Friday, January 27, 2012

Kate update

So at our Tuesday appointment we found out that she is still head up, though she flipped from left to right - explain that to me... We have scheduled the external version for Friday, February 3rd. I am scared and worried but I feel I need ot give it a try.

My doctor said the chances of success for us as of Tuesday were more like 50/50 now, instead of up to 65%, because she is now on the right and facing left, where the placenta is attached, so when he goes to turn her, that may create a bit of an obstacle for her head. Plus my fluid levels are a little lower than at the last check (but still within norm) which also means that turning may be harder. Supposedly the higher the fluid levels the better the chance. Oh well. What can you do... He said that it is not really related to my own intake of water/liquids, barring extreme dehydration, which is not the case with me. So I can't really try to fix it by gulping gallons of water... We'll see him on Feb 3rd and we'll go from there. The good of the situation: he has definitely done it before, he is taking all the precautions that are necessary (as in getting another very experienced specialist to help out AND doing it at our selected clinic so that we're safe in case of complications).

I found some info about this procedure on WebMD and I am putting it below if anyone is interested.  Randomly, I found another person among the people we know who is in the same boat as we are and who is having the version done TODAY! I can't wait to hear how it turned out for her and her little boy.


External cephalic version
External cephalic version, or version, is a procedure used to turn a fetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labor begins. When successful, version makes it possible for you to try a vaginal birth.
Version is done most often before labor begins, generally around 36 to 37 weeks. Version is sometimes used during labor before the amniotic sac has ruptured. This can be a good time to use version, when labor is constantly monitored and a cesarean delivery (C-section) can be done right away if needed. But the chance to do the version can be lost if labor speeds up or the amniotic sac ruptures.
A scheduled cesarean is used to deliver most breech births if a version doesn't work.
Fetal monitoring

To avoid harm to the fetus, a version procedure is closely monitored.
Fetal ultrasound is first used to confirm the fetus's position, where the placenta is, and the amount of amniotic fluid. Fetal ultrasound is often used to watch the fetal position during the version attempt.
Electronic fetal heart monitoring is used before, possibly during, and after a version attempt. An active fetus whose heart rate increases normally with movement is usually considered to be healthy. If the fetus's heart rate becomes abnormal, the version procedure may be stopped.
Before the version attempt, you may be given an injection of tocolytic medicine to relax the uterus and prevent uterine contractions. The most commonly used tocolytic medicine is terbutaline.
While the uterus is relaxed, your doctor will attempt to turn the fetus. With both hands on the surface of your abdomen-one by the fetus's head and the other by the buttocks-the doctor pushes and rolls the fetus to a head-down position. You will feel discomfort during a version procedure, especially if it causes the uterus to contract. The amount of discomfort depends on how sensitive your abdomen is and how hard the doctor presses on your abdomen during the version attempt. If your fetus appears to be in distress, as shown by a sudden drop in heart rate, the procedure is stopped.
If a first attempt at version is not successful in turning the fetus, your doctor may suggest another attempt, possibly with epidural anesthesia to help you relax and to reduce pain associated with the procedure. Epidural anesthesia may increase the success of repeated version attempts.
Serious complications are rare during external cephalic version. But they do happen. This is why a version is performed in a hospital where you can have an emergency C-section delivery if needed

After the procedure
You and your fetus may be monitored for a short time after a version attempt. You can resume your normal activities after the procedure is over.

How well it works:
External cephalic version has an average success rate of 58%. Version is most likely to succeed when:
The mother has already had at least one pregnancy and childbirth.
The fetus, or a foot or leg, has not dropped down into the pelvis (has not engaged).
The fetus is surrounded by a normal amount of amniotic fluid.
The procedure is performed near term (36 or more completed weeks of pregnancy), before labor starts.
Version is least likely to succeed when:
The fetus is engaged down in the mother's pelvis.
The doctor cannot grasp the fetal head.
The uterus is hard or tense to the touch.
Compared to the first attempt, repeat version attempts are less likely to be successful.

Risks:
With frequent monitoring, the risks of external cephalic version to the mother and fetus are low.
Potential risks of version, for which the fetus and mother are closely monitored, include:
Twisting or squeezing of the umbilical cord, reducing blood flow and oxygen to the fetus.
The beginning of labor, which can be caused by rupture of the amniotic sac around the fetus (premature rupture of the membranes, or PROM).
Placenta abruptio, rupture of the uterus, or damage to the umbilical cord. The potential exists for such complications, but they are very rare.
In the rare case that labor begins or the fetus or mother develops a serious problem during version, an emergency cesarean section (C-section) may be done to deliver the fetus.

1 comment:

Colleen said...

Praying for you guys! Keep us posted on how everything goes tomorrow.

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