lack of NICU

Announcement of pregnancy and birth following assisted reproductive treatment.
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deepa100
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lack of NICU

Post by deepa100 »

Hi All,
I have a Q regarding previa. I know complete previa pregnancies are considered high-risk. Like Suzanne, I also have complete previa. So, far my obgyn thinks he can handle my case fine. He did send me to a perinatologist earler for an NT scan and a L2 scan. My perinatologist works at the same hospital as my obgyn (well, my ob does surgeries at the same hospital). But this particular hospital does not have a NICU. They do have a neonatal nursing team. So, they send any premie babies that require more than 1 month stay to a Childrens' hospital in the city.

I have considered getting the C-section done at the Childrens' hospital but I am running into 2 things.
#1 It is 16 miles away where as the hospital where my ob works is 5 miles away.
#2 My ob does not have privilieges to do surgeries at the Children's hospital.

I am currently in my 32nd week and a bit hesitant to change my ob at this point.

Now this is all an issue only in case of complications. Has anyone dealt with a similar situation? What did you do?
deepa
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LauraLou
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Post by LauraLou »

With a previa, most the risk is to the mother (bleeding) not the baby, so they rarely deliver you early because of it. So unless you have some reason to think that your baby will come early (high blood pressure, etc), you should be fine at your regular hospital.

Good luck!
Me 38, DH 52
1st IVF 5/06- BFP m/c
2nd IVF 9/06- BFP identical twin boys!!
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deepa100
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Post by deepa100 »

LaraLou,
Thanks for your reply. But it is baby's blood (placenta) that mother loses. So, it is risky to the baby (Can be risky for the mother too but I believe that is a secondary concern). Some times the baby might require blood transfusion because of this. Again, this is the ER situation. In the cases where no bleeding occurs, regular c-section would suffice.
deepa
suzhan
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complete placenta previa - cpp

Post by suzhan »

Personally, I'm preferring to deliver at a hopsital w/ a NICU because of the complications I've already had w/ CPP. If you have a major bleed, it can come on without warning (no pain, nothing.....) And, if you're early, the baby may need special care. That said, you've made it quite a ways without bleeding at all, so the odds really are in your favor. Perhaps bring it up to your doctor and see what they say.

....btw...I had another bleed so my doctors now admitted me to the hospital until I deliver. This is primarily due to the fact that I've now had 2 bleeds and the chances that I will have another is very high. My doctors said there's a small chance, but still a chance, that this next bleed will be the hemmorhage that causes me to lose all my blood. Their feeling was that the main risk was to me, not so much to the baby, but then again if it happened today, the baby would need to immediately be taken care of in a NICU. Anyway, that's why they want me so close. Even though I'm only 10-15 minutes from the hospital, they won't let me go home because I might not make it back to the hospital in time if I had a major hemorrhage.

Don't forget, though, your situation is much different than mine since you've not had any bleeding at all. Many, many women with previa have elective c-sections with no bleeding episodes, or maybe just a minor bleeding episode at near term. Further, you still have a chance that the placenta may have moved up since you've had no bleeding.

Talk with your doctor - hopefully he/she can advise you as to the risks.

- suzhan
deepa100
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Post by deepa100 »

Suzhan,
Thanks so much! You always have kind words for others even when you are going through hardship.

I am sorry to hear that you had to go back to the hospital. But you are at the right place, they can take better care of you at the hospital than if you are at home. Hang in there, your baby will be alright. In a couple of months, this will all be over and you will be actively posting on "parents after treatment" forum. You will be in my thoughts and prayers.

Regarding my talking over this with my ob, I already did. Basically, the closest hospital with NICU is 16 miles away and traffic gets bad here in Minnepaolis during construction and rush hour. I asked him if I should move next to the hospital with NICU temporarily. He said no, he wouldn't move me for this. He thinks he and the folks at his hospital can handle this fine. I will make another appt next week and talk to him again.

Sending you my best wishes,
Deepa
deepa
PebblesUK
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Location: Essex

Post by PebblesUK »

Hi Deepa

Personally I would just keep your options open. If it looks like the baby is going to have to be delievered in the next few weeks then ask to be moved before delivery. It's much safer to move baby while still inside.

I had Ellie 14 weeks early and didn't really have a choice where she would be delivered. It was more which hospital has the facilities for a baby so little. I had to go to London which was 3 hours door to door. I think if it ever comes to it, we would all travel where ever we need to to have a healthy baby.

Best of luck to you, and you Suzhan

Jo
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deepa100
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Post by deepa100 »

PebblesUK,
I was just talking to DH about this last night. I will make an appt next week with the ob and tell him that I need a referral for ER situations, I just don't want a premie baby to be moved and I am not comfortable with it. On the other hand, if all goes well, my ob can do the c-section at 38 weeks.

BTW, previa is a bit different. When a hemrorahage occurs, the mother has to get help ASAP before the baby loses too much blood. Driving 3 hrs. just will not cut it. Suzhan has to be kept in the hospital for this reason. If she needs help, she will get it right away. This is the reason I was concerned about traffic and distance to the hospital. If something comes up, we will not have the luxury of waiting.
deepa
deepa100
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Post by deepa100 »

PebblesUK,
Hope your little girl is doing well now.
deepa
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