worried about pre-eclampsia pregnancy NHS treatment

[reaktor24]

Hi. My gf and I are currently in hospital maternity ward. She has a number of ailments. She has pre-eclampsia with protein and high bp. She has a dodgy kidney which is hurting her due to the pre-eclampsia. She is also diabetic which occurred during the pregnancy. On top of all that she has a cold. We were told on our last scan at 36 weeks that she was high risk and the situation was/is an emergency. That was last Tuesday and she has been in hospital since Wednesday. She has been given an insertion twice to induce the baby as well as membrane sweep which she said she didn't want. She wants a cesarean but is told no. What can we do?? She doesn't want ARM either due to the risks involved. The staff are not being helpful and are giving us no choice about the treatments. You will have this for so many days and then we will break your waters. This is bloody ridiculous so what are our rights? Can we demand a cesarian?

[DolomitesDonkey]

Are they doing scans to check that the placenta is still delivering enough oxygen to the baby? PE causes the placenta to break down and there is a risk the baby can get very, very ill. With a diagnosis of PE and a decision to induce at 36 weeks I don't really understand why they're happy to go with a 72+ hour induction/labour. Either it is, or it is NOT an emergency - but the fact they reckon the baby would be safer OUT at 36 weeks is somewhat indicative of the fact it is in fact an emergency. I'd be pushing to find out why the delay in getting the baby safely out.

Has she had magnesium?

[SchroSawMargeryDaw]

You could refuse any more induction attempts or treatment until they agree to the CS, you could also say that you will be discharging her and that you will put it in writing that it is because she does not want the induction and has been refused the cs.

This could be risky though but just saying it might change their mind.

[reaktor24]

Is it true that we have to request in writing to see her notes? That's what we have been told. Something very fishy is going on here.

[GlaikitHasHerFizzBack]

The request in writing would be under the DPA, but as she is currently in hospital I don't think that is right. I wrote to get a copy of my notes after ds was born so I could read them before my debrief and it took an age to get them, but if they are there on the ward I cannot see what the issue is. I really urge you to contact pals. They will know the correct procedures.

Are their notes on the end of the bed?

[HPsauceonbaconbuttiesmmm]

I really wouldn't be scared of an ARM. if it works, great you'll be in labour, if not, at least you'll have tried. Risks are very low and certainly substantially lower than a cs.
I'm glad you got to speak to the consultant quickly and you feel reassured. Continue to insist on full explanations and risk vs benefit discussion.

This is the NICE guidance or induction. It is guidance rather than what must be done, but it may help you to feel more informed. So long as your partners health is stable then what they are recommending is reasonable, but as pointed out above, why are they inducing now? And if so urgent, why not put a time limit on?

Fwiw, I'd agree to ARM tomorrow but only with a back up that if its not possible then you go for cs rather than another day of attempted induction.

[HPsauceonbaconbuttiesmmm]

And yes, contact pals. They are independent and there to help.

[reaktor24]

Her blood pressure and babies heart rate are being monitored every four hours. We have had no scans for a deteriorating placenta and she has not had any magnesium or any tablets apart from her blood pressure and diabetes. The baby seems to be getting more and more sleepy. When it wakes up it is straight back to sleep. Something doesn't seem right. The babies heart rate seems to be around 120 - 135. Now I see why they are considering closing this maternity unit. It's bloody useless!

[midori1999]

Your partner would usually carry her notes with her, as every pregnant woman in the UK does. When I've been on hospital these have usually been kept at the end of the bed, unless a midwife or consultant had had to take them off for some reason. (to show another staff member, for example)

I wonder if one of the reasons they have tried induction is due to the risk of steroids if you have diabetes of any sort? Have they given steroids? Have they mentioned them.

The clearest thing here is that no one seems to be explaining anything to you properly and they need to do so. I think you need to ask to see the consultant again and ask why they are going down the route of induction if they deem it an emergency and what he/she feels the risk of ARM are and at what stage they will do a c section anyway. However, ARM is pretty routine in induction and they do it because the benefits outweigh the risks.

[midori1999]

And just to add, once they had carry out ARM then they would have a time limit before a section.

