To ask for my baby to be delivered at 33 weeks?(128 Posts)
I'm a type 1 diabetic and I'm 32+5 weeks pregnant.
Over the last four days my insulin requirements have fallen by 50%. This is absolutely not the norm. Usually the hormones kicked out by the placenta inhibit insulin and levels increase - which they had done until last Friday.
I've had a scan and baby has grown and apparently blood flow to and from the baby was normal. This means that the consultants are saying that there's probably no imminent danger and that they will keep monitoring me.
However I am extremely concerned that this rapid drop in insulin requirements means the placenta is going to stop doing its job in the very near future. I am not happy to wait any longer than it will take for me to have the steroids for the baby's lungs to be honest. I want her delivered. No one can give me any other suggestions as to why this fall in insulin levels has happened. I am now taking the same amount of insulin as I was before I got pregnant. If I did not have an insulin pump I would be having some fairly severe hypos by this point.
Personally I cannot see what other reason there could be for this - despite what the scan showed - and I'm not sure how much time I have to be honest.
I'm going back to the hospital this afternoon and I'm going to push for them to deliver her. What's the chances they'll agree?!
At 33 weeks I would say likely slim as there are still quite a lot of risks. I have no practical advice but wanted to send my best. Hope everything is ok and your baby is here safely when best
I have absolutely no experience but you sound very much like you know what you are talking about.
I know docs are very reluctant to induce before term but if you have signs that your placenta may be crapping out then I'd definitely push for early induction. Better to have a 33 week premature baby than no baby (sorry if that sounds bling but it seems like that's the choice)
If I were you I'd really push unless they give you a very viable alternative
Zero. 33 weeks is really quite premature and involves lots of risks. You need to trust the Drs that they are happy that currently the safest place for your baby is in utero.
But there aren't any signs that the placenta is failing. From what the OP says they've done Doppler measurements of blood flow In the placenta and it's normal. If you had raised dopplers or problems with the blood flow then they would want to induce.
Exactly this happened with me with my dd3. I had GD though and had been on insulin since 12 weeks. My levels dropped off and I was having lower blood sugar readings AFTER eating than before. My consultants were so worried that they decided to induce me at 33 weeks.
I had a stillbirth at term before her, which they thought was undiagnosed GD although I went to a different hospital with dd3. They took it very seriously and I'd already had steroids so were happy that I'd gone far enough.
The inducement was quick as was the birth. She was 6lbs! I had no indications for GD other than pcos which constantly surprised them. She stayed in nicu for 2 weeks before being allowed home. All went well and she's now almost 4
I wish you well and I hope they listen. Things can change so quickly. I also had dd4 2 years ago, I got GD again and was on insulin from 9 weeks. I had her by c section at 37 weeks. They decided that she had to come out and didn't want to wait any longer.
Zero. 33 weeks is premature. You should see your consultant but they won't indice your baby yet
33 weeks would quite possibly be dangerous for your baby, so I doubt this request would be honoured unless your doctor thinks its necessary. As you're a type 1 diabetic I'm sure you're being closely monitored, but its a balancing act between keeping you healthy and maximising your chances of giving birth to a healthy baby. A baby is considered full-term at (I think) 37 weeks, so if you can hold on until then I'm sure your request would be more likely to be granted. At this stage I'd think its far more likely that you'd be admitted for observation or for you to be much more closely monitored.
Would they admit you for monitoring instead? Or ask for frequent doppler scans? I had scans every other day from 32 weeks for a different reason.
Oh and I had scans showing no signs of placental issues too, lots of them. They didn't think that meant there was nothing wrong though. I also had a scan a couple of days before losing my daughter, that didn't pick anything up either...
You would be better off asking for a daily scan/ monitoring to check the placenta. My ds was born at 35+0, and he was still pretty unwell when he was born and spent a week in SCBU.
I think it's more likely they'll give you more regular monitoring than deliver... Sorry.
I had gestational diabetes and delivered at 32 plus 5, couple of days NICU and she was fine - home at 35 weeks and would have been released a week earlier had my health been OK (another matter).
I would let them monitor you - see if they will give you the injections to help lungs etc, but at the end of the day they have more medical knowledge than you. You might want to research a bit then present them and ask them for their thoughts on what you find - but be aware this will annoy them intensely as you are questioning their professionalism. Make sure you speak to your consultant not registrars etc - I found that really with diabetes they don't have a lot of experience. The irony for me was that while I was in labour my team changed several times as they were off doing training on a new diabetes protocol - they still got it wrong
How often will they scan to check the placenta? Is there another specialist you can talk to and try to establish if there could be another reason why you need less insullin? It's not the same but DS has T1 and three years in I'm always amazed at how little some professionals know and that those who do don't always think to pass their knowledge on.
What a worrying time for you - hopefully there is an answer out there that will help.
I think I'd be pushing either to be admitted and monitored frequently for however long it took - 4 weeks to 37. Or id be asking for daily monitoring. 33 weeks is so early, I know there's lots of positive stories out there but the reality could be very very different
I don't think that asking will annoy the doctors. Doctors realised that people are worried.
I lost a baby at 34 weeks due to placental failure. I'd had the usual scans including one about a week before when I'd had reduced movement. I was told afterwards to pick up the problem, I would have needed frequent blood flow scans and daily fetal monitoring.
I think they would deliver from 34 weeks.
I feel it is very dangerous for her to stay where she is. The diabetes consultant could offer no other suggestion as to why this would happen and scans only show what is happening in that moment. I am fairly convinced there is a problem as a drop from 45 units and day to 20 units a day in less than a week is huge. I would probably have collapsed from being hypo were I not on a pump.
The midwives know very very little about diabetes. They keep referring me to the diabetes team for pump management. I do not need pump management, I need to know why this is happening. I am not happy to sit back and 'wait and see.'
I think a baby at 32 weeks has a pretty good chance, she weighs around 5lbs already and if I had the steroids for her lungs hopefully that would help.
I need them to take this issue very very seriously.
They're talking about weekly scans and I don't think that's enough.
This sudden change is linked to some hormonal issue. It has to be.
If your on insulin you will be offered an induction at 38 weeks, if your baby is large then maybe 37 week.
I was on insulin with GD after diet control and it was honesty like a roller coaster effect and actually had to come off insulin before I was induced from my BS dropping very low after eating. So I knew the insulin was too much.
Not sure exactly of the logistics with type 1, but I would say if they aren't any concerns professionally then no you aren't going to be induced at 33weeks.
GD is different in that it is caused by insulin resistence rather than the fact you don't make insulin.
Type 1 is linked to placental failure.
If things are changing fast, I think you must go with your instincts.
34 wks if fine, if they are better out than in.
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