Yesterday I went back for my Level II follow up appointment. It was actually sort of nice to see the baby again and to have a second pair of ultrasound tech and MFM doctors' eyes on the baby. This time the baby was more cooperative and the doctor was able to check out everything that he needed to see. I liked him a lot better than the previous MFM because he talked the entire time so I wasn't in danger of possibly falling asleep! The cyst in the brain that the first MFM found is already gone and yesterday the new MFM reiterated that if only the cyst is found there is no cause for concern.
However, he did mention that he would like to see me deliver at 37 weeks. There is a 10% chance of uterine rupture (my uterus was weakened after having a myomectomy) if I wait too long before having my c-section...so in order to stay away from that, he recommends that I deliver at 37 weeks. As far as risks to the baby, there is about a 5% chance that the baby will need some breathing help when delivered that early. I asked if they do steroid shots that late in the pregnancy but he said that they stop doing them earlier on- I think he said 34 weeks?
Ultimately it is my decision whether to deliver early and I will make that decision after talking to my OB. But now that I have had some time to think about it, I do have some more questions. What is the likelihood that I would go into labor at 38 weeks? Is there a higher chance of me going into labor early because this is my second child? Maybe because of my age?
Have you guys ever heard of delivering early for a second c-section?
11 comments:
After my myomectomy my OB was adamant about having a c-section at 38 weeks at the latest. And my son was born with no ill effects. So 37 weeks for a second doesn't seem out of line, but I've only had the one.
Interesting. My OB had no problem with me having my first c-section at 39 weeks.
So glad everything looked great with Baby Boy! In regards to the C-section, the standard for scheduling a routine C-section is 39 weeks. That is most OB and hospital rules. On my 3rd C-section I was scheduled 38 weeks 4 days, which was the earliest my OB could do it without having to get MFM approval. ( At my hospital MFM docs regulate at what gestation C-sections can be scheduled.) My last 2 C-sections were scheduled at 38 weeks exactly and both my OB and MFM were on the same page with that. If I have another child, it will again be 38 weeks for scheduling. If I have to go earlier for any reason, it would become emergent and no longer "routine".
My first child was a c-section at 37 weeks after laboring and she was fine, but I was also given steroids at 31 weeks due to pre-term labor.
37 weeks is the earliest possible "full-term" birth you can have, and while most babies are fine, it's still considered a tad too early by some OBs. So I would definitely talk to your doctor about it and see what he thinks. They might also be willing to give you steroids around 32 weeks if you know will be going at 37 just for piece of mind.
I have zero helpful things to say about an early delivery, I am just so excited for you that your babe is healthy!! Yaay!
xox
I'm glad that everything is going so great with the baby. It's always so nerve wracking to have these appointments, but always so fun after the fact when everything is OK. My MFM wanted me to deliver at 37 weeks (for gestational diabetes, so obviously a different problem), but when I talked to my OB they did defer to the MFM's recommendation, but when I pushed to wait until 38 weeks they were fine with that. So I would just suggest talking to your regular OB and see what they say, I feel like MFMs are fairly conservative.
I am glad the cyst is gone! I have no ideas on early delivery, and am embarrassed to say I have no idea what an MFM is. However, I think asking lots of questions of all your doctors and getting more information on risks and benefits can't hurt.
Very glad to hear the chat is gone and baby boy is doing well!
I can't tell you about scheduled c-sections. What I do know is that even though 37 weeks is considered full term, there is still a lot of development that happens in those last 3 weeks. That said, hemmorhoging is life threatening and you dying would have a bigger negative impact compared to baby boy arriving early. So talk with your doctors. I know the desire to defer (I went through it myself), but also remember that your health is also an important factor in this equation.
Any woman who had a vertical uterine incision either from a C/section (usually done when the gestational age is less than 30 weeks) or from a myomectomy is recommended to have a C at 37 weeks. As the risk of rupture is greater with a vertical skin incision, you want to make sure you deliver early enough to avoid any contractions. I'm guessing he's thinking there's more risk as you've now had two uterine incisions, but I've not seen anyone else recommend that.
So glad everything looks good!
Take a look at bunny's blog, https://glumbunny.wordpress.com/ - she also had a discussion about when her 3rd should be delivered, after myectomy and 2 previous C-sections. I don't remember the details but I think she pushed it out further than her doctor originally recommended, but I'm not sure.
This is verrrrrry interesting and timely for me - we just had our 20w u/s and they also found a CPC in our baby's brain. I did all the normal googling and found the same thing as you: a potential marker for T18, but because our 1st tri blood tests came back fine and baby's hands didn't seem clenched, I wasn't too worried. Except my ob called back later to say there were also 2 echogenic foci on the heart which they hadn't mentioned to us during the u/s, and apparently the foci + the CPCs can be indicators of Downs (although that was covered on the 1st tri blood test as well, so...?). So now I don't know what to think and it's stressing me out and it is taking forever for the doctor to call me back :P
ANYWAY. I am VERY glad to hear your cyst has cleared right up!! I read that some OBs are now considering finding those between 18-24 weeks "routine" these days because they're spotting them so frequently now that the technology has advanced well enough to identify them, and they're starting to think they've been there on a lot of babies all along, just the sonos weren't good enough to pick them up. I have noooo idea on the c-section though :)
I also had a myomectomy and my OB scheduled c-sections for both my kids between 37-38 weeks. She probably would have pushed it to 38 (no later) with my second because she knew a lot more after the first pregnancy and c-section but we went a couple days earlier because we liked the date better!
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