Pregnant and terrified NICU nurse here...

Specialties NICU

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Hello, my fellow NICU buddies...I swear this is NICU related. I had some concerns plus since you guys "see" me the most here, I thought you'd all like to know how the heck I'm doing.

I'm pregnant (12 weeks) and terrified. Now, I know that all NICU nurses are probably paranoid throughout their pregnancies, but I'm really scared. At 5 weeks, when the little bugger declared itself, my normally borderline hypertensive (130/85) BP shot up 25-30 points, I gained 10 pounds of fluid in my lower legs (pitting edema), and I had 3+ protein in my urine. My doc made a comment about if I "intended to keep this pregnancy" then I needed to get to a high risk OB immediately. Yeah, that's what you want to hear, first off. (Actually, I had kinda known for a week already thanks to a HPT, but I was seriously convinced that it was an HCG-secreting cyst because I have PCOS, am overweight, and was told by my reproductive endocrinologist that the chances of me conceiving naturally were slim. Plus I checked for ovulation that month and had no surge. :uhoh3: )

So anyways, I called my endocrinologist (who also does in vitro, etc., so I figured who better for a high risk early pregnancy) and left a message. Not fifteen minutes later the nurse calls back and squeaks, "Can you come in tomorrow morning?!?!" Great, now I'm even more terrified!!! So anyways, definitely pregnant, definitely hypertensive, definitely spilling protein, definitely low-end-of-normal progesterone level. Since 5 weeks I've been on Glucophage for the PCOS (to prevent miscarriage) and progesterone suppositories. The endo sent me to a high risk OB at 10 weeks and that doc decided I could go low risk OB at this time. I also had a visit with my urologist (have one small kidney stone and microhematuria, so I ended up getting a bladder scope in the office - fun! :o ) and a nephrology consult. All in all, my BP is back down to normal, lost most of the 10 pounds, less edema, no more protein in the urine, creatinine's been stable at 0.6-0.7, - but I do have to take my BP twice daily, get monthly urine cultures (to r/o a silent UTI due to my kidney stone), and eat a low salt diet.

Anyways, NOW for the NICU part...

First of all, with the PCOS I'm at a high risk for miscarriage and a high risk for gestational diabetes. I want to stay on Glucophage for the long run, but the OB wants me off of it because it's a category C drug. The endo feels it can go either way - he says it will help decrease the chance for gestational diabetes but that it's up to the OB to decide whether it's safe or not. My endo is a huge fan of the med in general, but the high risk OB was extremely skeptical of me even being on it during the first trimester and I get the feeling she hasn't seen the studies that show its use dramatically decreases the chances of first trimester miscarriages in the PCOS population. Have any of you seen any babies born to moms with PCOS or gestational diabetes who were on Glucophage (metformin) that had any birth defects or problems? I haven't, personally.

Second of all, because of the BP and protein issues, I'm at a 20% risk for pre-eclampsia, whereas most women only have about a 7% risk. So I'm very scared about that - this is what is scariest to me, I think. I keep picturing myself being on mag sulfate, having a crash c-section at 23 weeks due to HELLP syndrome...

Finally, the issue is this - I'm delivering at my hospital, because of insurance reasons and the possibility of the pregnancy becoming a truly high risk one, in which case our docs are great. The problem is that if my baby does need to go to the NICU, it's my OWN NICU. I don't know how I feel about that. I love my unit and I know he/she would be VERY well cared-for. I just think it'd be completely awkward though! Have any of you had that experience? I mean, if the baby was really early, it's not like I'd be able to go back to work in the time between birth and discharge from the NICU! I'd have to take such an extended maternity leave, I just don't know if we could handle it financially. I just don't know what to think...

I guess I just want to hear stories from you guys - someone else out there has to have had a preemie in their own NICU. What was your experience?

And how in the world can I chill out about this? The OB gave me the name of a psychologist who deals specifically with pregnant women. I'm seriously considering making an appointment. I mean, I don't think I'm being totally paranoid here! I do have lots of risk factors to worry about. Do you guys think I'm freaking out for nothing?

Anyways, thanks for reading the whole thing!

First off, CONGRATS!!!

I have never been pregnant, but I have great fears about it after seeing what we do!! I think it is natural to be fearful. If you feel like it is consuming your thoughts, maybe you should talk to the psychologist.

I have not researched glucophage, but i have been told by my OB that some drugs are made a class C because of the fact that they dont have any research saying either way, so they make it a C. That is what she said about allegra. Either way, it sounds like your OB has a good approach to your pregnancy....crossing each bridge when you get to it.

I wish you the best, and keep us updated!!

You mean I was right about Gomper's secret!???! :balloons: :balloons: :balloons:

Congratulations!

Wow, such good and thoughtful advice here. I don't work NICU, we are too small for that and send those (thankfully) few babes down the mountain.

I did opt not to have my last child where I work for privacy sake because I felt funny having a doc deliver my baby when he was a colleague of mine; just too weird to have him looking up my wazoooo, so to speak;) . Our son was a surprise pregnancy when my I was 42 and my dh was 47. We worried about the genetics of it because we were such old people. ;) We did have genetic counseling and it was good for both of us to talk with someone way more knowledgeable. I also opted for amnio - which I think I was just scared into and think was unnecessary but that is hindsight and he is fine. I wouldn't do the amnio again though because I wouldn't have done anything different and think I just gave in to fear.

As to Class C, I was taking a drug when I first got preggers and didn't know it and talked to my doc who mentioned, as others here have, that we have no real info on those drugs and to not worry. (I also had gone to dinner in SF with an old friend at a fancy french restaurant, where we had champagne and wine). I worried alot. The doc told me not to.

