again,

I was a little vague about this before because I didn't want folks
to tell me that I should hold out for that 1% or whatever it is, but
yes, it's not 100% certain that if we let things continue the baby
wouldn't survive. It sounds like the two most likely outcomes are
that I will miscarry on my own or that the baby will be still born
(i.e., make it past 20 weeks, but then not have enough lung capacity
to survive at all). I don't have any exact numbers, but those two
scenarios account for most of the 100%. The next most likely thing
is that the baby would survive, but with a high likelihood of all
the complications that come with extreme prematurity, on top of
diminshed lung capacity plus the other things that come with
low amniotic fluid (mobility issues among them). The remaining few
percent (and no, we didn't get any numbers, how could they know?)
are the chances of a healthy baby. There's also issues of infection
(and the effect that has on the baby) to throw in there, as the
amniotic sac appears to be breeched.

We also asked which of the three courses of action open to us
(D&E, induction, continuing the pregnancy and letting nature take
its course) holds the least risk to my health & future fertility.
The answer was induction, and part of the reasoning was the risk
of infection. Apparently D&E and induction are pretty close in
risks up to 20 weeks, and after that D&E becomes riskier, to the
point that they don't offer it past 20 weeks. Since I'm 20 weeks
on Monday (by the u/s dating, more by LMP, but I think I ovluated
late), that makes it sound like D&E is riskier to me. Plus, as
I've said elsewhere, I need to hold this baby and be present
in that moment. Neither are possible with D&E.


--
Emily
mom to Toby 5/1/02
#2 EDD 7/19/04

Thanks, Elfanie. Your support means a lot.

--
Emily
mom to Toby 5/1/02
#2 EDD 7/19/04

Emily,
I don't post much, but I just wanted to say I'm so sorry for what you are
going through.

Joy

"Emily" wrote in message
news:m1t%b.402942$I06.4380323@attbi_s01...
Hi,

We saw the perinatologist this morning. She was very kind,
and took lots of time with us and answered all of our questions.
We took another look at the baby on the u/s and saw absolutely
no fluid this time. It seems that (on top of everything else,
and probably not unrelatedly) I'm leaking fluid as well.

We confirmed that the chances of carrying this baby to term
and having it be viable and healthy are very, very slim. We
are also optimistic that the cause of the problem is unlikely
to be a recurring one, so that we can hope for an unproblematic
pregnancy in the future.

Emily,
Well, my mother is a mystery writer by trade, but a good writer is a good
writer, in my book. Her name is Sue Grafton. I swear, losing Nathan was
almost as hard on her as it was on me. She was by my side throughout the
whole thing, including the shot to stop his heart. Besides my husband, she
was (and still is) my strength, my core, and my love. She was just
inspired.

I'm glad you liked it.
--

Jamie & Taylor
Earth Angel, 1/3/03

Check out Taylor Marlys -- www.MyFamily.com, User ID: Clark_guest,
Password: Guest1
Become a member for free - go to Add Member to set up your own User ID and
Password

Handmade Baby Blankets -- www.geocities.com/digit_the_cat/Blankets.html


"Emily" wrote in message
news:_yJ%b.71148$4o.91529@attbi_s52...
Jamie Clark wrote:

Thanks Anita. Here is another one. I don't mean to be a downer or
bring
the group down, but this is a poem that my mom wrote for Nathan, when we
lost him. Still today, 6 years later, it brings tears to my eyes. It's
healing for me to get back into it a little bit.


A Poem for Nathan
By Nana

This structure is unsound.
The tiny boat you piloted has floundered,
leaving you stranded in dark swells.

We can see you drifting just offshore.
Through our spyglass
we can follow your progress
kicking in the deep
swimming for your life.

At this distance you seem no bigger than a fish,
some creature from the depths
not yet of this world
so rare and precious to us.


Had we a net we could pull you to safety
hold you curled in the palm of one hand
anointing you with tears.

You are everything to us.
You are all that we dreamed of
all that we hoped for
those months ago
when you first set sail.

How can we tell you how shimmering you seem
starlight on water
so delicate, so perfect, so pure.
Only the vessel is flawed
making landfall unlikely.

We've consulted mariners
ship builders
sailmakers
men who have toiled on the sea for years.
None of them could guarantee safe passage.


We've cast our lines into the surf.
There is no way to reach you
except with our prayers.

We can see your mast begin to tilt.
We can see how battering storms
have weakened your hull.


You list
taking on water.
Winds tear at your shroud.

Know, Little One, we have done
all that we could.

Keep faith.
We will build you a new boat
fashioned with sturdy planks
seasoned timber
canvas newly rigged
to carry you through rough waters.

For now we can only make you this covenant
tossing you this promise
to which you can cling
while we labor on your behalf.

Wait for us.
Hold fast.
You are not abandoned.
We have not given up hope of
harboring you among us.

This structure is unsound.
This vessel has floundered,
but yours is a soul we cherish.
We will come back for you
all of us
starting anew
building again
bringing you home safely.

Jamie, that's beautiful! Is your mother a poet, or was
she just inspired on this occasion? (My mother is a poet,
too.)

--
Emily
mom to Toby 5/1/02
#2 EDD 7/19/04