November 21, 2005
permalink 32 weeks - no sign of oedema!!

Wow - five weeks since my last post. Life with a toddler is indeed busy when you're pregnant with diabetes and trying to get heaps done!

From a medical point of view things are going really well. I'm 32 weeks tomorrow. Checking with my old ob's records and my endocrinologist's records I already had moderate oedema by this stage with the last pregnancy and I have none now. Yay!! This time last pregnancy I had around 2g of protein a day in my urine and this time I have 0.62g. I also have slightly higher serum albumin, which is a good thing too, at the moment.

This has pretty much flabbergasted me as I had assumed that my pregnancy, oedema and pre-eclampsia wise, would follow pretty much the same timeframe as with my last pregnancy and this bub would be born at 35, 36 weeks at the latest.

My daughter was born at just before 37 weeks, which I reckoned was probably leaving it a bit too long in retrospect, given the amount of oedema I had by then (27 kg weight gain). This time, so far, I have only put on 8kg. So fingers crossed on the pre-eclampsia front.

The irony is that me doing so well means bub is (hopefully!) going to arrive right at peak public holiday time over Christmas.... The docs reckon a delivery between 37 and 38 weeks is best and have penned me in for a caesarean when I am 37 weeks and 1 day along, 28th December. Originally I was chuffed at this idea as it meant I'd get further along in the pregnancy than I ever expected to, but now I'm having thoughts like, 'What if I'm going really well? Will bub's lungs be mature enough at this gestation? Should we pluck bub out at this pre-ordained time or let him stay in a bit longer?'. 'Should I be trying for a VBAC' (vaginal birth after caesarean) even though I'd no doubt have to be induced?

... By the dates I had kept in a chart when we were trying to conceive, I figured my little bubba would if anything be younger than 37 weeks and 1 day old on 28th December... I'd love bub to stay in as long as is healthiest for the two of us and I was a little freaked out that my obstetrician would be away until a few days before this penciled in date so it would probably be difficult for me to change them, especially given that it was Christmas! Just thinking about it is completely mind-bending.

My obstetrician gets back from overseas on the Thursday before my c-section is booked (Wednesday following week). I see her at 1pm on the Friday after she gets back. That afternoon the whole world finishes work for the Christmas holidays. I am due to have the c-section at 7am the following Wednesday (28 December) ie first working day after Christmas public holidays! So if my ob wants to change anything eg dates, people, the giving of steroids for lung maturity etc... it doesn't give her (or me) much time. Also, rescheduling would probably mean rescheduling for dead on 38 weeks, after the next public holidays for New Years and I'd be nervous about doing this unless I was able to be monitored closely for pre-eclampsia and bub's wellbeing over the 37-38 week period.

Anyhow, I am raving on, very very tired so I hope some of this is making sense.

Other factors are that my endo goes on leave on 1st January and my old ob who I hope might be able to assist at the caesar also goes on leave on the 1st. Hmmm...

In terms of trying for a natural, albeit induced, delivery, my obstetrician was more positive about an elective caesar, although she would support me in trying for a VBAC if all was going well. My endocrinologist was against trying for a VBAC given the risk of scar rupture. At the time I discussed it with them I figured I would still end up with a lot of oedema on board which would increase the risk of rupturing the uterine scar (as would being induced apparently). In addition, the Christmas period, with so many staff away, in the context of the potential high risk nature of the birth situation, made me want to control as many factors as possible. Not sure if this makes sense, but yep, I certainly did wonder what I'd been thinking when conceiving a baby to be born at peak holiday season!!!!!!!!!!!!!!!!

My brain is fading so I should go, but remind me to write about stem cells... yet more fun and games...

** Added over a year later...On a much more trivial note, at some point during both pregnancies, and also after this little bubba was born, I experienced pain in the arches of my feet (no doubt because of the extra weight of either being pregnant or carrying bub and possibly the changes to the connective tissue during pregnancy). I found great relief for this by using gel arch supports (available from the chemist) inside my shoes. So far, this foot pain has only ever been very temporary.

Posted by M.A. at November 21, 2005 06:32 PM

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