Please or to access all these features

Add post

Watch this thread

Save thread

Start a new thread

Flip thread

Hide thread

My feed

Active Unanswered threads

Getting started FAQ's

Unanswered threads Acronyms Talk guidelines

Hide shortcut buttons

Talk

Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Flip

1 2 3

Original poster

Consultant wants to take baby out now (32 weeks), I disagree, 2md opinion question.

64 replies

EBenes · 08/10/2008 12:46

A few weeks ago I was told I had low but within normal limits amniotic fluid and low abdominal circumference (just below 3rd centile) and they wanted to monitor both but were chiefly worried about the latter.

Today, my baby is 13th centile AC, and my amniotic fluid has fallen since last week, so is now very low. My consultant thinks it may be time to take the baby out. But he didn't even talk to me about the AC, I had to ask. Doppler, heart and movements are all normal.

My first baby was quite small (5.5lbs at 38 weeks) and I was monitored constantly for amniotic fluids (always low) and size, but they let her go to 38 weeks, which was considered full term, and only scheduled her then because it suited the consultant.

I feel like this is a retread of that pregnancy. My baby has grown tons in the last 2 weeks, they're no longer looking at her growth the same way, the amniotic fluid has been literally within normal limits, though worth monitoring, before today, and everything else seems normal. I feel like they're going to risk her life over one scan. But because the consultant is going on holiday next week, he's doing the follow up scan in just 2 days, which I don't think is enough to see a change with. I'm just terrified and broken-hearted. I don't doubt that he's doing what he thinks is right and that he has great reasons for this, but I think another doctor would take the course I had with my first baby, who is perfect.

I only have two days now, I was told to bring an overnight bag. I don't know how to get another opinion, and am scared that if I do, my consultant will be insulted and angry. I just want to be sure, it's my baby, I am pregnant therefore I am slightly crazy.

Has anyone sought a second opinion? Has anyone had a premature birth because of low amniotic fluid? I wish I knew what to do.

OP posts:

Are your children’s vaccines up to date?

Set a reminder

mogwai · 08/10/2008 20:39

Personally I'd go with what the consultant says, which may not be what you want to hear.

I'm married to one. They know much more than I do about these things and I trust their opinion more than (a) my own or (b) the opinions of other mums on mumsnet.

I'm genuinely sorry if that's not what you want to hear but I've heard one too many stories of mums who don't take the medical advice they are being offered. It's hard when you're pregnant to make rational choices, particularly if things aren't going smoothly. At least your consultant is acting (sanely!) in your best interests!

I can't believe anyone would think a consultant would want to "tidy things up before he goes on holiday". It never ceases to amaze me what thoughts/attitudes/deeds doctors (and especially consultants) are attributed. I always think it's funny how people slag the consultants off when the consultant is the first person they want on the job if it all hits the fan (and midwives are the worst for this).

Aitch · 08/10/2008 20:49

i LOOOOOOVE my consultant mogwai. him and his enormous brain. although the sod was on holiday when my baby decided she needed to make an appearance.

Original poster

EBenes · 08/10/2008 20:49

I'm genuinely sorry if you were offended by my attitude, I was just expressing my anxieties. And I don't think he has reckless or lazy motives: he told me that he would normally see me in a week's time, but will instead see me the day after tomorrow because of his holiday. Because the reason they were worried last week is now of no concern to them at all - and wasn't mentioned - and only a week later a whole new reason has been mentioned, I just wished that a whole week could elapse before a decision this important was made - and in this circumstance it normally would be - that's why I'm concerned.

OP posts:

TinkerBellesMum · 08/10/2008 22:47

I think sometimes when it's a term baby they will try and arrange it around their lives to a certain extent. I remember from spending 1/4 of my last pregnancy in hospital that CS and inductions were only done on certain days so that there's nothing happening over the weekend. When it comes to taking a 32 weeker out though there is far more at stake than the doctor's private life and he will be well aware of that. It's not a decision he will make easily or rushing into. It does sound like you have a healthy baby it's the pregnancy that's not. At 32 weeks a healthy baby will have a really good chance, could even be straight on the breast, so there's no putting baby's life at risk involved, as I said before it will be fattening baby up and getting them to feed without an NG.

ajm200 · 09/10/2008 09:56

Sometimes consultants can be a quick to take the 'easy' option so you should definately question their reasons until you are happy with the answer. Here is my example for earlier this week..

