(post is long) oligohydraminos,hyperemesis gravidum & enlarged placenta???

Specialties Ob/Gyn

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My sister went into preterm labor (after she had been on bedrest) after she had taken our Mom to the ER for low BP on wednesday june 29. While waiting for mom to be triaged,a guy came into the waiting area,walked past my mom to tell the triage nurse that he had a gun.My sister saw it,told the triage nurse that she was taking mom to another hosptal.Nurse asked why,sister stated that she felt unsafe there(MCG).Took mom to the other hospital,mom was dehydrated,IV fluids infused,mom was being discharged when sister felt "leaking",went to BR to check,blood in the underware,so back to MCG to labor & delivery.Sister's doctor is there,as she was high risk pregnancy.

back up 7 weeks:sister was (finally)transfered to high risk OB doc @~20 weeks because doc treating her finally decided that she needed to be treated high risk after she had to be admitted when labs showed K+ was panic low,also had spotting due to placenta previa.was placed on bedrest-that was why Mom was there. She had been being treated for N/V for several months, finally Zofran 4mg po q 4 hrs prn actually decreased vomiting significantly.New OB does ultrasound showing oligohydraminos & placenta was very large.Ultrasound was done each week after that.OB told her that placenta had growths on it,amniotic fluid was practically nonexistant.Each week for six weeks,just more bad news.No infection,baby's heart functioning normally,ultrasound showed urinary tract all there.

My dad calls me june 30,thursday morning saying that he's going to GA,I said pick me up,I'll be ready,called my director,told her that my sis had went into labor, I needed that evening until at least Monday off to go to GA.Had already told my boss about my sis so she would know the whole story as to why I was needing time off work.Kissed husband and son bye,drove 13 hrs to Augusta,went to hospital next morning(Friday),then back again that night to stay with sis.OB doc had started second day of mag sulfate drip that evening.BIL & I were planning on spending the night with Sis,who had IV,foley & strict instructions not to get OOB,as even sitting up could increase chance of delivery.Sis said she needed to pass gas, I told her if she could lift a cheek to pass it,then she could.She told me that she kept feeling gassy.I asked when they had checked her cervix last when she asked what it felt like to "push",(3 yr old at home was via csection due to being in the breach position. "sometime yesterday".I called nurse to ask them to check cervix,OB doc comes in,sister is at a 10.Crowning, Doc calls everyone in to deliver baby,heartbeat still in 130-140's.Doc breaks amniotic sac,cord prolapses,NICU doc asked what they want to do,did they still want to have the csection?Sis &BILhad decided,save the baby at all cost. Down the hall for a csection with 1 of the many OB docs hand in there to prevent prolapsed nuccal cord from doing anymore damage,once in OR,anesthesia said they were going to "crash"her,sister took off o2 mask and asked what did that mean,they told her she would have to be "knocked out".BIL said he could not risk loosing his baby and wife too.baby's heart rated kept decelerating to way less than 30.Sis gave one really good"poo" push instead of abdominal pushes;Elijah Eugene was stillborn that night weighing ~1.5lbs, placenta weighed 3-4 lbs.OB doc had told them baby had less than 2% chance of living if delivered full term,had warned about all the possibilities,except what oligo can do to facial features because of cramped quarters.

Not Potter's syndrome.Hope that someone has some information.Her doctor's told her that they had never before seen a placenta that size and could not come up with a reason for the oligohydraminos.Sis didn't have high BP.Am very glad that sis didn't have c-section, was worried that c-section would cause her to loose too much blood.

Do OB staff have info on grief counseling?This was a ?? from my sister.I thought they would have.

Nurse on duty that night,took footprints & pictures put in a sealed envelope, told my sister that they may not want to look at them now,but in time may want to and then not have the chance.Once babe was born,sister no longer had nausea.She had lost over 15 lbs since beginning of pregnacy.Sister and brother in law finally found grief counseling.MCG used a turned oak leaf with a tear on it on the door to signify loss.Nurse that came in to check IV pump didn't see oak leaf sign,saw pit drip asked Sis where baby was.She told nurse"my baby's dead".THis really upset my sister,that someone coming into her room asked that question.

Sorry this post was so long, just wanted to get details in that may be important info so someone can tell me what can cause all these prenatal problems together.

Specializes in Nephrology, Cardiology, ER, ICU.

I have no knowledge of this but wanted to express my sincerest condolences.

Specializes in Case Mgmt; Mat/Child, Critical Care.

Wow, I am so sorry for the ordeal you and your family have been through. My heart goes out to your sister. This is one reason why I don't like our PP demise pt's to stay on the Maternity floor b/k, inevitably someone is gonna go in the room and say something about a baby. Or mom hears other babies on the floor.... It is so sad. How far along was your sister? Sounds like a lot of complications along the way. This is very emotionally draining for you as well...again, I'm so sorry.

