Cord Levels Down

I am 32 weeks pregnant with mono/di girls. At my appointment yesterday I had an US and a NST. I have been having u/s every two weeks since week 28 and everything has been great. Yesterday the US tech looked at the cords and they found that the SD ratio is off. My OB ensured us that everything looks find and the NST test result was perfect and the babies are a great size. Baby A weighs 3lbs 10 oz and Baby B weighs 3lbs 4oz. What worried me right away was that they have been gaining about 12 oz every two weeks but in the past two weeks Baby A only gained 3ozs and Baby B gained nothing. That can't be good right?

Well a call was put into the high risk doctor and I will be going in every Monday now for doppler studies and every Thursdays to my reg OB. So now I'm just stressing waiting for Monday's appt. I have no idea what this all means. I just want to keep these babies in here as long as possible. Has anyone had a similiar situation and can share what the course of action and outcome was for them? My OB just kept saying your fine babies are great so just keep up what your doing which I'm so grateful for but can't help feeling this new level of stress. Thanks everyone!

Sonia

Sarah and Sienna - EDD 10/23/09
Addianna - 2.5 year old princess

 

First let me say congratulations on your mono/di girls (I'm kind of partial to them) and on making it to 32 weeks without any drama. I'll share my story with you, not to scare you, but to educate since I've been through this before. Like you, my girls were progressing nicely until my 26 week appt where baby a had all but stopped growing. There was a 45% size difference and I never went home from that appt. I was taken first to L&D overnight as my peri didn't think we'd make it through the night without delivering. Well, we showed him and did just fine. I was moved to the "keep 'em cooking" wing the next day and stayed there for 54 days until my scheduled c-section at 33w6d (our hospital won't let mono/di moms go past 34 weeks...it's controversial, but I was OK with it). During my 8 week hospital stay, I had 3 NSTs each day and 3 BPPs each week. The main thing they were watching was baby A's cord blood flow. Here's how it was explained to me (and please forgive me if I'm telling you something you already know). In utero, the cord does the pumping for the baby, not the heart. The problem with our baby is that she had absent/intermitten diastolic flow. Basically, when the heart contracts, it pushes blood out to the body. This was happening for her. However, when the heart retracts, there should be residual blood flow out to the body. This WAS NOT happening for her. The cord dopplers show a ratio that lets the doctors know what's going on with the flow during the different cycles. It should be low (like in the 3-4 range I think). Ours got up to 7 and 8, and was even absent from time to time, but was never reversed. Reversal would be if they saw that not only was there no 'residual' flow, but that the blood that was just pumped out was coming back in during that retraction phase. Had that happened, they would have delivered immediately.

OK, now that I've written a text book...lol. The purpose of my being in the hospital was to monitor the girls closely and keep me from doing anything I shouldn't. Thankfully, the girls did well and baby A was born at 2lb 4oz, baby B at 4lb 4oz. They both spent time in the NICU, but came home before their due date.

It sounds like they are monitoring you closely and that's the most important thing with this situation. However, don't be afraid to go to L&D or call your OB if you think something's up. It would be much better to get hooked up to a monitor for a few minutes and see that all is OK and give you some peace of mind. Good luck with the weeks to come and feel free to PM me with questions.

 

At 30 weeks I was put in the hospital overnight and then on bedrest because Baby A had low fluid and started measuring small. After that, I had u/s twice a week to monitor everything and check both of the cord flows....at 32 weeks, Baby A had not grown at all, but they wanted to wait 2 more weeks to check her growth. I was also told that sometimes the cord flow changes according to how you are feeling that day and some other factors...so my tech always told me they looked at all factors, not just the cord flow. And they would compare them over a couple of days time, not just at one visit. I remember feeling so worried, and wanted them to be born since they were at good weights! But, my doctor knew what he was doing, and they were monitoring me carefully, and I made it to 34 weeks 6 days and had to be induced because of preeclampsia. They spent 17 days in the NICU, but only as feeder/growers - nothing wrong with their lungs or anything else. They were born at 5 lbs 5 oz and 5 lb 15 oz!

Hope that helps! Drink lots of water and put your feet up whenever you can if you aren't on bedrest!

 

Thanks Ladies!! Your information really helped. I am feeling really good regardless so it kinda threw me for a loop. I have been trying to rest as much as possible and have increased my protein intake. 34 weeks is my mini goal. I'm going to try and not stress over it too much this weekend and hopefully get lots more info and answers on Monday. After reading your posts I have lots more questions to go in with as well. Thanks!

 

Jessy had SUA and this contributed to her low to absent flow for the last four or so weeks I was pregnant she only gained 3 oz a week. We were having cord studies twice a week and growth scan once a week to make sure her flow did not reverse. I delivered at 34 weeks 1 day due to the doc deciding she wasn't growing well enough. Jessy came home after three weeks