ELCS at 37 weeks(26 Posts)
Was told Thursday that I have to have a section with my baby, in fairness I was expecting this as she was measuring 90th centile and I had to have a section with my first, (a little gutted as i was going to try vbac but after dd1s death i just want dd2 out safe) but because she has had a sudden growth spurt and is about 94th centile now they want her out quick. I also have had diet managed gestational diabetes after failing my gtt by a tiny margin (in most areas I would not be considered diabetic) but they are concerned this has added to her growth. They aren't willing to risk me going into labour and her getting stuck (I live hours from hospital). I have also developed low blood pressure and my heart rate has been raised along with pgp, and hyperemesis causing dehydration so they think my body is simply not able to support her growth rate for much longer. My blood sugars have also been coming back slightly low.
I spent this last few days in hospital have preop bloods, iv fluids, and steroids to ensure her lungs are fully formed, now I have a day or two at home before going back in to have her.
I'm terrified and excited and I can't wait to meet her but I'm concerned about her lungs at 37 weeks.
Has anyone else had to have a section at this stage? Any advice on things I can do to help her when she's born? I'm already freezing breast milk (producing about 5ml every few hours) incase my milk doesn't fully come in straight away so she has something as a back up, would like to avoid formula but if she needs it she will have it, while I would prefer to bf fed is best.
Thankyou for reading my rambling and in advance thankyou for any advice!
Ds was born by elcs at 34+5 and has breastfed for 2 years+ after two formula bottles given by DH while I was still in theatre after his delivery. I had steroid injections and he did not go to SCBU. Several other ladies in antenatal ward at same time as me had elcs at 35-37 weeks and all breastfed fine, their babies did not go to SCBU either.
Thankyou stitch, I know I shouldn't be panicking and I'm trying not to but I don't know anyone who's ever been in this position. Its so nice to be able to hear positive stories!
I guess after everything with dd1 I'm terrified of her leaving my side even if it's just for the scbu, dd went there, then was moved to picu and never came back. Just want her with me (irrational I know and if they have to take her there I wont try to stop them)
It is totally understandable after your loss that you would be worried. It is not irrational and I hope your midwife team are offering you extra support with preparing for your elcs.
It sounds as if 37 weeks is a sensible well-thought out delivery time based on your health and dd2's size. Safer for you and dd2.
I didn't want to have ds at 34+5, but it was safer than the original plan of 37 weeks in our case.
Even after a csection as soon as you can mobilise you can be put in a wheelchair and be taken to dd2 IF she has to go to SCBU.
Thankyou my midwife team have sort of washed their hands of me as I'm under consultant led care which is disappointing but the hospital are lovely. Just getting a little frustrated as they were supposed to call this morning to confirm my section date and when I called them at 1pm they still weren't 100% sure on which day this week.
I'm trying to follow their advice, if its the safer option I'm all for it. As long as she is born safe and well I don't mind how/when.
Thankyou for your support I really appreciate it
A friend had dc2 by elcs at 37w due to previous unexplained stillbirth. All fine and she was home the next day.
I recently had dc2 at 36 weeks (vaginal delivery, medically indicated induction). She had steroids first and was also fine.
Also my DD was able to BF straightaway after delivery. If your blood sugars are a bit low there is a better chance she won't need top ups. Does your consultant know about your low sugars? Can be a sign of placental problems in type 1 diabetes, not sure about gestational as presumably you are not on insulin?
I failed my GTT because of a high blood sugar reading (such a tiny margin my doctor was surprised it counted as a fail). They have said she might need top ups because of her sheer size caused by her sudden growth.
They have said the blood flow and everything to my placenta is brilliant, I hadn't thought anything wrong there because of how active she is and how much she gas grown. What sort of placental problems could this be a sign of so I can bring it up?
Sorry no I'm not on insulin, and my diabetes has been diet controlled for the whole pregnancy
I pushed for my c section (#3) at 37 weeks and they were really reluctant to do it. I ended up having one at 37+1 but had to have the steroid injections just as you have done. DC3 was a 9lb baby, which I'd anticipated. I was enormous (and only 5ft), in a lot of pain and just wanted the baby out! No GD, although pg#2 I was just over the limits, despite having no high results during the subsequent monitoring, so I had previous history.
No issues at all with the placenta, although there were a lot of previous adhesions which made it quite a lengthy op and it was touch and go as to whether I'd need a transfusion (probably should have agreed to one, but am a blood donor and wanted to avoid it).
Only difference with this one was that I had a far hungrier baby and found it more difficult to establish bf.
They've told me my date and I will be 37+4, in fairness I've been in a lot of pain pgp and other complications so I'm looking forward to her being born because I'm struggling with being pregnant but I didn't want to hurt her accepting what they said.
My gtt score was high but they've never had a high result since yet I'm still down as having gd? I'm wondering if this is an accurate diagnosis soon as all my other monitorings have been normal.
I don't have any adhesions showing on any scans and my placenta is at the top and back nowhere near my scar but I have said I will accept blood if I need it as I just want to be with my daughter
Did you find anything helped when you were trying to establish feeding as I had heard it could be more difficult? Open to any hints and tips! Expecting a big hungry baby myself if I'm lucky!
For me low blood sugar was a sign of the beginnings of placental failure as it showed the placenta wasn't requiring as much insulin. I think this would only apply to people taking insulin so doubt it is relevant for you, but always worth asking if blood sugar changes could signal a change in placental function.
Good you have your date!