PS: It sounds like the hospital is involved in the Resolve thru Sharing program...they should've given your sister a package and a memory box. Did she get to hold her little one?

PS: It sounds like the hospital is involved in the Resolve thru Sharing program...they should've given your sister a package and a memory box. Did she get to hold her little one?

Elijah was stillborn at 26 weeks,6 days, on July 1,2005.There was a manilla envelope w/ footprints on some kind of certificate and a sealed envelope with photos of him.

The nurse brought the manilla envelope & the death certificate paperwork in for her to fill out while she was in the room by herself.Sis had sent BIL back to the house for him to get some sleep,by that time,I was asleep w/ my niece. If I had known that they would have brought that in to her that night, I would have went back to the hospital when my brother in law came back from there.I don't think anyone should have to do that without a support person with them.

Neither of them held him.He was so tiny.When he was delivered,my BIL saw them holding his limp little body and blocked my sister's view,afraid that she would go into shock.After they released her from the hospital,he was unpacking her things,and looked inside the envelope.He locked his self in their room and wept. He was not prepared for how the baby looked in a photo. I explained to him that even babies w/ no problems can temporarily have facial distortions from lady partsl delivery.That the photo taken after birth was not actually how he would have looked.I didn't know how to explain to him that the lack of amniotic fluid had caused what he saw.

I guess that in a way, I am the luckiest person in this situation.When the OB doc did the cervical exam,and he was crowning, I asked my sister if I could look.She told me that she didn't care.So I looked over the doc's shoulder when she did the exam.I saw his tiny little head crowning.He had a head full of hair.

So that is my memory of my nephew.Heart still beating regularly,before amniotic sac was ruptured.Head full of hair. That is how I will remember him.

Can you tell me more about the Resolve thru Sharing program? They had such a hard time and are having a hard time finding answers.most difficult was not having access to counseling when they knew that more than likely they would be needing it.

I had a stillborn baby boy at 39 weeks gestation on June 18. Search for my postings and you can read all about it, if you so choose. It has by far been the most painful experience of my life, and I am so sorry for you, your sister, her husband, and all of your family. :icon_hug: I cried when I read your post, and I'm still crying. :crying2: Sometimes life can be so unfair. One thing that I've learned from my reading since my angel baby was born is that sometimes this just happens, and the majority of the time we can not pinpoint a cause. There's nothing we can do about it, it just happens. My baby looked perfect. My pregnancy was perfect. I have no idea why my baby had to leave me, and that is one of the hardest things to accept. There are studies that can be performed on your sister's placenta, and I hope that it brings some answers for her. The most important thing for you to do is to just be there for her. She is going to be feeling so many emotions over the next few weeks, including guilt, anger, denial, and intense sadness. Don't minimize her loss - her grief is the same as it would be if she had lost an older child. Hold her hand and rub her back when she cries. Don't be afraid to talk about him. Share the memories of his crowning with her. She will want those pictures - I look at my pictures at least 5 times a day and I don't know what I would do without them. That's really all the advice I can give - I'm still trying to work through this myself. I just wanted to wish the very best for you and all of your family. Give her a hug for me.

Sorry to butt in...I know we don't know each other, but boy, do I feel for her! I had my son three years ago in an emergency C due to SEVERE Oligo (level II u/s only found about a tsp in his bladder) and of course, failing heartrate, shunting blood to his head, intermittent bloodflow in between his heartbeats in he and the placenta (but the placenta test came back "normal" - oh, okay), IUGR...all of this was discovered at 35 weeks and despite weekly visits and my constant complaints of what I now know were symptoms of preeclampsia and toxemia if not HELLP syndrome, no one knew anything :rolleyes: No rupture of the placenta on tests and I know for a fact I never leaked. I didn't have raging BP so I was blown off despite having almost every end stage sign besides that (I have very low BP 80/60ish and they didn't bother thinking hmmm...110/90 is pretty high for her). The landslide started at 2 - at 9:18 my joy came screaming into the world at a slight 4lbs, 7oz. but healthy as a horse with triple 9's on his apgars. Interestingly enough, he has Down syndrome - something else they missed...Yes, I ditched that doctor! I have never, ever been able to find out what happened to the fluid and for a while, I have to say, he is doing so well a lot of people including his ped wondered if there was some mistake and the oligo cause the features rather than the DS. From about 30 weeks on I kept complaining of feeling like I was sitting on his head - turns out I probably was and I will bet that is when enough fluid was used up that he stopped being bouyant. That was a while ago and we know he has it, but in the absence of all else, as crazy as it sounds, maybe there was a congential anomily even if it didn't look like it. I will never know what happened there withthe flid - with the placenta fine and his heart and urinary tract fine, there had to be something else going on. Probably the toxemia? Sometimes no one knows why these things happen, they just do. It's a poor explaination, but when all else fails, I a decent I don't know from a doctor would have made me happy. Perfect souls rerely come in perfect bodies and some are too pure for this earth. I wish your sister and all of you peace in this troubled time.

