Early induction due to placental calcification(3 Posts)
I would be so grateful for your advice and opinions. I have recently had a scan at 32 weeks, which identified a) that the baby is very large (head on 95th centile, abdomen well above 95th centile), and b) that my placenta has some signs of calcification.
I was tested for GD last week, but don?t have that, so it seems the big baby is just a big baby because he?s a big baby! I'm assuming that in itself isn?t a cause for concern or a reason for taking action - or at least that's what everything I've read seems to suggest.
However, I understand that calcification is a sign that the placenta is starting to wear out, that usually this doesn?t begin to happen until at or close to full term, and that it is the main reason why people who go overdue are induced, as otherwise there is a risk of stillbirth. So a pretty serious issue.
We had an appointment with a doctor (a registrar, not the consultant) to discuss last week. The plan is to scan me again on Thursday (at 34+0), to re-assess the state of the placenta and the baby?s growth. (Unfortunately the sonographer didn?t note the degree of calcification ? there?s a grading system ? so we don?t have a benchmark to measure against). The doc said that I will then be induced somewhere between 36 and 38 weeks, but that he was almost certain I won?t be able to go over 38 weeks. Obviously my planned hypno waterbirth is completely off the table . And I should probably finish work before my planned end date of 36+1!
My concern about being induced as early as 36 weeks is that I feel that it is likely to fail, because it?s so early, because he is less likely to be well engaged at that stage (especially with him being so big), and because this is my first pregnancy. I can just imagine several days of pain and discomfort and exhaustion, ending in escalating interventions and an emergency CS. I would feel more comfortable with the chances of successful induction at 38 weeks, but of course I have no say in when it happens, it depends on how long my placenta remains viable.
Would it be unreasonable to say that I will go along with the planned induction if I get as far as 38 weeks, but that I would prefer an elective CS if they need to get the baby out at 36 weeks? It just feels as though that would be less traumatic for both of us (although I'm aware the baby may have some respiratory issues as a result of not being squeezed through the birth canal). I got the impression at the last appointment that I would have to battle for a CS at any stage. I don?t know what I would want to do at 37 weeks!
Or perhaps my assumption that induction is significantly more likely to fail at 36 weeks is completely flawed? Perhaps there?s no difference between the choices to be made at 36 and 38 weeks? In which case, please educate me!
Any ideas about what I should ask the doc (hopefully consultant this time) on Thursday would be really helpful. Sorry this is so long!
I don't think that would be unreasonable at all, to request ELCS instead of an induction which would possibly fail - the further along you are the more likely it is to work, but even at term you're not guaranteed that induction would work or be straightforward.
If they think there is a chance that the placenta is calcifying and therefore failing, then I'd want them to get baby out ASAP rather than going down the induction route which could take days to get going.
I was induced at 36 weeks and it didn't fail; got going really quickly and I was well on the way to pushing him out when they decided on an emergency caesarian due to concerns over his health. But it wasn't a nasty panicky caesarian: it was all still very relaxed and I was able to have skin to skin and breastfeed.
Have also been induced at 37 weeks and again got going really quickly- that time I had a vaginal birth.
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