My first born was 37+2 days SVB and was absolutely fine, I had no steroids as was already 4cm dialated when I went to hospital and he never had any breathing problems. My 3rd baby I had GD was on metformin at 30 weeks and she was massive! Nearly 10lb at 38 weeks I had a scan at 37 weeks was told she would be 7lb max! She had low blood sugar at birth and they kept trying to give her so much formula after breast feeding that she was just being sick all the time. She ended up in scbu with a feeding tube so they could feed her formula every hour as he sugars were getting lower but at least that made breast feeding easier as she wasn't getting a bottle which can interfere with establishing feeding. After 24 hrs her sugars were fine and feeding breast only every 2 hrs and maintaining her sugars. Try not to worry too much as 37 weeks in considered to be term now x
My dc2 was born at 34 weeks ( vaginally) and I had GD too but in hindsight they realised it was prob steroids that pushed my numbers up < and possibly the ice cream > - he was in scbu but is a happy thing now!
My dc3 was an Emcs at 35 weeks and she came out noisy and lungs all good
Gruffalo I will phone my consultant in the am and just query this with her. She's lovely and always says to ask anything I want. Better safe than sorry so thankyou for telling me!
Happymum it's her blood sugars being low they are worried about hence why I have started expressing already, hopefully I'll have something they can top her up with aswell as formula if she needs it.
Imnotaceleb thankyou for the positive stories always good to hear when things went right, helps me calm down. I wonder if the dose of steroid in my inhaler I have to take twice a day could have messed with my reading or if its the wrong type of steroid? I hadn't even remembered that steroids could affect sugar levels.
I'm booked in for my section 7am Thursday morning! No backing out now, I'm nervous but excited.
Not long now until you meet her!
The main thing that helped me with supply and feeding in the early days was lots of skin to skin and good quality snacks. Hospital tea and toast doesn't sustain you for long. Oats are good for lactation. I kept cereal bars, smoothies and glasses of water on hand. I was also producing milk colostrum prior to delivery which meant I could encourage ds to latch from him tasting drops on the nipple when offered. The expressed top ups are a great idea too in case you need them. I couldn't express large quantities before delivery due to risk of me going into labour with praevia, but even after 2 formula bottles ds had no issues latching on and feeding.
I'm so sorry to hear of your loss . There are no words.
My DD was born at 37+5, due to slow down in growth, and several episodes of reduced movement. I could have had steroids if I had wished, but declined when I was informed just how low the risk of breathing problems actually were at that stage, and knowing how potent steroids are. DD was absolutely fine, no breathing problems at all, in fact she had an apgar score of 9!
Good luck for Thursday!
Dd and ds were both induced at just turned 38 weeks. Ds needed some top-ups because of low blood sugar (and the consultant insisted it had to be formula from a bottle not my pre-expressed colostrum) but despite that he picked up bfing well and I was able to stop the top ups on day two.
So sorry to hear of your loss.
DD2 was born naturally at 36+6. She was smallish (6lb 13) but totally fine. No steroids - no time due to fast birth, I believe they don't recommend them after 35/36 weeks anyway. No breathing issues, no jaundice, fed straight away. Great apgars. Pretty normal newborn in other words.
Very very different to DD1 at 34+0. It's amazing how much difference three weeks makes.
It took us 2 days to get her home because I also had GD (though like you totally diet controlled) so they had to do regular blood tests on her. She failed one of them so we were in for another day, sigh. My advice is to top up after BFs with some of your colostrum in a syringe to keep her blood sugars up for the first few days. Sounds like you are already expressing so will have something available for her which is fab.
the consultant insisted it had to be formula from a bottle not my pre-expressed colostrum Why???
I'm so sorry for your loss.
Dd was born at 38+2 by c section. I didn't have steroids beforehand but she had no breathing problems. Best of luck.
Oh, and she's always been exclusively breastfed. (She's 5 months now.)
mini good question and I didn't get a proper answer to it. I think it was because he wanted me to give a specific amount and wasn't sure how much colostrum would be needed to substitute (and he didn't care about the impact it would have on breastfeeding). He wanted me to give the bottle instead of cup feeding because that way we could be sure of it all going in. I was incredibly pissed off at the time, but was told the alternative was a glucose drip in SCBU. He was only very mildly hypoglycaemic and showing no symptoms so I think they were being unnecessarily heavy handed but I didn't want to risk it.
After about 12hrs they moved me to the postnatal ward and the midwives there were much kinder and showed me how to cup feed and got him a "hot cot" so he didn't waste any energy trying to keep warm. After that he got his three normal readings and we went home.
Jeez. Ah well, not the end of the world but hope that consultant has been re-educated since. (To be fair I only thought of the syringe alternative because of my previous experience with prem DD1.)
The top ups they wanted me to give would have taken ages by syringe. I was a bfing peer supporter at the time so the whole thing made me because of the whole "babies stomach is the size of a walnut" stuff if learnt in training. The suspicious part of me thinks that the midwife messed up my glucose/insulin slide in labour (my sugars immediately after birth were 24!) and wanted the consequence of her mistake solved as quickly as possible.
I think they prefer formula top ups because the milk has everything added to it baby would need to stabilise blood sugars where as colostrum hasn't. That is what the consultant in scbu told me with my DD. It all depends on how low babies blood sugar is though. Normal is around 4 but 3 is acceptable anything lower than 2.8 can be very dangerous in a new born baby. My little one needed 90mls of formula milk top up every three hours as she was unable to maintain her blood sugars. In the end the were feeding her 30mls every hour through a feeding tube and she threw most of it back up! She was never sick after Bfeeding because the amounts were so much smaller. Once her sugars were ok no formula was needed and she was fine but my milk had come in at that point so that might be why.
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