First of all, let me say how sorry I am for your sister's (and your whole family's) loss. I too had an experience with Oligo - and I lived in Augusta, Georgia at the time!! About 26 weeks, I didn't feel my baby move as often for an entire weekend. On monday, I called my OB and he had me come in. He hooked me up to a monitor for a while, and noted several incidences of decelerations in the baby's heart rate. He sent me straight to a high risk pregnancy doctor at University Hospital. After several tests and an ultrasound, the oligo was discovered. The doctor grilled me about smoking, drugs, etc. I told him that I didn't do any of that!! He had no explanation for it. Over the next few weeks, I saw the high risk doctor once per week and my regular ob-gyn once per week, and the baby's condition was carefully monitored. I was hospitalized once for about 3 days for pre-term labor (on mag-sulfate) and spent the remainder of my pregnancy on total bed rest. Finally, at 36 weeks, the doctors agreed that leaving the baby in was more dangerous than delivery, so I was scheduled to be induced. During the night prior to my induction, the baby's heart rate decelerated for an extended period of time and had to be delivered by emergency C-section. Luckily, my son was born healthy (athough he did have IUGR). He weighed 5 lbs. 5 oz. and is a healthy 8 1/2 year old today. My doctor told me that I had about 1 tablespoon of fluid when he did the C-section. I had never heard of anyone else having this problem until today. I think it is poorly understood and evidently has disastrous consequences at times. By the way, I had no other symptoms (normal BP, etc.). The placental study did come back saying that it was basically through functioning normally. A few years later I had a miscarriage and I was just handed a pamphlet by the nurse at University Hospital, so I'm not sure that there are any great "support" programs there. But with a medical college and all of the hospitals in the area, you would certainly think so!! Your family will be in my thoughts and prayers!

Specializes in Case Mgmt; Mat/Child, Critical Care.
Elijah was stillborn at 26 weeks,6 days, on July 1,2005.There was a manilla envelope w/ footprints on some kind of certificate and a sealed envelope with photos of him.

The nurse brought the manilla envelope & the death certificate paperwork in for her to fill out while she was in the room by herself.Sis had sent BIL back to the house for him to get some sleep,by that time,I was asleep w/ my niece. If I had known that they would have brought that in to her that night, I would have went back to the hospital when my brother in law came back from there.I don't think anyone should have to do that without a support person with them.

Neither of them held him.He was so tiny.When he was delivered,my BIL saw them holding his limp little body and blocked my sister's view,afraid that she would go into shock.After they released her from the hospital,he was unpacking her things,and looked inside the envelope.He locked his self in their room and wept. He was not prepared for how the baby looked in a photo. I explained to him that even babies w/ no problems can temporarily have facial distortions from lady partsl delivery.That the photo taken after birth was not actually how he would have looked.I didn't know how to explain to him that the lack of amniotic fluid had caused what he saw.

I guess that in a way, I am the luckiest person in this situation.When the OB doc did the cervical exam,and he was crowning, I asked my sister if I could look.She told me that she didn't care.So I looked over the doc's shoulder when she did the exam.I saw his tiny little head crowning.He had a head full of hair.

So that is my memory of my nephew.Heart still beating regularly,before amniotic sac was ruptured.Head full of hair. That is how I will remember him.

Can you tell me more about the Resolve thru Sharing program? They had such a hard time and are having a hard time finding answers.most difficult was not having access to counseling when they knew that more than likely they would be needing it.

Geez, I am so sorry. I'm glad at least, that you somenting positive to look back on. And that you were there w/her. Resolve thru Sharing is a hospital/OB based program that the nurses usually participate in. Many times there are parent support groups, counselors and specially trained nurses to help deal w/pregnancy loss. I am including a couple of links that you and your sister may find helpful:

http://www.silentgrief.com

http://www.babysteps.com

http://www.empty-cradles.com/

http://www.havenofhopeandhealing.org/

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Geez, I am so sorry. I'm glad at least, that you somenting positive to look back on. And that you were there w/her. Resolve thru Sharing is a hospital/OB based program that the nurses usually participate in. Many times there are parent support groups, counselors and specially trained nurses to help deal w/pregnancy loss. I am including a couple of links that you and your sister may find helpful:

http://www.silentgrief.com

http://www.babysteps.com

http://www.empty-cradles.com/

http://www.havenofhopeandhealing.org/

This is a very helpful post.

I am sorry, even as an OB nurse, I hesitate to comment on such situations for many reasons. I just want to tell you how sorry I am for your whole family and the entire painful situation they have been put through. I feel such grief for you all------please accept my heartfelt condolences and thoughts. They are with all of you right now. :o

Specializes in PeriOp, ICU, PICU, NICU.

I am so sorry for the situation, please accept my condolonces :o

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