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Update on Mama and Baby RN (x-posted) *UPDATE 5/27* baby may be here tomorrow.


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  #1  
May 22nd, 2011, 07:18 PM
MamaRN's Avatar Platinum Supermommy
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Hi All,

So most of you know I had pre E with DD and they have been watching closely with this pregnancy and so far it has been pretty good in terms of blood pressure, one flip episode of blurred vision and high BP around 29 weeks that was transient and resolved on it's own after a few hours of monitoring at the hospital, and all my Pre E labwork came back negative.

Well last weekend I had a pretty severe headache off and on through out the weekend, my BP at home was OK and I had some congestion so I attributed it as likely to allergies but did tell my MW about it at my appt. on Monday and as a precaution she sent me over to the hospital to have another Pre E blood work panel and urine panel done. Well Friday morning she called with the results and my platelets have dropped significantly, which can indicate the start of Pre E/HELLP syndrome.

So, she had to consult with their back up OBs and they want me to come in tomorrow morning for an NST and repeat blood work, appt., and then I will have to start doing twice weekly NSTs next week and have the lab work repeated weekly. If baby appears to be doing well than we might be able to drop the NSTS down to once a week, but I'll be more closely monitored from here, and, unfortunately, this may affect my ability to VBAC and be in the care of the midwives exclusively for the remainder of the pregnancy and my delivery. If baby needs to come early if this is in fact an indicator of the start of Pre E, than it's a flat out c-section since they will not induce after a section.

*sigh* I'm hoping it's a blip on the radar and things stay stable for at least another 3 weeks or so, I don't want to have another early NICU baby, or another section. I've been checking my BP's at home over the weekend and they are pretty stable, 120's/low mid 80's.

and..... just for fun I started developing this rash on my belly friday that was mildly itchy. I thought it might be due to a soap I used (a lavender vegetable soap) but now it seems worse and is spreading to one breast. I suspect it may be PUPPPS as it typically occurs in the 35th week, starts on the belly, spreads rapidly and gets worse, and 70% of cases are those who are pregnant with boys. (like me) Apparently once it starts it only gets worse to the point that women are trying to claw off their own skin, and the only 'cure' is delivery, and even then some women have it for months after. Ugh. Really???? I've been washing with Grandpas Pine Tar Soap and slathering with A&D ointment after doing some research about it since there is no real effective treatments and most doctors prescribe steriods which I'd rather stay away from if at all possible.

Say a little prayer for us?

I'll try to update tomorrow when I get back.

Thanks!

UPDATE 5/23:

Had my NST today and baby looks great. My BP was also great at 117/73. All labs were normal... except for my platelets, which have dropped again. The MW called me this afternoon and said she lobbied with the doctors, saying everything else looks great it's just the platelets, but they are worried. They are going to recheck them on Friday and I go in for another NST too. If they drop below 100,000 (normal is 150K-400K and mine are currently 101K, down from 163K five weeks ago and 114K one week ago) The doctors are pushing to deliver me next week, and it would have to be by c-section since they can't induce a VBAC.

Could use some prayers mamas.... I'm scared of another early baby since DD was in the NICU at 36w6d, and I really don't want another section.

ETA: the rash is much better since I've been using this pine tar oil soap, I showed it to the MW and she said it was safe to use and keep using it so hopefully that isn't an issue any longer.

UPDATE 5/27:

So baby looked great on NST today, my BP was great at 118/74 and no protein in my urine. However, my other pre E labs, although still within normal limits (except for platelets) are trending up and my platelets have dropped 10K more since monday down to 91K. Tomorrow I go back for a repeat draw and depending on how the platelets look we could be delivering him as early as tomorrow, but if they are stable we may be able to buy some time until next week. Either way he will be here early, and my VBAC is no longer an option. In fact, if my platelets drop any more there may be an issue with me being able to have a spinal for the surgery and having to have general anesthesia (knocked out and intubated). I cannot stress enough how much I do NOT want to be asleep when my baby is born!!! (nor do I want the side effects of that to put my baby at risk.)

Could use all the positive thoughts and prayers you mamas have!

We will try to update tomorrow as we know more.
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Last edited by MamaRN; May 27th, 2011 at 03:32 PM.
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  #2  
May 22nd, 2011, 07:39 PM
geogeek's Avatar Marsi's Mommy
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You are in my prayers! I too hope it is a blip and you will be great for a few more weeks. I have never heard of that rash. I hope that gets better quickly!
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  #3  
May 22nd, 2011, 07:59 PM
Ashl3y
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Definitely praying for you!
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  #4  
May 22nd, 2011, 08:03 PM
NutMeg76's Avatar Platinum Supermommy
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Awww man that stinks!

