What To Expect from a 32 Week Twin Preemie

Hello ladies! I'm not sure where to post his, but I posted in the expecting forum about my low amniotic fluid issue. I'm expecting one baby this time around. A quick summary, one week ago it was at 8.3cm and this week its at 6.5cm... the panic point is 5 cm. So, doc is giving me medicines to mature the lungs of my baby and wants me to do an ultrasound on Sat to see if the fluid goes down or up. If it goes below 5cm he want to deliver my baby. Although it is not a nice scenario, I really want to know how a 32 week preemie will be. Is there a possibility due to the early birth she might become special needs or will she have lung issues, apnea, etc. Are there things I should request from my doctor for the baby. How long can I expect for the NICU stay and what is it like. I delivered my twins at 37 weeks, no problems. Although I pray that the amniotic level rises I just want to be prepared just in case. Thanks

Marta

 

Hello ladies! I'm not sure where to post his, but I posted in the expecting forum about my low amniotic fluid issue. I'm expecting one baby this time around. A quick summary, one week ago it was at 8.3cm and this week its at 6.5cm... the panic point is 5 cm. So, doc is giving me medicines to mature the lungs of my baby and wants me to do an ultrasound on Sat to see if the fluid goes down or up. If it goes below 5cm he want to deliver my baby. Although it is not a nice scenario, I really want to know how a 32 week preemie will be. Is there a possibility due to the early birth she might become special needs or will she have lung issues, apnea, etc. Are there things I should request from my doctor for the baby. How long can I expect for the NICU stay and what is it like. I delivered my twins at 37 weeks, no problems. Although I pray that the amniotic level rises I just want to be prepared just in case. Thanks

Marta

 

First thing, have you gotten the steroid shots yet? If not I would ask for those to help mature the lungs.

My twins were born very early, see siggy, and I got the steroid shots about 10 days before my DD was born, ( 1 lb. 10 oz) she was only on a vent for 4 days (born at 25w3d), my DS was never on a vent (born at 26w6d at 2 lbs. 7 oz.). I truly believe those steroid shots helped my little preemies so much. Since they were born 10 days apart their NICU stays are different, but they both came home together when I would have been 35 weeks pregnant with them, so Emilie's stay was just under 10 weeks and Trevor's 8w2d.

They have never had any lung or breathing problems whatsoever!!! We had a very easy NICU ride, I didn't think so at the time though, with Emilie needing 4 blood transfusions and she had an infection, and Trevor needed 1 blood transfusion. That is it!! I was told most babies need a blood transfusion at some point before they leave the NICU. Trevor had his about 5 days before he came home.

They of course had all the monitors hooked up to them in the NICU and had lots of bradycardia and apnea, but they did not come home with monitors!!! Bradycardia and apnea are very common in preemies and every baby in the NICU had them, but they out grow it. Don't be alarmed by that, he/she will out grow it. It is scary at the time though, but we got used it and knew what to do if it happened.

They both have reflux, which is also very common in preemies and are on prevacid, but my older DD had reflux too and she was not a preemie.

There is a chance your baby may be special needs and have some issues, but there is also a chance he/she won't be. My twins have absolutely no issues at this time, besides being on the small side. Emilie is 16 lbs. 7 oz. and Trevor is 19 lb.s 6 oz ( so weight wise he's not really on the small side). You just don't know.

I hope you don't have to go through having a preemie it is very hard being in the NICU, but the smallest babies are the biggest fighters, mine are proof of that. Good luck and keep us posted.

 

My girls were 32 weekers. There is a risk of the lungs not being mature, but it sounds like you are being given the steriod shots? for the babies lungs. I had those at 24 weeks for my girls and their lungs were completely mature at delivery, they never needed any type of oxygen. THey were closely monitered in teh NICU for signs of problems. Generally speaking 32 weeks is great, the majority do fine with no long term affects. Brooke was in the NICU for 19 days, was 3 lbs 12 oz at delivery and 4 lbs 9 oz at discharge. Madison was in for 22 days, 2 lbs 12 oz at delivery and 3 lbs 7 oz at discharge (yes she was only 3 lbs 7 oz when she went home). The only things we had to work on with the girls was them controlling their body temp and eating. This NICU stay with them was alot easier than my ds, a 27 weeker, and even he doesnt have any known lasting affects from being born so early.

Keep us updated!

 

Well, each child is different. My boys were 31.4 weekers, and they were in the NICU a little over 3 weeks. I also know 32 weekers that were in 5 days or were in 6 weeks, so you never know.

