So, um, yeah, I had promised to update more frequently, and then, last week kind of fell apart. I waited, hoping it would get better, settle down, but alas….
On Monday, my high risk OB stopped by to tell me that she’d spoken to my perinatologist. He was out of the country on vacation when I ruptured, and my OB had consulted with both of his partners. Even though delivery was on the books for 34 weeks, and the literature states 34 weeks, and EVERYONE (including the two perinatologists) agreed that 34 weeks was the best option, my perinatologist suggested that we might try to get closer to term. My OB said that she planned to talk to him again, after he’d had a chance to talk to his partners, etc…
While we were talking, I found out that she hadn’t received the final report from U of M (NOT happy about that), which stated that they couldn’t rule out a small VSD on Baby B, and that a repeat echo should be preformed after delivery. She wanted to get it done right away.
On Tuesday, one of the other high risk OBs in the practice stopped by. She said that in her opinion, we need to deliver at 34 weeks. It’s clearly in the literature, and what if we keep pushing, and then something bad happens, which it likely will. She said, “At this point, there are too many cooks in the kitchen” and there are already so many people working on this case, we need to draw the line somewhere, versus continuing to ask people for their opinions. She said we can ask 100 doctors, and we will continue to get different answers. There are too many variables in my case.
On Wednesday, this hospital’s pediatric cardiologist and his team arrived in my room to do another fetal echocardiogram. After an hour of scanning, much of which the cardiologist did himself, it was determined that Baby B has multiple small VSDs (ventricular septal defects) and a possible bicuspid aortic valve. He said it’s not clinically significant and probably wouldn’t require treatment. After they left, nurse after nurse came in, teary-eyed, and offering hugs. Hmm, okay, now I was upset. Then my doctor came in, same thing. When she left, she said she was on her way to speak with the cardiologist, as he hadn’t entered his report yet. She promised to return in the evening.
Sure enough, she later came waltzing in the door. She said that she’s spoken to the cardiologist and he felt terrible for upsetting me. I told her that he hadn’t upset me; he basically told me it wasn’t a big deal. It was everyone else that seemed so concerned, which in turn, made me worry. So, as it stands, this is not a big deal and they will repeat the echo after delivery.
And then there was delivery. I asked her the dreaded question, “If you were going through this, what would you do?” Answer, “I’d be done at 34.” Yep, signed, sealed delivered. That is all I needed to hear; I completely trust her. She was going to speak with a few of her partners, but in her opinion, 34 is it. We talked on the phone a bit later, and sure enough, two of her partners (both have super impressive backgrounds, and I’ve worked with both) said 34 weeks. My nurse overheard part of the conversation, which included one of the doctors saying that this case has too many unique circumstances, and that we shouldn’t push our luck. Going further is “begging for complications” and “setting ourselves up for disaster.”
One of the doctors who was consulted on the 34 week delivery plan stopped by the following day. She offered lots of hugs, and then I thanked her for her involvement in my case. Her background is very impressive (training at two world-renowned university hospitals on the east coast.) She has done a lot of research on my case, even though she’s not my primary, and I’m technically only her responsibility when she’s on call. In her opinion, delivery needs to happen at 34 weeks. This is “uncharted territory” in her words, and there is nothing in the literature about a demised twin, PPROM, and continuing to stay pregnant this long. Therefore, we need to play it safe and be done at 34 weeks.
34.1 it is!