38 week Amnio?

I am currently 22 weeks pregnant with my first child and my due date is at the end of May.  My doctor told me that at week 38 they will perform an amniocentisis to check the lung maturity of the baby.  If everything is fine, they will induce...this moves my "due date" up to the middle of May. 

I was just wondering if any current T1 moms out there went through this procedure and would mind sharing your experiences.  Any advice and/or suggestions are appreciated.

I did not have an amnio for either of my pregnancies (and I'll tell you, it seems pretty invasive to me).  If there is nothing wrong (baby is sized ok, no distress, placenta isn't failing, stress tests are fine, etc.), I wonder why they are so gung-ho about inducing at 38 weeks.   Of course, I was induced for both of mine at 38 weeks  - but didn't have an amnio for it... the reason for first was found to be low placental fluid via ultrasound and the 2nd was for my sanity of being low all the time, I requested it.

I'd do some research and find out if you really want to have this happen.   Maybe it is common practice, but I have not heard of this before.  i look forward to hearing what others out here have heard or done.  Congrats on the pregnancy!

I had to come back out here and let you know... that on Wednesday night (just hours after I wrote my response above), I was at an adult-type 1 get together and a few of the women were taking about pregnancy and childbirth.  Another girl, she's in her early 30s I'd say, said that when her daughter was born 5 years ago, her doctor did an amnio at 37 1/2 weeks and did a C-section once confirmed lungs were developed .    ???  Who knew!!! ??   Just wanted you to know that I have now heard of it. 

The doctor told my husband and I that sometimes if a T1 on insulin carries a child to 40 weeks - the child will die without any reasoning (still born).  This scares the you know what out of me.  He said it is his practice to do the amnio at 38 weeks to check the lung maturity...and if it's OK then they will induce.  He said babies of T1's lungs sometimes develop a little bit slower than non-T1's so they do the amnio to prevent a problem before they induce labor.  I have a feeling that I will end up having a C-section, which is fine by me as long as the baby is healthy.  

Thank you for writing another message on the topic.  :o)  I appreciate that!

At my first Dr. appointment he told us all the tests that will be done...and this one (amnio) was mentioned, so at a later visit I asked him if I will definitely have to have that done, and he said "yes".  So I guess we'll see what happens.  My hemoglobin A1C which was drawn a couple of weeks ago on 1/6/10, was 5.1.  I just celebrated (and I use that term loosely) my 18 year T-1 diagnosis anniversary yesterday.  I was on shots at first and when I got to college I went on the pump - which was one of the best decisions of my life so far.  This past May I received my CGM and at first I was a little frustrated with it because it seemed to be off quite a bit, but my opinion has changed and I am very thankful to have it now during my pregnancy. 

 

Nicki is correct. Many theorize that like the rest of our vasculature, the placenta of mothers with T1 DM ages (or deteriorates) more quickly secondary to fluctuating glucose levels or unknown factors associated with the disease. For this reason, by 40 weeks gestation, the placenta may not be well adhered to the uterine lining or the connections are not providing adequate nutrition/O2 for the fetus. This leads to complications including cerebral palsy, placental detachment and stillbirth. I had an amnio at 37 weeks with both of my babies (my family are tall and have big kids anyway). It was simple, painless, and ensured that the fetal lungs are mature enough for delivery.

One of the reasons why there are so many more successful pregnancies in T1DM is the knowledge and experience of the perinatologists. Though I'm certain there are some who make it to 40 weeks without difficulty, why would you risk it? It is impossible to predict who will have those outcomes. Frankly, I would be worried to deliver somewhere that didn't practice this method or at least acknowledge it as it suggests a deficit of knowledge. No matter how tightly we control our blood glucose levels, our disease predisposes us to certain risks.

 

I had my son 3 months ago and I didn't end up doing an amnio. My doctor talked about it, but when all the check ups looked continuously well, we preferred not to have one done and out doctor seemed fine with it. I was however induced at 39 weeks and ended up having a c-section (stopped dilating). I'm on the pump and used a CGM. My A1c was around 5.8 during my pregnancy. I have a healthy boy. His sugar was low in the first 24 hours, but they brought it up with formula and we haven't had any sugar related problems since then.

Good luck with everything. 