[SchroSawMargeryDaw]

Midori, that isn't your full notes, just a short copy. I think the OP wants to see the long hospital version that is fully detailed.

[LazyMonkeyButler]

What has the midwife or Consultant said about the baby seeming more sleepy? I honestly can't remember if that's normal or not, it may be.

I completely agree with midori1999, you need thorough clear explanations of what is happening now, why and what might happen.

[HPsauceonbaconbuttiesmmm]

Notes are no longer kept at the end of the bed in hospital as its a confidentiality risk. Anyone could pick them up.

You could ask again to informally have your notes explained, or state that the request will come from your solicitor. But no, they don't have to show you them without written request, and then only within 21 days.

Is there another maternity unit nearby you'd consider transferring to?

[LazyMonkeyButler]

The heart rate sounds OK though BTW, so long as it is strong & steady.

[SchroSawMargeryDaw]

RE: baby being more sleepy than usual. I had a scan because of this but with me DS literally would sleep constantly so I don't know how sleepy they would have to get before a scan is done, I was monitored a lot for a while before they did this.

"Is there another maternity unit nearby you'd consider transferring to?" That is a really good idea.

[reaktor24]

Hi. Thanks for your help. She has had her third induction and had gas as well. She said it was the worst one and was in extreme agony during the process and in floods of tears afterwards. She felt embarrassed that everyone in the ward was listening. She says she doesn't feel she can cope with another one and it looks like we don't have much choice with regard to ARM. We did have a good chat with the consultant and he did basically say he though it was in the best interests of both mother and baby as the baby seems quite happy during the monitoring. We weren't told if the cervix has actually been dilating though.

[SpottyTeacakes]

They won't be able to do the arm if the cervix hasn't dilated. What method of induction did they use this time? Did they do a sweep? The fact that she was in pain sounds like they might have but that would mean she's dilated a bit which is a good sign I'm glad the consultant came and had a chat with you.

Sorry she felt embarrassed being on the ward, I spent most of my labour on the ward (being sick, wet myself , breathing loudly through contractions all without pain relief) unfortunately more often than not they're just too busy to give everyone a private room. Hopefully her labour will get underway soon and as she's now considered term there's also less risk to the baby.

[reaktor24]

Hi. Just updating everyone. The third induction failed. They examined her today and said it would be impossible to perform an ARM. Her body just isn't responding. We are going to have a cesarean tonight. Finally! Her blood pressure is too high and she has poor urine results so they have agreed that a cesarian is the best course of action now.

[SpottyTeacakes]

I know you're probably thinking 'why didn't they just do this in the first place?!' But try to think of it that your baby has been in the best place (mum's tummy) for even longer. Let us know when baby is born!

[GlaikitHasHerFizzBack]

Well finally common sense has prevailed. I'm just sorry you have both had to go through all this before getting to CS.

Please give you GF my best wishes. And do let her know that mumsnet is here if she need anything later. Even if it is just to make sense of everything g that has happend.

Good luck and in a few hours you'll be a dad! :o

[reaktor24]

Hi. Thank you very much for all the advice. I will let you all know once little baby is out.

[gallicgirl]

Please talk to PALS after this is all over. Your partner will probably find it beneficial and hopefully it will trigger the realisation that there is a communication problem.

Good luck with the cs. Pop back and let us know the outcome. It won't be long before you're cuddling your baby.

[Liskey]

Good luck and hope you both meet your baby soon.

I had pre-eclampsia and got induced at 36 weeks (sweep was the worst, absolute agony!) Dd was born via emergency c-section as she got distressed and oxygen deprived. I reviewed my notes 6 months later with a senior midwife (via PALS) and it really helped me - really helped me recover from the traumatic birth.

[reaktor24]

Yes she hated the membrane sweep which she made sure they didn't do again. Just updating to say mother and baby are doing absolutely fine. He was born last night by cesarian and weighs around five and half pound. Scored an impressive 9/10 on his test thing. I forgot what thats called. He is as cute as button. I just want to say thank you very much for all your help and support. It really was a godsend during a very traumatic weekend for both me and the gf. We will get in touch with PALS and review the notes. Thanks again. :)

[SpottyTeacakes]

Congratulations

[Heathbaby]

Congratulations!!!