30 Weeks

Another good scan, the baby is doing well, she’s growing apace, the dopplers are good and so is the amount of amniotic fluid. If we carry on like this we are good for 36 weeks, possibly to 37 weeks. I’m in a lot better state too, I’m tired and achy but no longer shattered.

However there are two main things that could stop us getting to 36/37 weeks.

I’ve had a procedure that involves puncturing the amniotic sac I’m at a higher risk of my waters breaking early than for a normal singleton pregnancy.

Of course this isn’t a normal singleton pregnancy – it started out as being a twin pregnancy with one placenta, a placenta that was wired up wrong causing the malformation of the acardiac twin. The placenta has already had a “wobble” four weeks back, we are very fortunate that the baby hasn’t suffered, she isn’t small for dates or show any other stresses from placental insufficiency. We are also very fortunate that the placenta started performing its part again. But because it wobbled once, the chances of it doing it again are far higher than in a normal pregnancy even for a woman of my age.

The frustrating thing is we can’t put a figure to those increased risks, the consultant is very loathe to even try, partly because she doesn’t want us going away with a false sense of security and partly because the factors and events of my pregnancy are if not unique, pretty darn rare. That rareness means the medical literature almost stops being scientific data and starts to be scientific stories. I read in one abstract about TRAP Sequence that since it had been first described in the 17th century there had only been about 400 recorded cases, that not a lot to be going on with.

Even though the risks are higher than for a normal pregnancy it is not a racing certainty that the baby will be born preterm, it’s probably not even likely that she will be, but being prepared for it makes sense.  I have my hospital bag packed, it’s sat waiting by my side of the bed.  I’ve tried to research what might happen if the baby was born prematurely, but as it is so common the information Dr Google gives is somewhat garbled, repetitive, and loaded with anecdotes from mothers who have had preemie babies in the past and are now trying to reassure those who are going through the same thing.  Worthy and comforting but not really useful.

I asked my consultant to run through what would happen if the baby was born today, at 32 weeks, at 34 weeks and at 36 weeks, she and the midwife on the unit did one better they got me a visit to the NICU.

The babies were tiny, the atmosphere was calmer and more cheerful than I had imagined based on what I’ve seen on TV, and far more hopeful too. If the baby is born tomorrow, if she is pink, wriggly and making all the right noises, I would get a chance to hold her almost straight after birth before she’s transferred to the NICU.  Assuming that she didn’t need surgery, she would stay in the QEH NICU until term, getting out early would be a bonus. Surgery would mean transferring to a different hospital.  At first she would be in an incubator with various tubes going in and out as she would have difficulties with breathing, eating and maintaining her body temperature.  Survival rates are roughly 95%.

If she was born at 32 weeks exactly the same things would happen except they would expect her issues to be reduced and survival rates are even better.

At 34 weeks her weight comes into play, if she weighs more than 1.8 kilos at birth, she may not spend that much time if any in an incubator, she may go straight into a cot in the NICU – it does depend on her health of course.  If she’s a heavy 34 weeker she is far more likely to come home early, probably not with me but hopefully before her due date.  Survival rates are pretty much the same as for term babies.

At 35 weeks she’s very likely to be over 1.8 kilos, if she’s healthy at birth, there’s a very good chance that she would join me on the delivery ward after birth, only going over to the NICU for checks and tests.  Theres also a very good chance that she would come home with me.  At 36 weeks those odds are even greater and at 37 weeks she would have to be poorly for the NICU to see her.

Warning – these are typical timescales – our baby may not be typical, and for anyone landing on this page researching what happens with preterm babies these timescales are only good for the Queen Elizabeth Hospital, King’s Lynn and in this year.  Check with your hospital to see find out how they manage preemies it may well be different.

It doesn’t work for everyone, but I feel a lot more in control, (no matter how illusory it may be), now I know what the typical scenarios are for a preemie baby.  I don’t feel as scared of the NICU as I did before I went in, I was worried I would see the tiny tiny babies and burst into tears – I didn’t, I did have a wee cry but that was over something different.  And finally having seen the staff and the parents tending to the parents I have a good feeling we’d be in good hands.

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