Tuesday, February 2, 2010

Bed Rest

Today I had another appointment with the OB. During the non-stress test, the baby's heart rate was non-reactive. They gave me some juice and waited a bit longer. Just as they were about to do a BPP ultrasound, the baby showed some reaction. I had no idea what all of this meant, I just knew it wasn't how the test usually goes. I found some more information about it and if you want to muddle through it, it is posted below. During the test they also monitor contractions. Mine were coming every 4 minutes. They weren't strong but they were uncomfortable and large enough to register on the monitor. When I spoke with the Nurse Practitioner they let me know that they are going to do a BPP next Monday and that I have to be on bed rest. They are going to try to get me to 39 weeks now that the baby is no longer breech and they think that at that point I could be induced rather than have a C-Section. I just cried when I got home. I had no idea how I was going to do this. Tonight was a wreck, Matt was very helpful but the kids were impossible and I just knew there was no way that this was going to happen. Matt's step-mom called tonight and once again is coming to the rescue. I am so thankful for her. She is coming down this weekend to stay for 2 weeks. My mom has offered to come early as well and so between the two of them I may actually make it through all of this without having a complete breakdown. My guess is though that this baby is not going to wait until 39 weeks, I have been having contractions and cramping off and on all afternoon even though I have been down flat. It will be such a relief to have her here.

Reactive vs. nonreactive tests

The usual baseline fetal heart rate is between 120 and 160 beats per minute. Once the monitor is in place, your practitioner will look for certain measurements to see how the baby is faring, including if his heart rate rises when he moves. An NST is considered reassuring if there are accelerations of the fetal heart rate of at least 15 beats per minute over the baseline, lasting at least 15 seconds, occurring within a 20-minute time block. This is called a reactive NST. If these accelerations don't occur, the test is said to be nonreactive. In addition, since many women have mild contractions that they may not even notice, your practitioner will note any of the baby's responses to contractions or if the fetal heart rate dips below baseline

What does it mean if the NST is nonreactive?

A fetus who is sleeping may not demonstrate accelerations. Your practitioner will have to wait, then, for him to wake up. Although a reactive NST is a good sign, a nonreactive NST does not mean the baby is in trouble. If you and your practitioner aren't reassured by the results of the NST, or if the fetal heart rate slows down alarmingly, more testing is usually done. This might include a more prolonged NST, a contraction stress test, or a biophysical profile.

The Biophysical Profile (or BPP) is a fancy name for a prolonged ultrasound, sometimes lasting over a half-hour, that monitors the baby's movements in utero. In the third trimester, many practitioners use the BPP if they want to more closely evaluate how well the baby is doing and would like more information than is provided by a non-stress test. Sometimes a non-stress test is done the same day.


Mary said...

When I was monitored on the NST machine, a couple of times they gave me some juice too. Once I had some sugar in me, he would move around more.

I am so glad to hear that yo uare getting some help.

Luke and Tina said...

I will be praying that everything goes as it should. Good Luck and Congrats on the almost arrival of your little one.