Thank you ladies for sharing your stories and information. I did not know about the placental deterioration...I had not heard of that before, but it makes sense.  Thank you for your input.

Congrats on your new arrival Manuela!  What is your little boy's name?  How much did he weigh?  When was he born?  Glad to hear that everything is going well.  My most recent HgA1C was 5.1 (taken on 1/6/10) - I was extrememly pleased!!  I use a Minimed pump with CGM and it's working great!

I'm approaching week 24 within the next week...so I am getting nervous about the insulin resistance. 

 

I think the amnio is practiced often in some places and not at all in others.  In the hospital where i delivered, they do not do it automatically.  I'm not sure if they do it if there's some reason to induce really early (like before 37 weeks).  However, i firmly believe that the baby is best on the inside as long as he/she wants as long as both mother and baby are healthy.  That's why they do the NSTs and BPPs.

I delivered at 41w1d to a beautiful, healthy baby girl almost 18 months ago.  My blood glucose levels had been really good, all my NSTs and BPPs were perfect, but there were zero contractions on my NSTs.  No high BP, no protein in the urine and a cervix firmly closed, indicating that an induction would be unlikely to work very well.  So since everything looked good and baby was not measuring big, they let me go until she was ready to come out.  To me it made the difference between a natural labour and delivery with no pain meds and an induction that would have surely ended in a c-section (since even with the natural labour we only just avoided ending in a c-section).  She was just over 8lbs at 41weeks.

Good luck with the rest of your pregnancy!

Andrea

Congrats on your a1c!

I def agree about having an induction by 38 or 39 weeks, rather than risking going to 40. I was induced at 38 1/2 weeks and even got to chose the day of the week to go in. (: I think most peris have learned that with better control, they are less likely to need to induce at 36-37 weeks like they used to unless there are other concerns. So, your dr sounds like s/he's following typical procedure by suggesting 38 weeks. I think more T2's are allowed to go to 39 or 40 for whatever reason.

I also didn't get the amnio before induction. From the T1 mommies I've talked to online and in person, people still get them, but I'd say only about 1/2 of the ones I've talked to. My peri has been doing this for years, and he felt personally comfortable not doing it. He said he's noticed over the years that by 38 / 39 weeks, the lungs are typically mature, but that the liver is less likely to be mature. My son was treated for jaundice, as were the children of some of the other t1's I talked to. Jaundice is no big deal if caught early, but it's annoying, so I wished he had warned me more about the liver thing.

Hang in there! Around 36 weeks, my insulin resistance started to drop and I had the most amazing control of my life! If only I wasn't so tired so I could have enjoyed it more. (;

Hi Nicki,

Congrats on the pregnancy, hope things are going smoothyly.  I had amnios w.both my pregnancies (I'm T1 for 23yrs, have a 3yr old and 5 month old).  For my first (my son) amnio was unplanned, I had what seemed like ruptured membranes (water broke) at 30 wks and at 34 weeks they were trying to decide if they should deliever early or try to keep him in.  They said lung maturity had a lot  to do w.making that decision.  His lungs were surprisingly beyond where they hoped for (very developed) so I was induced (and ultimately had a c-section).

2nd baby (daughter) had a huge growth increase in mid-30s weeks and they wanted to schedule a section around week 38.  I was told they would have to do an amnio if we were scheduling a c-section for even 1 day earlier than 38 weeks pregnant, which ended up happening.  I was scheduled to have her 37 weeks, 5 days and therefore amnio scheduled for day before scheduled section.

As for the amnio itself, it hurts, but not horribly and not for long.  I found the worst part to be how damn scary it was. "Okay, lay perfectly still while we stick this long, long needle into your very pregnant belly and try not to move while it's in there."  Scary, but over fast.

NOW- the part you may not want to hear.  She was born after the amnio, a day earlier than planned because it broke my water (BUT- I may have again been leaking slightly prior to amnio, I was having contractions for previous 2 weeks).  But- that is not unheard of and they were not surprised.  Apparently while the risks are much smaller than having an amnio at beginning of pregnancy (ie- not risk of miscarriage) there's a risk of it making you go into labor.

Sorry to not bear only good news- but that's the deal as I know it.  Not fun, but I think pretty routine.  Probably much better than having a baby with underdeveloped lungs!  Take care and good luck, Rachel