To go past 37 weeks or not

My doc said he doesn't usually take twin pregnancies past 37 weeks unless the woman really really wants to keep going. He thinks the twins are fully cooked at 37 weeks and no reason to keep going. I am curious what you guys think. IF I make it that far, I'm not sure I want to be induced if there are no other symptoms or I'm able to keep going.

Thanks,
Lanie

 

My doctor (specializes in twins) stated that babies at 37 weeks gestation, even if they are twins, are still only 37 weeks old gestation. My dh was really wanting my babies to be born and 'quoted' the 'teacher' of our multiple class in saying that 37 weeks is full term for twins. My doctor told him this in no uncertain terms. If you are having no issues, I"d wait.

 

My doctor said it is possible for me to go past 37 weeks, to even 38. I do not want to be induced personally.

 

I was supposed to have a scheduled c-section at 38 weeks, having no problems, buy my favorite doc in my ob/gyn practice was on vacation that week. So we scheduled at 39 weeks for the day she returned. She has twins herself. I felt more comfortable with her, and the babies did need as long as they could - they ended up with jaundice, and we were told the extra time made it easier/less for them to have to go through with the jaundice. Not that jaundice is a huge deal compared to what some people deal with, but it was enough for us.

 

My doc had me scheduled for 38 weeks, but I ended up going at 37 due to pre-e.

 

I think if you can go longer than 37 weeks go for it unless there is a medical reason why you shouldn't. My doctor sceduled my induction for 39+ weeks. I ended up going into labor on my own at 38+ weeks. I think 37 weeks is great but if you can go longer it can be even better for the babies.

 

My Dr said he will induce me at 38 weeks. Sounds good to me.
It's up to you, dont be pressured to do what you dont wanna do though.

 

My OB and I discussed this last week. She suggested that I not go past 37 and a half weeks which sounds good to me. As luck would have it, DH and I have our 2nd wedding anniversary within that week so we'll see how it all turns out.

 

Not sure if this will influence you or not...but I've read several articles in my vbac studies.... one of which stated that 47% of inductions wind up as c/s..the other stated that inductions, particularly in first time moms, made the patient 3 times more likely to have a c/s!! yikes.

Anyway, if it were me..I'm not sure I'd be willing to try induction unless...1.there were a good medical reason...37wks with twins is not a good reason..now if you were hitting 39+ weeks, then maybe... 2. my cervix looked favorable.. in other words dilated to some significant extent and shortened...preferably 75% effaced or better. Inductions are much more likely to be successful when you are already significantly dilated and effaced.

To tell the truth...my docs all said 36-37 weeks was a good time to do a c/s for my twins... Well, when it came down to it NONE of them were willing to do it that early since I still looked good. They all wanted to wait closer to 38 weeks just in case the babies lungs weren't developed. Well, my babies were born via c/s at 37wks 5 days...they were 5lbs 11oz and 5lbs 15oz.... born a week earlier they would have been closer to 5lbs even... I just think that's smaller than what's ideal. Better to let them cook for a week longer if your body will hold out.

 

I personally would go further if everything seems to be going well. The longer they are in the better.

 

If you're not feeling awful then I'd wait it out longer. My doc didn't want me going past 38 weeks (that was his limit) and I was induced at 38 weeks 1 day. Good Luck! :good:

 

My OB said the same thing. I needed a c-section anyway, so I scheduled it for 37 weeks (and was soooo happy not to have to wait any longer). However, if I had been planning to deliver vaginally, I would have waited a little longer to see if I would go into labor naturally. Twins may be fully cooked at 37 weeks (I'm not sure how I feel about that), but going into labor naturally is always better than being induced, if there's no reason why they have to be born right away.

I know someone who waited to go into labor naturally and wound up having them at 40 weeks on the dot. They were quite healthy but still only 5 lbs 12 oz and 6 lbs even. If they had been born 3 weeks earlier, they would have been smaller.

