loads of concerns and they won't talk induction

[CakeandFineWine]

Hi all

I haven't posted in ages but here goes.

I'm currently 36+4 weeks with DD2(which incidently is when they induced me with DD1)

I'm in hospital daily due to:
Small bump & baby
Low fluid
Reduced movements
Protein in urine
borderline BP

Having daily CTG's, twice weekly scan (doppler and liquor) and reglar growth scans so they are obviously concerns.
My consultant has been on hols for last week and this and was told yest she not back next week either

I said yest I'd rather be induced and know she's ok than continue with risky pregnancy which midwives supported but Dr's poopooed as this pregnancy is not yet risky enough but will be assessed daily......I'm soooo frustrated!!

Any advice out there????

Is there another consultant you can see?

if your baby is on the small side they won't want to induce before 37 weeks in case of respiratory/temperature control problems in the baby unless they think its absolutely necessary. I understand where you are coming from though - in your shoes I would want the baby out pronto too. Demand an appointment with a consultant to talk through the pros and cons of inducing now/leaving baby in a few more days. good luck.

Thanks both,
Didn't mention I had severe sudden onset pre-eclampsia last pregnancy hence sudden induction but was v.poorly and required beta blockers and monitoring for 3 months following labour.
I briefly saw another consultant yesterday who said she didnt't have any concerns (but didn't actually read my notes!)
Back in tomorrow for full assesment with scans etc........

Good luck for tomorrow, hope everything goes well for you. Try not to worry, if you do have any concerns make sure you let them know..

your chance of pre-eclampsia in a second pregnancy if you had it in your first is actually only 1 in 10 - its much more common with first babies.
If a consultant tells you she has no concerns ask if her she has actually read your notes - don't let her fob you off.

thanks my actual consultant (the one on hol) reassures me of the stats,
however she commented 2 weeks ago before going away that i def had some signs and as my protein in urine has gone from trace - +1 and now is +2 and bp continues to rise it's not looking so good......

Induction at this stage isn't without risk either. I think the best plan for both of you is the very close monitoring you are getting. Your baby could do with extra cooking time if at all possible. Appreciate it's very worrying for you though.

I know there's risks still,
But I'm 37 weeks on Sunday so technically term, I don't understand why they won't make plans for next week if all is well til then ?

I would insist on talking to another consultant if I were you, was it a registrar you saw before? I think at the very least you need a full explanation as to why they don't want to induce, if your PE came on quickly before there is obviously a risk the same could happen again.

Hope it works out OK for you.

Okay - this is what DH (doctor) suggests.

Talk to another consultant/registrar tomorrow. Ask them to explain, with reference to your individual situation, what they think. If they do not want to induce within a time window that you feel comfortable with (after hearing their rationale), ask them to document their opinion in writing and in detail. Specifically, ask them to write down exactly why it is safer for them not to induce at this point i.e. risks and benefits of this strategy. Ask them to sign it and record their GMC number at the bottom. If you end up talking to a registrar, ask for their consultant's signature etc. on the letter too. Explain you would like a copy of this asap. Then request a second opinion, and do the same re: writing and GMC number if second doctor says no too.

If they still aren't convincing you, ask for daily CTG monitoring and more regular biophysical profiles (I assume that this is being done along with the doppler measurement of umbilical arterial flow? What ratios have been recorded in your notes - assume you're not seeing reverse flow?)

(DOI: had IUGR first baby and convinced them to induce at 38 weeks by rather similar strategy as suggested above. Looking at state of baby and placenta when she arrived, v v v glad that we pushed it to the extent of making ourselves hideously unpopular with the staff.)

Meant to mention, strategy above basically designed to i) stop doctors fobbing you off ii) get them to seriously explain their risk / benefit reasoning iii) encourage them to contemplate whether they could defend their actions and whether they're willing to stake their GMC registration on it. If they still refuse to talk induction, you can at least be very very certain that they have thought through their actions.

Oops, just noticed that you're already having daily CTGs. Sorry, should read more carefully.

wow thanks frozenNorth thats really helpful,
Me & DH are health professionals ourselves yet this is all so stressful and ovewhelming its difficult to think rationally and practically....

They just keep saying "oh you have small babies!" DD1 was 4lb4 they are currently predicting this one at 4lb9 but its def gone below 10th centile....

Ugh, I hate the 'small babies' line. DD1 was 5lb 1oz at 38 weeks when she was induced. I hope that today goes okay - please update us if / when you can.

Hi all, been to hospital
Waste of time...... Liquor now reduced to 2.5? But they were happy with CTG, BP and urine, didn't actually see a doctor but was apparently reviewed by one
Been told to ring up over weekend if I'm concerned about movements so asked the (rather unhelpful) MW whether I should be concerns as I'm only having around 4ish movements a day to the response "hmmm" with a shoulder shrug!!

Think I'll ring delivery and go in on Sunday as I'll be 37 weeks then as there is no other plans until Tuesday otherwise!!

God I'm fed up and sick of all this

Hm, I really don't understand why they're not more concerned about you. Do you have a home doppler? I ask only because it helped me stay sane whilst waiting to be induced. Will you get to see a consultant on Tuesday? If not I think I'd make a massive fuss til I did see one, and then get them to put their rationale in writing etc. I'm sorry they're being so crap. How was the biophysical profile / cord doppler?

Hi frozen, yep have home Doppler using it alot thiS week hardly used it til now! They said cord Doppler was ok no figures or anything in my green notes but my liqur is now 2.8?
Will see a dr on tues doubtful it'll be consultant think she's off another wk prob spec reg?
Movements are almost non- existant I'm 37 weeks tomorrow so going to ring labour ward n go in for CTG?!?!?