I can tell you about my boys. They were each 4 lbs, though they dropped down to 3.2 lbs. They both were breathing on their own and were not intubated. I was also given the steriod shots, which I am sure were a huge help!!! Aaron was on the c-pap, which is just giving him a little extra oxygen, for about 24 hours, after that he was fine. Neither could take a bottle, they did not know how to suck. That is the biggest issue with 32 weekers. They have not developed the suck/swallow reflex. They were on feeding tubes and in incubators to help them stay warm. They could not regulate their body temperature.
We were told they had to be able to do the following three things before they were realeased: 1. breath on their own 2. take all feedings by bottle 3. regulate their body temp. The eating took the longest, and there were days I just prayed they would be able to take all their feedings by mouth. It was hard.

If you read about twin vs. singelton preemies, you will find that twins have a faster lung development than singeltons. So often a 32 week twin is in better shape in terms of lung development than a singelton. Keep that in mind, especially since you are having a singelton this time. The survival rate of 32 weekers is excellent, it is just that there is a chance there might me a longer NICU stay that you anticipated.

I wish you the very best of luck!!! Having a preemie is emotionally hard, but hang in there! There is a NICU forum here that can help too!

 

In the NICU forum, there is a resource sticky at the top with tons of valuable info. I think that's the best place to start. I hope you don't need the information, but good for you for trying to be prepared.

 

Checking out the NICU forum is a good idea. I'm also going to shortcut this post over there so you can get a more specific response.

 

I am so sorry that you are going through this, Marta. I really hope the meds work and you can keep her cooking a little while longer.
All three of my kids were preemies. My DS was a 35 weeker. He was 7 lbs 1 1/2 ounces at birth and 20 inches long. He was on a vent for 6 days and in the NICU for 11 days. Also, he had a blood infection. He's about to be 5 and thinks he's going on 30. He does have to have breathing treatments when he gets sick and congested. He has a little wheezing but not full blown asthma. I didn't have the chance to get the steroid shots to develop his lungs. Developmentally, he's been on target. He's already reading, knows his way around the computer, and is learning Spanish.
My girls were 31 weekers. They were born 4.4 lbs and 4.8 lbs. They were 16 and 17 inches long. I got one steroid shot about 20 hours prior to delivery. They were on a vent for 4 days and in the NICU for 40. It was a pretty easy NICU experience. They had apnea and low red blood cell counts. They had problems feeding, too. They have some delays from time to time. They were a little later walking and talking. By 18 months, they had caught up. They are just as big and sometimes bigger than other toddlers their age. People can't believe they were preemies.
I really hope you can get some more time. The NICU staff would told me that girls do so much better in the NICU usually than boys. I would get the steroid shots ASAP. That really made the difference with my girls. Good luck! Please keep us posted!

 

Marta,
Mine were 34 weekers adn I also got the steroid shots for lung development. Mine spent 17 days in the NICU as growers/feeders. Like pp said, she would be hooked up to all the monitors which is par for the course. Morgan came home on an apnea monitor b/c she didn't outgrow her episodes by the time they were ready to release her...she was on it until 4 months but we never had a "real" episode at home. Just precautionary.

I think the rest of the advice you got was great, so I won't repeat. But, best of luck to you on your neext u/s. I hope your levels go up and you can continue o nwith a healthy pregnancy. Please update when you can.

 

Marta, mine were born at 31.6 weeks and spent 5 weeks in the NICU. Neither had any major problems while in the NICU, and both are ahead developmentally now at 3 and completely caught up size-wise. Since you have had the steroids, odds are your little girl will only be in the NICU as a feeder/grower (learning to eat and gaining weight). For most babies, the sucking reflex does not kick in until 35-36 weeks, so she will most likely be tube fed until she learns to suck.

The NICU can be very overwhelming at first with all the beeps and bells from the monitors. My advice to you is to tour your NICU, talk to the nurses, and see what it is like before you are visiting your little girl there.

I pray that her fluid will have increased by the next US!

 

In my university hospital the non written "rule" is: 24-28 weeks, danger zone, 28-32, ok zone, 32-36 fine zone! Doctors do not hesitate to deliver a baby at 32 weeks, if there is a risk in utero.
Of course there are always exception but generally babies born at or around 32 weeks survive at a 90-100% chance and the same goes for incapacities, so 90-100% are healthy and do not show any handicap that could be caused by the premature birth.
I have worked in NICU for a while while doing practise (12 weeks nursing) and there were 32 weekers than came and stayed for up to 8 weeks and babies that "came, saw and won" and left after only a week.
Since your pregnancy is very controlled, you are getting the shots etc... I would think your baby would not have to stay the full 8 weeks, but of course each NICU ride is different as each baby is different!
Maybe you could go and visit your NICU before actually giving birth, some prants did that and it helped them once their own baby was in there, because they knew the staff and a little bit their way around there.
Good luck and I hope for some more weeks of cooking and a higher fluid level, CJ

 

My girls were born 1/2 a day shy of 32 weeks. They weighed 3.8 & 3.13 and stayed for 4 and 5 weeks in the NICU. They were intubated 1 day and 4 days and did not do CPAP. I had 2 rounds of steriods. They were in an incubator for a week or two and then moved to an open air crib. They had blood transfusions 3 weeks after they were born for low blood counts. Both had apnea and came home on monitors & caffine, but after discharge only one had 'real' episodes at home and thankfully they were mild.