 

I delivered at 39w3d (it was 40 weeks according to my doctors chart - she went on last period) I was induced. I was begging to be induced at that point since I had a thrombosed hemmrroid that was almost more painful than the labor. She would have had me still pregnant! Anyway, I don't really believe that 37 is full term. I think if mine were induced at 37 weeks, they could have been much smaller and might have not latched and nursed so well to begin with. I would push for at least 38 weeks, you really want to avoid NICU time if at all possible. It's great to have them with you right away and be able to go home all together. There is never a guarentee but the longer you wait the better (assuming they are doing well - you can always have BPP done to gauge this)

 

Although 37 weeks is technically considered full-term, unless you were having issues or went into labor on your own, I would wait it out a bit longer. 37 weekers still have more risk for respiratory issues, jaundice, poor feeding, etc. than 38 or 39 weekers. My peri practice was hesitant about scheduling my section for any less than 38.5 weeks, simply for that reason. If there's no reason to add any risk to the outcome, why do it? On the flip side, I'm realizing how hard it is to wait that last 1-2 weeks, but in the end, it's probaly better for the babies to grow a bit more....

 

i delivered after my water broke spontaneously at 38 wks 3 days. I would have been induced at 39 wks exactly.

it was ironic b/c i was on bedrest at 28 wks and hospital bedrest and PTL and all that at 32 wks.

if you want to keep carrying them, and your body is able to do so, and your doc is willing to give you the extra week, then TAKE IT! mine were 5-4 and 6-8.

 

Gotta love this site! I just can't believe how long people go...some late 38 weekers and some even at 39 or 40. Wow! I think I'll hang in there if all looks good at 37 weeks. Right now the little boy is falling behind a bit so this may be a moot point if he doesn't start gaining weight. But one step at a time. Great advice and information. Thanks so much!

Lanie

 

My OB said he wouldn't induce unless I went post-dates (clearly that was not an issue in the end). They say twins mature faster, but 37-week twins are still only 37 weeks. There's no reason to force them out before they are ready, as long as there's enough fluid, they are healthy, and you are healthy.

 

My OB's office said to me that they want those twins to stay in there at least 38 weeks. They have not said if they will induce if we make it that far or if they will let me go until it naturally happens.

 

i asked my ob and peri yesterday if we could do my C sooner than next fri. they flat out said no b/c there is no guarantee of lung development and no medical reason to take them earlier than 38 weeks.

 

If all were going well, my doc would have allowed me to go all the way to 37wks but would not have allowed me to carry into my 38th week. 37 weeks is generally accepted as a full term pregnancy for even a singleton, so I would have been comfortable with delivering at 37 weeks. I would rather deal with an induction (as a last resort) than carry past the point that placentas can handle. There is a point where the rate of fetal demise (such an ugly term ) increases with statistical significance in twin pregnancies and the general consensus seems to be that that point is at 38 weeks.

Of course...that said...many moms carry well into their 38th week and beyond with no problems. My mom carried her twins until 42 weeks. Thank goodness they don't allow that these days! *shudder*

 

My OB would not schedule my c-section til 39wks. However, I had them at 36w5d due to failed dopplar study and failed BPP.

April

 

my dr from the begining said we would go to 38 weeks unless the babies decided to come earlier..well now we are delivering in 11 days at 37+ weeks. The girls are getting really big, they are both over 6lbs right now, so my dr is concerned...

I think most babies are developed by 37 weeks. I do understand your concern, its your body and your babies so if your not comfortable with 37 weeks you can tell them you would rather go another week. Or just have a date in your mind when to set it and make sure its after 38 weeks..

GL

 

I had a scheduled section at 37 weeks 3 days. I really wanted to go natural, until my last ultrasound. Twin B was blocking Twin A with her feet. Up until that point Twin A was head down and she was the bigger. I really thought I would be able to go vaginally even though twin B was breech. My Dr told me it could be dangerous if my water broke the way they were positioned now. So we scheduled a section at that appointment. I was soooo uncomfortable I asked if it could be sooner than later. She had no problem as the girls were measuring ok and she had said originally she will usually induce or section around 38 weeks. Both my girls weighed 6lbs 3oz and had no NICU time at all. They has slight jaundice, they just kept an eye on it but were never treated.

For me I felt good about having the section at 37 weeks. But I think it depends on the situation. If your Dr and you feel they are done at 37 weeks, and you dont think you can go further.. Go for it. If you feel great and think you can go past 37 weeks, I say go for it as well.

 

My Ob said that my perinatologist doesn't like twins to go over 37 weeks, so I don't think I will be going much farther then 37 weeks. I figure by then I will be ready for them to come out anyways, and I am just going to listen to my doctors. Everyone is different though so if your not comfortable with having the babies at 37 weeks then I would talk with your doctor.

