35 week growth scan in to 36 weeks
All has been well in the weeks since my last scan at 28 weeks. I have seen the midwife for the usual check ups every two weeks and other than being mildly anaemic and having to go on to iron tablets things seem perfectly normal. I had a scan booked in for 35 weeks and 6 days to check the babies growth and check the functioning of the placenta. I expected to have the same as usual, consultant lead scan with a few assistants and a midwife. But I was called in to be scanned by an ultrasonographer who was lovely but straight to the point lay down get scanning type of person. She got on with the scan checking babies heart beat and rate, measuring various bits of him and then moved on to the placenta. She found the umbilical cord and did a Doppler scan showing the blood flow coming to and from the placenta, this measured the umbilical artery pulsatility index. This is a number calculated from the speed of the blood travelling to and from the placenta. This number starts high at the beginning of pregnancy and reduces as pregnancy goes on and should be much lower toward the end of pregnancy. High pulsatility index has been used as a measure to assess blood flow to the baby and is usually assessed alongside a measure of blood flow in one of the major arteries in the brain the middle cerebral artery.
Lower blood flow to the brain mean less oxygen to the brain and that is never good. So basically all in all this is a sign that my placenta is not functioning fully and could mean that the baby has reduced growth or stops growing altogether. My reading was 97% which anything above 95% is worrying and the ultrasonographer wants to have a chat with the consultant to see what the next step is. She tried to get a measure of the blood flow through the babies brain but his head is so far engaged that she cant get a clear picture. The ultrasonographer asked me to return to the waiting room while she showed my results to the consultant and then they would let me know the next step. After I had been waiting a little while a midwife calls me through and takes me into one of the day assessment rooms. I’m asked to get a urine sample and then return to the room and they will set me up on the sonicaid
monitor for a Dawes and Redman criteria assessment.
This involved the placement of two ultrasound probes on my bump. One over the area where the strongest heart beat sound of the baby can be measured and another on the top of my bump where they measure the fundal height.
This probe measures the strength of contraction but in this case it was measuring the strength of my Brixton hicks contractions. The Dawes and Redman criteria is a way of assessing the health of a baby. It’s a complicated algorithm that takes into account readings such as heart rate, strength, the amount and frequency of heart rate variability in the baby. So for example if the baby has a deceleration in heart rate that last a while or happens during contractions it can indicate the baby being in distress. After the usual blood pressure and other checks the midwife set me up on the monitor and I’m left for about an hour while the machine beeps and prints out various traces of the baby’s heart rate. I met the Dawes and Redman criteria twice during this time and when the midwife comes back she took me off the monitor and then took all the traces to the consultant for her to check. After a few minutes the consultant came back and has a chat explaining everything that has happened today and she is happy that the baby is doing ok but wants to monitor me closely from now on. We decide that I should come back in four days time to have the scan and the monitoring repeated but that the consultant would do the scan this time as she might be able to get a better look at the baby and then go from there.
I arrived back on the Thursday for a repeat of the scan. This time the pulsatility index has gone down to 94%. This however is still on the high side and the team put me on the monitor again to check the babies heart rate. Again everything seems ok with the baby although measurements on the scan put him just above the 5th percentile for weight which is why they think his growth has slowed or possibly stopped. As the tests have shown the baby is doing ok at the moment they are happy for me to go home and the come back on Monday for a repeat of the scan and monitoring. I got the feeling that this is how things were going to be from now on. Check ups every few days until he decides he wants to be born.
Monday came around pretty fast and for some reason that morning I felt that I should get things ready for his arrival. We had recently moved back into the house I owned with my sister as we had sold our one bed flat but not been able to buy yet. This meant me and my husband were living out of two rooms in the house, one for us and one for all our stuff. That morning I felt that it was time I set up the Moses basket and sorted some clothes and a changing area for our baby. I don’t know why I felt I had to do this maybe some sixth sense but I am so glad I did.
My appointment was in the afternoon so after lunch I made my way over to the hospital to repeat everything I had done the last two times. But this time when I was called through they took me to a side room and a different consultant has a chat with me. The first thing she said is that I have been booked in for induction the next morning and that they needed to go through the process with me. This is the first I had been told about being induced let alone being induced the next day. A wave of fear and anxiety rushed over me. The consultant must have noticed this tone of surprise in my voice as she asked me if I knew about this which I said that no one had mentioned it to me. So she gave me a leaflet and talked through the process with me. She was very nice but I got the feeling that she had other things to do and was trying to be quick with me. When she had finished it seemed like she was going to just let me go home so when she asked if I had any questions and I said that I thought my appointment today had been to have another growth scan check and monitoring done on the baby with my consultant, she was not sure so went to go and check and left me in the side room for a good while. This time I do get to see my consultant and she took me in to redo the scan. Everything is pretty much the same as last time but at least this time she gets a clear view of the baby’s head and can do the measurement of the blood flow in the brain. After she finished the scan the consultant said she was not too worried about the baby at this point but as I was nearly 37 weeks I should be induced sooner rather than later. She then said she would ring the labour ward and see if they were busy and if they could fit me in tonight for induction. This again was a big shock as I though I would at least get the night to prepare myself. So back on the monitor I went while I waited for her to get back to me. After about an hour she came to find me and said they had a space and could I come back at 6pm. It was 4pm now so I had two hours to ring my husband and get him back from work and get home, eat something and pack my hospital bag.
Roll on 6pm.