I understand the concern about inducing after a c-section,but it can be done if they are gentle about it. There is recent research that shows labor augmented with pitocin during a VBAC is more likely to lead to rupture than induction with pitocin. They could also try something like the bulb to dilate your cervix, this is considered pretty safe in a VBAC momma. As a VBAC momma I would want a gentle pit or bulb catheter induction before I would consent to a RCS. Especially if they wanted baby to come early, the labor is so good for the baby and helping with breathing after birth, even if the end result is a surgical birth.
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  #5  
May 22nd, 2011, 08:44 PM
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Oh man, I will keep you and baby in my thoughts.
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  #6  
May 23rd, 2011, 07:52 AM
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Saying a prayer that all goes well and you don't have to deliver early or have another Csection. KUP!
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  #7  
May 23rd, 2011, 04:35 PM
MamaRN's Avatar Platinum Supermommy
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bump for update 5/23.
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  #8  
May 23rd, 2011, 05:22 PM
missy123's Avatar Platinum Supermommy
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((hugs)) You are going through so much.
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  #9  
May 23rd, 2011, 05:43 PM
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Lots of T&P for those platelets to get back up!!!! Everything else is looking so good, come one you silly platelets, get in the game guys. We want Baby RN to keep cookin'!!!

At least the pine tar soap is working. PUPPS on top of everything else would have been terribly unfortunate.
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  #10  
May 23rd, 2011, 07:38 PM
IAMommy's Avatar Platinum Supermommy
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Glad your net was good today...sounds like your drs are keepng a close eye on you and baby which is great.

I had pupps with Cecil's pregnancy...I delivered at 35 weeks and my rash started right after I delivered and lasted 7 weeks. It was all over my body and very uncomfortable. Cool showers really help....avoid the heat, it will make the rash worse. I basically sat around my house in my underware with the air conditioning on high and tried not to itch myself. I hope it clears up for you soon.
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  #11  
May 23rd, 2011, 08:06 PM
MamaRN's Avatar Platinum Supermommy
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Thanks ladies.

So after having some time to think about things and doing a little research (I didn't ask any questions when the MW called, I woke up from a nap to the phone ringing and spoke with her and barely registered what she said at the time) this is what I've learned:


It appears that thrombocytopenia (decreasing/low platelets) can by itself indicate HELLP syndrome, which is the worst of pre Eclampsia. It is the reason for low platelets in approx 21% of cases in which this is seen, and in 50% of those it presents as 'incomplete', meaning only 1 of the criteria for HELLP is there, 1 of which is the low platelets. Apparently your blood pressure can be within normal limits and you can have no protein in your urine, liver tests etc can look good and it can still be HELLP, which has an 11% fetal mortality rate and a 1% maternal mortality rate.

That scares me some... and if it were the case I would feel better having him out sooner rather than later.

I think the concern with watchful waiting (and I'm only speculating here because I haven't talked to the MW or the doctors about this) is the risk of it being HELLP and mortality rate associated with that, along with the trend of my platelets continuing to drop, and risk of bleeding that presents both with a vaginal delivery or a c-section increasing the more they drop. Platelets are pretty easy to transfuse which is the good news (a bag can go in in about 10-15 minutes) but they only have a lifespan of about 10 days.

So, I have a lot to talk to the MW's about on Friday when I go back, and we'll see what my counts are then.

Ugh, this is so scary. I wish I could just have a normal, drama free pregnancy.
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  #12  
May 23rd, 2011, 08:30 PM
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I am so sorry your platelets keep dropping. I hope they stop dropping. Prayers that either way all works out good and baby is born healthy and strong with a healthy momma. That mortality rate would worry me some.
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  #13  
May 24th, 2011, 08:34 AM
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I don't like those statistics either Mama. That sucks. Any whole-number-percentage mortality rates are not cool at all, and 11% fetal mortality rate is downright scary. I am sending tons of T&P for your platelets to magically up themselves so you don't go under that 100k threshold. But it definitely sounds like you should be prepared to do what's necessary for your safety and your baby's safety. I think you can take comfort in the fact that you are a very well-informed mama who understands the medical aspect of this - so if it does come to another early-ish c-section, you will know in your heart that you did what was right for you and your baby, given the circumstances.

I *really* hope your platelets get back somehow and you don't have HELLP syndrome and you get your midwife VBAC though!!! KUP hun...
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  #14  
May 24th, 2011, 11:08 AM
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That really stinks! I hope that the numbers improve by your next blood draw!
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  #15  
May 27th, 2011, 03:32 PM
MamaRN's Avatar Platinum Supermommy
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bump for update 5/27.
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  #16  
May 27th, 2011, 03:51 PM
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hun, and lots of T&P... I hope things magically turn around for you at your repeat draw tomorrow... but either way, whatever happens will be all for keeping you and BabyRN safe and healthy - you will be holding your baby in the end!!!!
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  #17  
May 27th, 2011, 04:46 PM
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  #18  
May 27th, 2011, 06:05 PM
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I hope that things turn around for you!!
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  #19  
May 27th, 2011, 07:25 PM
JessP's Avatar Lovin life and family
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Continued prayers that he arrives safely.
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  #20  
May 27th, 2011, 08:42 PM
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huge huge (((((((((((((((hugs))))))))))))))))))) Having done the nicu thing - I so so understand why you want to avoid it. Can the give you a steroid shot before the c-section for his lungs? Can you talk to them about a 'natural' section - where they let you see the baby come out and put him on you ASAP - as soon as he's out?
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