My son was born w/o any problem, except that I didn't dilate and had to have a cesarean . ... but that wasn't his fault. Just an old uterus.

I'm very happy for you - I'd really try to control the GD with diet and exercise and then talk with as many "experts" as possible about the Glucophage.

As to pregnancy dreams - I remember them well. I stopped reading Stephen King with my first pregnancy because his stories just played right into my dreams . . ....

Best wishes!!

steph

Congratulations Gompers!!!

I can't help with the questions, as I deal with the opposite end of the age spectrum, but I WILL pray for you and your precious little one... how miraculous that you were able to defy medical predictions!

Praying for you... BOTH of you!

Lori

Specializes in NICU.

First of all, congratulations!:balloons:

I know not all nurses have problem babies, but sometimes it seems that way. We'll be going through this pregnancy with you, and pray for a nice baby who doesn't complicate life in your NICU.

Specializes in NICU.

Thank you guys!!!

Now enjoy your pregnacy,darn it!

Dawngloves - Yes ma'am!!! :)

You mean I was right about Gomper's secret!???!

Steph - yes, you were! Thank you for all the advice and support!

Also thank you Lori and Mimi for your well-wishes.

Today I'm doing a bit better. My blood pressure is now staying under 120 systolic and I'm very happy about that! I also have a handful of Clinitest strips and there appears to be no protein in my urine at this point. I haven't gained any weight yet, which at this point I think is a good thing for someone who is already, oh, 60-70 pounds overweight. I'm eating a lot less because of my poor appetite and nausea, but I'm making good choices like fruit and protein.

Thanks again for all the support!

Specializes in NICU.

With my youngest, I ate lots of fruit and veggies, cut the bread, pasta and potatoes. Then on my way home from my check-up, I'd stop by the donut shop....one a month wasn't bad! A month before he delivered, I'd gained 14lbs, and I delivered him on the day of my next appointment. He weighed 7-5, and I lost weight after the delivery.

I guess my glucose was fine, in those days we weren't checked.

Thinking good thoughts for you!

Specializes in NICU.

Gompers - Congrats to you and your husband!! :)

I have no advice, but I do want to wish you the best ..... I hope you have a healthy pregnancy and healthy baby. Take care.

Specializes in Med-surg; OB/Well baby; pulmonology; RTS.

Gompers,

First of all CoNgRaTuLaTiOnS! I remember you posting you had PCOS (I do too) in some other threads.

I'm not a NICU nurse: I'm a former NICU mommy x 2 ;) . When I became pg with my DD (my second pregnancy) I was on Glucophage as well to help with the PCOS and IR. I stayed on it the whole pregnancy as my doctor told me that with PCOS you have around a 50% chance of miscarriage and there was some research that showed it may help stave off GD, which you are at a higher risk with PCOS especially if you are insulin resistant. My DD was born at 32 weeks (due to preeclampsia) and she was born healthy. I have also had several friends who have been on Glucophage the whole pregnancy like I was and their babies were born healthy too.

I can't help with anything else, but I hope the above helps ease your mind a little anyway.

And if you think talking to someone would help, go for it! Anything to reduce your stress level.

I wish you a happy and healthy 9 months :balloons: and I am sending "stay away" preeclampsia vibes :monkeydance: (I had pre-e with both pregnancies-the last time it was much more severe).

Specializes in Neonatal.

Hi Gompers, Congratulations!:balloons:

Well, I am a NICU nurse and my son low and behold ended up in MY NICU where I worked. He wasn't a preemie, he was term with sugar issues, and ended up staying for 3 weeks, he ended up having an insult on MRI:o . Looking back it was one of the most stressful and emotional times of my life because it was completely unexpected. Having him where I worked had advantages and disadvantages. The advantages were I completely trusted my co-workers and docs, got VIP treatment, and everyone was super nice to me. Also, I knew how things worked and operated in my NICU and what to expect. The disadvantages were that I had no privacy. Even while visiting my baby there was always someone coming to say hi, which was nice, but sometimes I wanted to be alone and anonymous. Also, everyone on the unit knew what was going on with my baby- so again, privacy issues.

Hopefully, you will not have to be in that situation though because your baby will be just fine! **Positive energy and thoughts your way**:)

Specializes in Telemetry/Med Surg.

Hiya Gompers! So this was your secret that I was questioning you about a little while back. Wonderful news. I have no advice for you but wanted to wish you all the best. take care!!!

Specializes in ICU, CVICU.

Hi Gompers! Congrats on your pregnancy!!!!

I have PCOS and concieved naturally too. I never used glucophage (but did use progesterone) and I did not have any issues with GD. My perfectly healthy boy was born at 41 weeks so I hope that gives you some encouragement.

I hate to tell you this but that feeling of panic doesn't ever go away! Even when the kid is born you are still going to worry :) That being said, I hope you have a wonderful and uneventful pregnancy.

Hi Gompers

My son was a 27weeker(800g) and I was Staff on the NICU that takes any baby blow 30 in my area here in London. I was glad my baby was in safe hands coz the staff always said he is one of our own and did their best(can't thank them enough). That was an advantage and then the other side was to be honest some of the staff maybe one or two seemed cheesed off coz they felt I was getting VIP treatment and some unpleasent comments would be said and it did hurt my feelings even upto now when I think of it coz I wasn't there on my unit "for leisure".And when I had to deliver 2 of the Intensivists were there and my nurse colleague boy do I even know which way to look even up-to-today?. After my son was born he was on the unit for 13weeks I did not go back to work I did go PICU agency and NIcu agency and my worry was the funds were tight.

Long story short you will have to weigh the pro's and con's. And all the best you are in my thoughts and prayers.

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