 

my peri doesn't let twin mom's go past 38 wks - he likes to have them delivered between 37-38...the OB's office would have let me go as far as 40 weeks but I developed pre-e at 36...at 36 weeks they had no issues just tiny...and waiting another week would have made the pre-e so much worse so they decided to deliver them...

 

My personal opinion is that if there are no problems then why not wait until they tell you they are ready? My doctor scheduled my c-section for 38 weeks, but does not think I will go that long. He did say that IF I did, and felt a need to wait then that was no problem either (provided no problems of course). I can tell you that personally, I would wait to go into labor naturally rather than be induced if you can have a vaginal delivery.

 

I would go at least 38 weeks and buy some time. 37 weeks is barely full term and if the dates are a little off (in case of natural conception) or they didn't grow as much as they should do, you'll end up with small babies that could have several issues. If you can manage, the babies do well and your body is doing well, I wouldn't accept 37 weeks.

This is quite an interesting study. Look at the chart halfway through. There is a pretty big difference between the 36-37 week and 37-39 week sample, but not much difference between the 37-39 week and 40 week sample.

http://www.ispub.com/ostia/index.php?xmlFi...vol5n2/twin.xml

My doc and hospital won't schedule anything before 38 weeks unless medically necessary.

 

i made it to 38+3. I say go with what you are feeling when you get to that point. I really wanted to be induced but they wouldnt do it until 39 week.s grrr..

 

I agree with those who said if you can keep going, go for it.

FWIW, My daughter was born at 37w3d (just when she decided it was time) and had no problems. Some babies born later than that have problems and some born sooner have none (I have a friend whose 33 weeker came home from the hospital with her). There are no guarantees and I think letting nature take its course -- if you can -- is your best bet.

 

I was induced at 37wks 6 days due to increased bp, they started the pitocin at 3:30 p.m. and the babies were born vaginally at 4:30 a.m., so not all inductions end up as c-sections. Both babies had to spend a few hours in the special care nursery being monitored as they were working pretty hard to breathe, but they did fine and came home with me less than 48 hours later. But I think the norm is that most docs won't induce before 38 weeks unless there is a reason to do so.

 

QUOTE(Donia @ Sep 28 2007, 08:04 AM) [snapback]427356[/snapback]
If all were going well, my doc would have allowed me to go all the way to 37wks but would not have allowed me to carry into my 38th week. 37 weeks is generally accepted as a full term pregnancy for even a singleton, so I would have been comfortable with delivering at 37 weeks. I would rather deal with an induction (as a last resort) than carry past the point that placentas can handle. There is a point where the rate of fetal demise (such an ugly term ) increases with statistical significance in twin pregnancies and the general consensus seems to be that that point is at 38 weeks.

Of course...that said...many moms carry well into their 38th week and beyond with no problems. My mom carried her twins until 42 weeks. Thank goodness they don't allow that these days! *shudder*


I want to address the important point of placental degradation. First, calcifications can be seen on an ultrasound so the doctor will be aware if your placenta/s are aging prematurely. Secondly, if your babies have their own placentas, premature placental degradation is no more a risk than with a singleton.

There are huge differences in the recommendations made for moms carrying mo/mo, mo/di, and those carrying di/di. Yes, there are statistics lumping all twin pregnancies into one category but to generalize in this way ignores the obvious differences in risk level for individual circumstances.

 

My Dr said i wouldent make it to 37 weeks but i ended up being induced at 38 weeks and 4 days.

 

My hospital would not allow a c-section or scheduled induction before 38 weeks and would not budge even one day earlier unless there was a medical need. My OB was on rotation the day before 38 weeks and 1 week later, so I went in for an induction with someone else at 38 weeks on the nose. My girls were fairly small for 38 weeks-one each on either side of 6 pounds.

 

my peri is one of the best in the country re: twins and he said 37 weeks was his maximum (for me carrying id twins). After that, the risks do not outweigh the benefits so if i hadn't had them by 37 weeks, he would've scheduled me asap. That's not to say there aren't plenty of women on here who went a bit longer, but it's not the norm and not usually recommended. of course, like a pp said, it depends on your particular twins too . . . you never know what is going to happen in the end and for now, I would just go with what the dr suggests.

 

My peri schedule my c/s for 37 weeks 5 days. My boys were 7 lbs 8 oz and 6 lbs 6 oz, 9/9 on their APGARs and no NICU time. I showed no signs of labor and probably would have gone longer, but we had healthy boys before 38 weeks.