Deliver in week 34 or 35? Vasa previa dx

We were given a diagnosis yesterday of Twin A - he has vasa previa. If I go into labor, start dilating, water break, etc. we will lose the baby. I must deliver before any of that happens. Ob is trying to decide if week 34 or 35 would be best. Of course the longer gestation the better however the longer I am pg the greater the risk that I will lose that baby.

Everything I have seen about 34 weekers indicates that they usually do very well. Maybe 10 days max in the NICU but overall they do great.

I am waiting to get in to see the high risk ob now. They are booked but will squeeze me in hopefully later this week. I am 30w today.

What would you do - deliver via scheduled c-section at 34 or 35w knowing that a catastrophic loss is a possibility the longer you wait? My cervix is great, BP is still low, no swelling, babies are measuring 3 pounds+ each, no history of PTL.

 

I am so sorry that you and your family are under such stress! What a terrible decision to have to make. Of course the decision is a personal decision that you will need to make, but I would wonder how much benifit the week would be... As you said the longer you can keep them in the better, but at what risk? I would definately talk to your doctor and try to get all the information and all of your questions answered no matter how insignificant they may seem... Then you will have to decide what you feel is best for you and your family. I am sorry, this is such a difficult place to be! My thoughta are with you and your family as you make this difficult decision.

 

not sure exactly what vasa previa is??... is that the same as placenta previa??... hopefully the high risk ob can help you make your decision...I think they'd be a lot more qualified to offer advice than a regular ob/gyn. I think I'd rather be on hospital bedrest...what happens if your water breaks before 34 weeks???.... Ask the tough questions and be your babies advocate!!

 

Wow, I'm sorry you have to make this decision. I agree to talk to the high risk OB and see what his/her thoughts are on it. But for me personally, if the choice was to deliver at 34/25 weeks or risk going longer and go into labor on my own that could hurt the baby, I would deliver then. As you said 34 weekers typically do great and have a short NICU stay. You would have already made it so far and then you wouldn't risk any potential harm if your body went into labor on it's own. That is what I would do if it were me. :hug99:

 

Vasa previa is an unsupported placenta blood vessel that is between the cervix and the baby. It is a very rare condition and one my ob has never seen in twins. It is just floating in fluid and if the water breaks then the vessel gets pinched or it gets severed from the placenta and the baby bleeds out and gets no oxygen. We have known for weeks that I had a low lying placenta but it never moved up like they thought. It wasn't until yesterday's u/s that they discovered this wayward blood vessel. Placenta previa is where the placenta covers the opening of the cervix and you just have a c-section so as not to deliver the placenta first. It is pretty common and not usually life threatening unless of course it is never detected.

There are no symptoms for me to warn when it happens (get compressed or severed). I could go to my next ob appt and find out the baby is already gone. There is no way I can make it to the hospital in time even if my water breaks at home. In the hospital I probably wouldn't make it to the OR in time either but at least on a monitor I would know if I was contracting and we could make some educated choices.

I'm really warming DH up to the idea that I am going on bedrest and he is going to have to deal with DS (age 3) and all the household stuff. There is no way to bedrest at home. DH is in for a big surprise when I am not here.

 

Kristine, wow, I have not heard of this. How scary. It seems like they would want you on bedrest, and would be monitoring the baby constantly, if you are at such a high risk? I guess you will find out more from the peri. If it were me in the situation, I think I would definately opt to deliver at 34 weeks given the risks that you described. I'm really sorry, I can't imagine the stress you are feeling. :hug99:

 

Wow, what a scary condition. I have never heard of that before. So it sounds like hospital bedrest is coming up then? I would certainly want that, just having that added layer of attention, support and security.

My kids were born at 34w4d and did not need NICU time. So it is possible to deliver totally healthy babies at 34 weeks!

Keep us updated if you can. Hopefully your high risk OB will be able to offer you some more constructive, informative feedback.

 

It's times like this when you kind of wish they could stick you in the OR for the duration of your pregnancy with an u/s probe constantly on your belly!! Do you not even have minutes??...one or two ??... I kind of feel like I felt for Buttercup's little baby...like why wouldn't they just take them now or at 32 weeks when they can at least pretty much guarantee that they will live??... I know lots of preemie babies have issues and some of them don't make it... but I think I'd rather take that gamble along with steroid shots for their lungs rather than sit around waiting for a tragedy to occur... I will certainly pray that God keeps His hand upon that baby and that blood vessel and keeps everything safe and healthy. At this point I think that's all that can be done.

 

I would definately do it sooner rather than later. I would just be too nervous to carry the baby any longer than 34 weeks. The babies sound like they would be safer out of your stomach after that time. I feel really bad for you and your family. Please keep us updated on your situation.