One daughter has severe reflux and had double hernia repair. BUT both are walking , talking , and doing wonderful! They a a bit small weight wise, but right on for height. I have one that is a bit delayed gross motor wise, but nothing serious!

Doctors gave me a very good chance that all will be well and they will be all caught up by age 2.

HTH!

KC

 

Thank you all so much for your responses and advice... I pray that my U.S. on Saturday shows an improvement in her fluids. But it is reassuring to know that my baby will most probably not have health issues. Thanks

Marta

 

My girls were born 31 weeks exactly and both wieghed over 4 lbs each and spent 3 1/2 weeks in the NICU. They did come home on apnea monitors, but it wasn't too bad (I actually felt more comfort with them on them anyway). Other then that they were on CPAP for a few days and never needed any additional oxygen. Every baby is different, but I honestly think that at 32 weeks, she will be fine. Small, with a little hospital stay to overcome preemie "stuff", but fine nonetheless. Best of luck!

 

I just wanted to encourage you that a friend of mine had the same problem around 32 weeks or so... the fluid was really, really close to the point where they were going to deliver the baby. Well, it came back up and they had no idea why...she went on to deliver at 37 weeks..induced b/c the baby was really big... Hopefully something like this will happen for you too....(well...not the big baby part...but the holding out a little longer part...) She too got the steroid shots, and it did make her feel better about being induced at 37 weeks...

 

My girls were born at 31 weeks exactly. I had a round of steroid shots at 24 weeks, then a rescue dose 48 hours before I delivered.

Baby A had no lung issues and was on room air from the very beginning. Some apnea and bradycardia which was controlled with caffeine. She was a feeder/grower and was in the NICU 5 weeks. No IVH.

Baby B was on oxygen via canula at first, then moved to c-pap. She had to spend a day on the vent during which they administered surfactent, then she went back down to the canula with a little O2 flow for a couple days, then the canula off and on with just pressure. She had a PDA that they just watch (and they're thinking it's now closed on its own). She was in the NICU 6 weeks. No IVH.

I know they docs really, really wanted to get me to 32 weeks - it's a great milestone. We almost made it but my baby A was just too anxious to see the world, so she PROM'd and tried kicking her way out into the world.

Hoping the fluid levels stay steady or increase and you have some more time.

 

Hi Marta! My baby b had a rupture (and chronic placental abruption) from 20 weeks and low amniotic fluid was a constant for us. Many weeks, his fluid levels were under 3.0 cm.

The thing to remember is that your amniotic fluid is continually replenished. Even if you are losing fluid for some reason, new fluid is also being produced. YOu can help keep the balance on the plus side (more being produced than lost) by putting yourself on strict rest and drink plenty of ice water! Obviously, the water itself will not replace the amniotic fluid, but by keeping yourself really well hydrated you will ensure that there is always enough water for your body to produce more amniotic fluid, AND excellent hydration will keep your uterus calm.

I hope you can keep your little one inside for longer, but if it comes to an early delivery, she should be fie. You are getting the steroid shots for her lung maturity (which is the biggest preemie issue) and after 32 weeks, babies have an excellent chance of survival without problems.

My boys were born at 32 weeks 5 days...baby b needed a little c-pap for 24 hours but no intubation. They both stayed in NICU for 12 days learning to feed, for bilirubin and to maintain their weight. They came home withoutany monitors or special instructions (except feed on a 3 hr preemie timetable! ). They are bright healthy active boys today (11 yrs old), and have never had any long term issues from prematurity, from the early, serious complications or from the low amniotic fluid. Our peri actually told e that the stress of hte low amniotic fuid would proably elp baby b develop more quickly...and indeed, he was bigger than his brother by half a pound at birth!

 

quote:
Is there a possibility due to the early birth she might become special needs or will she have lung issues, apnea, etc. Are there things I should request from my doctor for the baby. How long can I expect for the NICU stay and what is it like.



No she won't become special needs. Both of my twins were born at 32 weeks. The baby will probably have apnea and some lung issues, sense ypur fluid is low that baby isn't going to be able to pratice breathing. The baby will be in the hospital 3-4 weeks. Feeding growing, keeping body temperature and learning to eat.

ERIN

 

My 2 were born at 32 weeks and were fine no breathing issues or health issues just a little jaundice but most babies get that. They were just a little small and needed to figure out how to feed! They were out withing 4 weeks weighing 4lb 3 and 5lbs 4 x