July 20, 2010

Work and pregnancy update

What a night! Busy, busy, busy! Thankfully, we are starting to pick up in the baby department after several months of s-l-o-w. Summer is usually pretty busy and business has been booming. Of course, it's never a even level of busy. It's either dead or we've filled every labor and post-partum room. No happy mediums for very long anyway. This weekend was no exception. Saturday was pretty slow, which ended up being a good thing for me, which I'll get into later. Sunday night we were pretty busy but nothing crazy. Last night, we were busy from the start: short-staffed for what we had and quite a few patients. I was in charge and if things went as they were "supposed" to, it would have been fine. But, we all know that's not how life is in healthcare. About 5am, when I need to start calling people to see if they would work dayshift (who was also short) a labor was very close to delivery, we were expecting 2 people at any moment for 5AM for scheduled procedures, and we had 2 pretermers down in the ER. No one from nursery was available to attend the baby at delivery so I planned on doing it...until I realized I would need to admit one of the new patients. Thankfully, both people we were expecting at 5am were late. Tthe laboring patient wasn't completely ready to deliver until the dayshift charge nurses had arrived at about 6am and she ended up getting quick trip to the OR, which bumped our scheduled 7am c/s and the to-follow c/s. It was just crazy! But, we managed and I got to bed about 8:30.

I saw Doc today and talked about some of the preterm contractions/irritability I've been having. In the last 3 weeks, I've had 3 episodes of contractions and irritability that were frequent, consistant, and painful. I won't go into too much detail, but the last episode was Saturday night and I ended up going home early...with the promise to come back as a patient if things picked up or didn't slow down. Thankfully they did eventually slow down. Now I will say that I was fairly certain they weren't doing anything to my cervix - they were just very uncomfortable and miserable, and I have no intention of letting things get out of hand. I have no intention on having a preterm baby if I can help it. So at my appt today I talked with Doc about these issues. I had mentioned what was going on 2 weeks ago when she came in for a delivery so she kinda knew things were happening. She did a fetal fibronectin swab and I should have the results of that tomorrow. My cervix is closed, but she thought it was thinning a bit, but wasn't too concerned at this point. The fetal fibronectin is a substance that is like a glue that holds the amniotic membranes to the uterine lining. It's normally not detectable between 24-34 weeks. If it is detected in the secretions, or positive, then it indicates that the glue is breaking down and that there is a high risk of preterm delivery in the next 2 weeks. If it's negative, or not detected, then there is (I think this is the correct percentage) a less than 5% chance of delivery within 2 weeks. It's just a way to keep from intervening with bedrest and such for preterm contractions if it isn't necessary. So if it's negative, then I can continue like I am, but if I have another bout of painful contractions, then I earn myself some brethine, procardia or hydroxy-progesterone injections to calm my angry uterus. If it's positive, well, that changes things, and we'll see what my future holds.

1 comment:

trooppetrie said...

please keep us updated. after having my water break at 26 weeks i am praying this blessing stays put