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!

Specializes in NICU.

Hey everybody!

I just got back from my new OB's office and things went very well. BP was great, no protein in the urine, fetal heart tones in the 150's and baby was moving, uterus size was normal, PAP smear was mercifully quick, and apparently I have a very healthy looking cervix :chuckle . I had my quad screen for chomosomal abnormalities but chose not to do the cystic fibrosis test since my insurance won't pay for it and the chances of me and my 100% Asian husband having a baby with CF are really low to begin with. I go back in two weeks to check my urine, BP, and fetal heart tones. Next month I'll have my level 2 ultrasound. The doc said that I should relax and start enjoying my pregnancy because, even though I had a rocky start, things are going well now and she's pleased. Still on the low sodium diet and doing BP checks twice a day, but other than that she said I should have no real restrictions as far as activities. Plus she said I didn't have to take the fancy prenatal chewables - she said since I'm in the second trimester that one Flintstone or Centrum chewable a day was absolutely fine and that they're cheaper and taste better than the prescription ones anyways.

And when I got home, my husband presented me with a treat - pink bubblegum ice cream from Baskin Robbins. Now that they stopped making my favorite ice cream ever (Ben & Jerry's Heath Bar Crunch), my second favorite will have to do. I can't wait to have some later! :)

Thanks everyone for your support. I'll keep you updated.

Specializes in NICU, Infection Control.

sounds good, Gompers!

So glad to hear everything is looking good. Now take your doctor's advice and relax and enjoy. Thanks for the update. Oh, and enjoy the ice cream too!

Specializes in Maternal - Child Health.

And when I got home, my husband presented me with a treat - pink bubblegum ice cream from Baskin Robbins. Now that they stopped making my favorite ice cream ever (Ben & Jerry's Heath Bar Crunch), my second favorite will have to do. I can't wait to have some later! :)

Thanks everyone for your support. I'll keep you updated.

Wow! If you can eat bubblegum ice cream, you must be feeling better :)!

Glad to hear it!

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

Glad everything went well! Enjoy that ice cream!

So late in sending you my congratulations...my apologies.

Glad to hear the 2nd trimester is looking up! I hope you'll be able to enjoy the rest of your pregnancy. Well, I don't think any of us really enjoy those last couple of weeks!

Take care of yourself.

Sparky

Specializes in NICU.

Hey guys!

Just wanted to give an update:

Had my "big" ultrasound today (20-1/2 weeks) with the hubby at my side. My OB said I was really fine to have a "normal" ultrasound with radiology but I kind of begged for a level II so there would be a perinatologist there. ;)

Pretty much, everything looked good! Placenta in a nice position and no obvious fetal abnormalities. I had two OB techs doing the scan first, then the attending was supposed to come in but she just sent in the fellow instead to get one more view of the heart vessels (they were fine). So I think that's a good sign and am so relieved!

Only thing was that the baby was kind of big (15 ounces instead of 10-13 like it should be) and the belly was measuring a week larger than the rest of the body. Given my history of PCOS (plus being overweight), they're going to test me for gestational diabetes a little early at 24 weeks and also do another ultrasound at that point for measurements. But overall, things are okay!

I see my nephrologist next Friday and did all my urine and blood labs today so that will all be in order for that appointment. Pray that there is little or no protein spilling! My BP has been stable.

I'm ALMOST starting to relax now.

Thanks for your support for the past five pages, guys! :)

Specializes in NICU, Infection Control.

Gompers--you're not gonna relax for another 20 years or so, start liking it! :lol2:

Keeping fingers and toes crossed that things continue to veer towards normal! (it's hard to work/walk like this)

congrats gompers, i'm sending some very belated happy thoughts your way. hope things are continuing to progress nicely for you!

Specializes in NICU.
congrats gompers i'm sending some very belated happy thoughts your way. hope things are continuing to progress nicely for you![/quote']

Thank you very much!!!

Things are going pretty well - 29-1/2 weeks now and baby is about 3 pounds per ultrasound. Still seeing lots of docs - OB, maternal-fetal medicine, urology, nephrology - and having lots of appointments. Still spilling protein but not so much that the docs are really worried since my BP is stable. I did have a very scary night around 22 weeks where I started bleeding during my shift and spent the rest of the night in L&D, but it turned out to be fine.

Here's hoping I can make it about 8-10 more weeks!!! Thanks again for your support.

Specializes in NICU.

keeping my fingers crossed for you as my baby is pooping in my lap. see what you're getting into?

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

So glad things are going well!

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