I was under threat of a CS a couple of days ago for a footling breech and PIH. The consultant came in, saw my BP and said they'd spend up to 10 minutes trying to turn baby and then I'd go for the CS.

I made it clear that I only wanted the CS in a medical emergency.. asked lots of questions and when she realised I wasn't going to meekly follow her suggestions she started to explain properly.

When pushed, she admitted that they could try the ECV for up to one hour as long I could stand it and baby wasn't distressed. If it failed, I could come back for a second attempt a week later before the CS was necessary.

She took 45 minutes to turn baby, my tummy is very bruised but recovery will be faster than after a CS and when baby turned my BP dropped back to normal

Good luck...

ilovemydog · 09/10/2008 10:17

DS was delivered at 38 weeks due to low amniotic fluid. I had a scan the day before as I was being monitored as he was breech, but turned.

I was induced the next day, and was pleased as the placenta was pretty well crapped out.

ilovemydog · 09/10/2008 10:19

agree with aitch. love my consultant.

Aitch · 09/10/2008 10:31

my placenta was tiny, bright red with blood and had big yellow patches of calcified something or other. not two days left in it, apparently, so you can imagine how grateful i am that they took dd2 out. pics on the profile btw eebenes, she doesn't look too teeny although she is.

TinkerBellesMum · 09/10/2008 10:34

Yes, but at 32 weeks they're not going to be in a hurry to get baby out. Once you're past 36 weeks I'd agree that you need to make sure they need to do it, but at 32 weeks no one wants to do that for the sake of it. Yes, I would want to be sure the risks both ways, but I wouldn't think it was convenience. If the doctor is going on holiday or has a golf trip planned (I am being facetious) and it's not convenient to his diary at 32 weeks either it can wait till he gets back or someone else can do it. The hospital's convenience will come before the doctors, have you ever been in the NNU?

Aitch · 09/10/2008 10:38

sounds like a different situation, ajm, and agree there's no harm in asking for another opinion. but am certainly v glad i took my doctor's advice as have dainty dd2 to show for it.

although, and i do not forget this, i was TERRIFIED. so eebenes, please don't think i'm underestimating how frightening this is at the moment for you, cos i know it is. for me, though, i can at least know that it's worked out for the best.

ilovemydog · 09/10/2008 10:42

sounds like your placenta petrified, aitch...

Aitch · 09/10/2008 10:44

well i was certainly shit-scared, ilove. haw haw.

Aitch · 09/10/2008 10:45

apols for joking, eebenes.

madmarriedNika · 09/10/2008 11:37

Ebene, really feel for you.
It is great that your baby has shown good growth this past 2 weeks but as your amniotic fluid is dropping fast (and you're not leaking) this could still indicate placental problems which is probably what the consultant's so concerned about. Like in Aitch's situation things can change very rapidly and they would not want to risk missing the warning signs. Low AFI is associated with pre-eclampsia and placental issues (that do not necessarily manifest in PE in the mother but can still be very serious for bubs). Low AFI can also hinder lung development.
I am 100% sure your consultant has very good reasons for warning you that he may need to get your little one out very soon- it's just such a shame he hasn't done a good job of explaining why- and you need to know this to be able to reconcile with it all.

For your info I've had 2 prems- DS at 30 wks and DD at 36 wks- DS spent 8 weeks in SCBU and DD spent 1 week in. Both are great now. Like others have said passing the 32 week mark is very important as most systems are now mature and the latter stage of pregnancy is then just fat building for the baby pretty much... But lungs are not likely to be fully mature so hopefully you'd be offered antenatal steroids before delivery if they go down this route pre 36wks- this helps the lungs secrete surfactant so they can breathe air ok. Also some babies don't develop a suck reflex until after 34 weeks or more so feeding is usually by nasogastric tube before then- hence the need for SCBU care.

Definitely make sure your consultant explains his thinking clearly to you- don't be afraid to keep asking questions as you need to be reassured why such drastic action is really needed.

