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

[EBenes]

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.

Its such a difficult situation . And frustrating that the most difficult part is the consultants feelings - that almost makes me cross, actually! Plus he ought (yeah, I know!) to be professional enough to deal with his issues without your care suffering.

Do you know what he measured your amnio as yesterday? Do you need to mention the scan today? Can you just use it as a way to bolster your confidence that things may not be completely dire and so give you the strength to ask a few more questions? I think the best thing you can do is probably to have a list of 1001 questions written down and not let him move on until you're happy with the answer.

Take notes. Don't be afraid of wasting his time and don't be afraid to ask "why" a lot. And if he starts scaremongering rather than dealing with information you can always ask him to reconsider what he's just said, if he won't then ask for his GMC number and the spelling of his surname, and if he still won't get back on track then tell him that you'll consider any further discussion along those lines as harassment! (All tips from Mary Cronk, btw, and the last is better done in a reasonable tone of voice). Not to be done lightly, but as a patient you still deserve to be treated with some respect.

If he does get horribly offended and/or you decide you no longer trust his judgement, you do have the right to ask to be transferred to a different consultant.

Fingers crossed for you that you can get to the bottom of things

Are you sure that amnio fluid levels are subjective? I thought it was a measurement?

I've had registrars do a scan on me before when I asked... I also had low amniotic fluid and it was alarmingly low all of a sudden. About a few weeks before I had a leak and wasn't sure if it was amniotic fluid or wee. I called the delivery suite and they said if a sanitary pad was sufficient, it wasn't amniotic fluid

Anyway, don't worry about sparing the consultant's feelings. This is your baby.

Besides, if he's an OBN/GYN, am sure he's been sworn at a few times by women in labor anyway

"Are you sure that amnio fluid levels are subjective? I thought it was a measurement?"

Well, the scan lady said that they take four measurements from the uterus, and they can be affected by the position of the baby. But the baby hasn't moved dramatically in a day, so although there might have been some difference, I don't see how it could have been the difference between low normal and urgent. I asked about the dangers of talipes and she pointed to the black space above its feet which she said was okay. dh coming with me tomorrow and he is much less of a nut than me, so I'm sure it will be fine.

consultants are not evil people - I specifically went against my consultants advice. He made me sign to say I understood what I was doing but was perfectly pleasant about it, and held no grudges. Don't put your own emotions on to him. BTW the sod was proved right - and managed not to say I told you so.

Mine may be too. I think today just gave me some perspective and this thread has helped me formulate the right questions to ask, today and tomorrow.

Good luck for tomorrow Ebenes. I think you can probably get away if you feel really uncomfortable with not telling him about the scan etc today but instead ask him about the actual measurements he's made with all his scans, and therefore his rationale for considering such drastic action. Perhaps he has seen something else other than 'just' low AFI- have you had a doppler scan done to look at blood flow through the uterine artery/placenta?

It's very encouraging that your AF hasn't reduced and does seem very strange that your consultant seemed to think it had just a couple of days earlier... All measurements on scans are prone to error as sonographers/midwives/consultants differ with getting their "eye in" to interpret the scan and choosing where to place the cursor to make the measurements- which is partly why so often a baby's size is wrongly estimated- but it's still more info than you'd get any other way...

I really hope you can find the courage to quiz the consultant tomorrow when he scans you- this is your baby and you have every right to fully understand what they think is going on.

Good luck xx

Ebenes - Sorry I've only just noticed this thread - so I've probably not caught you in time.

My DD1 was born at 32 weeks and I had dangerously low AF. I had careful monitoring in the Day Assessment unit and a scan twice a week. I was eventually induced because of an infection as I'd been slowly leaking AF since wk 26.

DD1 is fine now - but the low fluid level did give her a few problems - mainly with her walking (feet and legs slightly turned inwards) but she walked at 21 mths and all is well now. She was also tight around the neck - so we sought out physio. She also has slightly wide apart eyes and a tight epicanthal fold (corner of the eye by the nose) which is apparental common in low AF level babies.

Please, please don't worry about quizing your consultant - he's not God - he's there to provide you with a service! If the AF levels have stabilized could you ask if they have a day assessment unit? I know I had to fight tooth and nail to use ours but it was really worth it, otherwise I'd have been stuck in hospital for 7 weeks!!!

Good luck and I'm sure everything will be fine x

If he's professional he won't be offended and if he is that's his problem.

You would be amazed how much scans can vary, for example I've had cervical length scans through this pregnancy and with Tink (they make sure that there isn't any incompetence in the cervix and that I'm not going into premature labour).

One scan said I was 1cm dilated, I was 1mm the norm - my partner is a civil engineer and works with things (like roads and railways) a lot bigger than my cervix and he said that's a terrible over measure even that much would be costly and a problem in his job.

One scan said I had traces of water (don't fully understand that, think it's trying to say I was dilating) but again it was the normal 1mm gap that they were measuring wrong.

Before one cervical scan they took baby's measurements, they lopped quite a bit off of her age, when she finished doing the cervical scan she realised I was 20 weeks so did the 20 week scan and amazingly the baby was 20 weeks again!

Not too late, jeanjeannie, and thanks for your excellent post, it's given me a lot to think about. All replies excellent, as well, thank you all very much. I wish it was possible to be a bit saner about this kind of thing - we all know exactly which risks we'd take for ourselves, but the idea of taking a risk and blaming yourself for your child's health for the rest of your life is just too much to take on board. But, that said, it's good that we live in a time where patients are given information, when in our mothers' era they'd just have been told what was happening. Anyway, I'm just going to try to clear my head and sleep.

How did it go?????

Any news? Hoping you're all OK, EBenes

Sorry, just thought of this thread again today, and hadn't realised I'd ignored posts on it.

A quick - not very interesting to most people, I'm afraid - update to round things off because if anyone ever searches on second opinions, it seems wise to finish the story.

My lovely new consultant plans to take my apparently healthy baby out at 39 weeks. I'm monitored twice a week for CTG and growth and amniotic fluids have been normal since 24 hours after my first consultant's verdict of 'moderate to severe oligohydramnios'. I wouldn't hesitate to advise anyone in a similar situation: if you feel that something is wrong, if you instinctively are unsure about a medical opinion, it is a good idea to try to get a second opinion, for your own peace of mind. I don't know how things would have turned out if I'd gone back to the first consultant with my overnight bag packed as requested. I don't know what my baby will look like when he/she is born, I can't know what will happen. But it does make a big difference totally liking and trusting your consultant.

Ah, such a nice ending to this thread! Glad bubba is staying put for now & your happy with new consultant!!! xxxxx

Glad to hear baby is still inside and doing well. Hope all goes well when you have him/her at the right time.