DH Needs help again.....

I swear, at some point, I really want to post when my DW is home, and maybe even after the kids are born.....

I posted some time ago about some issues we were having with our hospital and you all were a ton of help. I need some more help now.

As background, my wife (trouble squared here), just made her third trip to the hospital. The first was pre term labor concerns (3 days in), then preeclampsia (6 days in). After they released her, the OB had her on twice a week NSTs, with 24 hour urine and blood tests with each visit. As of right now, she is 34w 4d.

Today she was admitted because during the NST, baby b's heartrate dropped pretty far, and stayed low for a while. They think it is cord compression, but wanted to monitor them for 24 hours to make sure.

Then, later this evening, they tell us they are now watching her plateletes, as they are trending down. At 6 pm, they were 139, at 12:30, they are at 125. We were told that 'normal' was 130 or higher. So, now the concern is HELLP. I have been researching for the past hour, and am finding some interesting facts about it, and quite frankly, some things that worry me. Since I am the first person to tell my wife to stay off the internet and let her doctors do their job, I am now thinking that I should do the same. At the same time, I do want to be able to ask some intelligent questions and get a feeling for what the course of treatment will be.

Our OB has a reputation in the hospital for being overly conservative. That, coupled with the very unfortunate fact that there was a mother of twins who died in this same hospital on New Years Eve from HELLP, makes me think that my wife will be looked at closely. I am still nervous of the fact that there are residents there seeing her, but am conforted by the fact that our OB is there overnight (there are 4 Drs in our OB practice, and during the week one is always in the hospital).

So, my question to you all is this: what should I be asking the Dr (should I be asking about the D-dimer test, etc....)? Are her platelettes really low (I only found one resource that talked about actual levels, and from what I can see, until she dips below 100, it is mild, and at 50, I should panic)? Am I over thinking this?

Thanks once again for any help you can provide me!! And I promise, if DW lets me, I will actually post at some point with some good information and when she is sitting on the couch next to me.

 

Wow, it sounds like you have a lot on your mind. I can't really offer you advice from a technical standpoint, but I think in this case being informed is important. I also think it is great that your wife is in the hospital and being watched closely by a conservative doc. I used to work in a teaching hospital, and I always found that the more eyes and ears on a situation, the better. I was horrified to read about the mother who didn't make it, and I am sure that must weigh heavily on your mind. My only advice to you is to stop reading if you get too freaked out, to remember that your babies are far enough along that they will be okay, and to try to stay positive. I will be praying for your family. Please continue to post and let us know how everyone is doing. God Bless, Lisa

 

I don't know anything about HELLP syndrome or pre-e. But, have they discussed delivering her at all? At 34w4d, it seems like she's getting to the point that it would be best for her and the babies.

Hang in there.

 

Mark;
I found some things about platelets:
The platelet count has been found to be moderately predictive of severity: under 50 million/L is class I (severe), between 50 and 100 is class II (moderately severe) and >100 is class III (mild). This system is termed the Mississippi classification.

The advise my OB gave me was: Google is NOT your friend! If its there, its typically worst case scenario.

Give K a big hug from me!! Again, call if you guys need anything at all.

 

I don't know anything about HELLP but I would encourage you to ask the dr. any questions that you have. It sounds like you have a few, which is normal, and the only way to get a direct answer would be to ask the dr. I have stopped googling anything because everytime I do it makes me worry more. My dr. told me to stay off chat rooms and such, but if I did want to look anything up go to Web MD. There is so much out there that is either misconstrued or just inaccurate and you don't want to add more worry than you need to. so my recommendation is have as long a talk with the dr. as you need to to learn everything you can to get you guys through this. I also agree with PP, maybe it is time to think of delivering while things are still alright. The babies are far enough along where they should be just fine. Good luck and keep us posted. Send my best wishes and prayers to DW.

 

Okay, I developed HELLP syndrome during my twin pregnancy(37+ weeks). Basically my liver electrolytes were high and my platelet count was low. My count went down to 40,000 and it required that I have two platelet transfusions before delivering via Emergency c/s. I had a pain in my upper right abdomen/back and had been having stomach pains for two days. They were all set to send me home when a nurse asked about the labs....when they came back, everything moved pretty quickly.

I would ask whether she will need a transfusion. Ask at what point they will decide to deliver. They may start giving her Mag Sulfate which makes you pretty disoriented. How is her blood pressure? Swelling? It is said to be a form of pre-eclampsia. Are they giving her steroids for the babies' lung development. It is my understanding that when HELLP is detected, delivery is recommended.

They will need to monitor her very closely AFTER delivery. I was kept in the birthing unit until the day after I delivered. I had the twins at about 5 PM and was moved the following day maybe around lunch time. They do bloodwork throughout the night to ensure that things are returning to normal. I wasn't able to get out of bed until 2 days after I delivered the twins and my blood pressure remained high for several days and they were not ready to release me. They ended up sending me home on the 5th day but had a visiting nurse come to the house for a week afterward to monitor my blood pressure. Please, please please let me know if you have any other questions, I will answer them as best I can. I did not realize the seriousness of the diagnoses until a couple of days after I delivered.

ETA: I delivered the twins under general anesthesia and my husband could not be in the room with me.

 

Thanks for all the help. Ended up not needing it as the doctors made the decision to take the babies this morning and they were delivered at 940am. Everyone is doing fine, and I will have DW post an update when she can.

 

Congrats on the babies! Glad everyone is doing well

 

Congrats!! I didn't have any advice, but wanted to say that I delivered two healthy babies at 34w4d. I just wanted to give you some hope that babies born at that gestation can do just fine!!!

Looking forward to an update when you can!

 

QUOTE(MarkL @ Feb 5 2008, 04:29 PM) [snapback]607187[/snapback]
Thanks for all the help. Ended up not needing it as the doctors made the decision to take the babies this morning and they were delivered at 940am. Everyone is doing fine, and I will have DW post an update when she can.


Congratulations, that must be such a relief. Good job dad!

 

Congrats!!!

 

Congrats! Can't wait to read the birth story! Thanks for hte update