I really hope your AF levels do improve somehow, though realise often this isn't the case. Wishing you lots of luck xxx

Original poster

EBenes · 09/10/2008 15:32

I managed to get a second opinion at another hospital today because of a friend's husband working there pulling in a favour.

The amniotic fluid reading is 10cm, exactly the same reading as the scan 2 weeks ago and the scan 3 weeks ago. It hasn't changed in 3 weeks - in fact, it was 10.1cm today, but that may just be because the other place rounds up or down.

Today's consultant said he would not on the basis of today's scan tell me the baby had no chance of lasting 6 weeks. And I can't see the reason my normal consultant told me the amniotic fluid had 'dramatically reduced' over the week and was now severe olig... whatever that word is that I'm too thick to remember, when today it's the same as it was 3 weeks ago. The scan lady today told me everything was low but within normal limits and it was a normal scan.

So now I'm a bit stuck again. Primarily, having a normal scan is a big relief. And I understand that a consultant knows more than me, but if he tells me he's taking it out tomorrow - and if he reads the scan the same way he did yesterday tomorrow, isn't that a possibility? - I will not know what to say.

OP posts:

ilovemydog · 09/10/2008 15:37

When are you seeing the consultant again?

Are there any other possibilities, for instance, daily monitoring (scans etc). What would be the level where it would become an emergency?

Original poster

EBenes · 09/10/2008 15:42

Tomorrow. As I understand it, 6.5cm is emergency level. It's totally possible that he will suggest scans rather than removal. What I don't understand is why he told me it had reduced when it hadn't, why he wrote in my notes it was severe when it's classed as normal in the same hospital's notes two weeks earlier, and why he seemed so sure I wouldn't go to 38 weeks. But I would be afraid to ask him!

OP posts:

poorbuthappy · 09/10/2008 16:04

Did you get a report with your scan today?
You need to have the information from today to take to your consultant tomorrow and ask him to explain again how he considers the fluid to have dropped...

If he tells you he's taking her/him out tomorrow ask him to explain why in light of today's scan. You are in a strong position to ask because you have the facts from today's scan.

I assume he will scan you again tomorrow? Ask for the actual reading of the fluid - comment on how its the same / less / more than today's scan, and how it compares to the last 3 weeks...

poorbuthappy · 09/10/2008 16:06

DON'T BE AFRAID - hope its alright to shout that (i'm preggies too so could be my hormones)...

Deal only in facts, keep calm, hope you aren't going in on your own - if your other half is going and can't be "trained" what to ask, is there a gobby person around you who will ask and help the situation along?

Original poster

EBenes · 09/10/2008 16:08

He will scan tomorrow. If I tell him I sought a second opinion (I didn't tell him beforehand) he will rightly be offended. I'm also worried about, not so much his judgement, but definitely the way he communicates it to me.

OP posts:

ilovemydog · 09/10/2008 16:15

Could the variance be due to the person doing the scan?

Original poster

EBenes · 09/10/2008 16:34

Yes! Scans vary quite a lot, and all readings are subjective. But this is a big difference, and a 32 week child is a big deal, and that's why I don't know how happy I am staying with a consultant who's so alarmed by the same evidence that's seen as normal by another scanner.

OP posts:

poorbuthappy · 09/10/2008 16:37

He probably will be offended, however don't let this cloud your judgement because this is a major decision for you and your child.

You will never meet this person again (hopefully - unless of course you socialise with him and his family ). He is not god and sometimes I do think we would all do well to remember that when in this type of situation...

poorbuthappy · 09/10/2008 16:39

Sorry, my last post sounds a bit shirty,
obviously not meaning to be...actually just going through something slightly similar myself so am getting worked up!

toodles · 09/10/2008 16:52

If you're scared to talk to him can you take someone else along with you who can prompt you to ask questions if you freeze. Write down all the questions you need to ask now so that you don't forget to do it and make sure it's in your hands when you go in and see him.

You know what, this is not his baby and he certainly won't care about the baby as much as you do. Your second opinion counts a lot especially as it shows that your amnio is within normal limits.

I wish I could be more helpful. Good luck with everything tomorrow.

Flip

1 2 3