Can someone talk to me about placenta deterioration please!

[Babysaurus]

Hello,
I am (obviously) going to call the diabetes unit first thing but if anyone can help me or share their experiences in the meantime I'd be grateful!

I appear to be running very low suddenly and have been most of today. My basal (background) levels are quite high and have been as I have needed it to be to keep tight control (especially as I am now much less active at 36 weeks) but now I seem to be constantly hypo (nothing dramatic, but constantly under 3.5 unless I check and snack all the time) and am wondering if my basal rate is now too high due to the placenta deteriorating...? I realise I can turn the basal rate down but am concerned about turning it down too much as I don't want to get a sudden spike!

I have read on here that sudden drops in current insulin requirements may be a sign of the deterioration of the placenta so am a bit concerned! Alternatively, it may simply be that the basal rate is now too high and just needs tweaking down and this may be a storm in a tea cup.

Exerperiences and thoughts are very welcome! Thank you! x

 

[trophywench]

I'm not sure Babysaurus - I know it can be a sign of the placenta failing so that call is of course urgent. Do you actually have a number for the maternity ward at this stage though? You could ring them if so? They'll soon tell you if it's something or nothing?

 

[beckyp]

I think that recurring hypos in pregnancy should never be ignored. If you can find the thread of Twitchy's in this forum then you should read it and take it to your appointment with you! She was having recurring hypos and it was a sign of the placenta failing. It's called something like 'never ignore hypos in the third trimester'. I found it really helpful and was really pleased that I'd read it. It gave me a little bit of knowledge to take with me to the appointments and made them realise that I knew what I was talking about and wouldn't be fobbed off.

I was having recurring hypos and my diabetes team didn't care - my obs was even harder to get hold of when I needed her. My insulin needs dropped by 50% at the end - from about 35 weeks (I was 38 weeks when I ended up getting induced a week early due to pre-eclampsia) and all they said was that IF I could get my levels above 4 at each hypo then it wasn't the placenta failing - I went on like this for 2 weeks until I freaked myself out one weekend (too much google!) and was taken in on the Monday afternoon. For some reason my insulin needs dropped throughout my pregnancy instead of increased.

Having said this - this is still something that should ALWAYS be checked. Ring your team as soon as you can. If you feel that something isn't right - it's probably because it isn't. You know your body better than anyone and trust your instincts.

I hope it gets sorted out. The stresses of pregnancy! 😉

 

[beckyp]

I forgot to say. I called the labour ward when I was worried and was just passed between the diabetes ward (with my usual DSN on holiday) was told that they couldn't answer pregnancy questions and then back to the day assessment ward. In the end I was told to go in for 'monitoring' to check the baby's heartbeat "to put my mind at rest" - I told them this meant squat in the grand scheme of things but in the end my blood pressure was up and I had 3+protein so my obs was called (they managed to get hold of her when I'd been speaking to her secretary for the whole morning and failed miserably).

You need to speak to somebody that knows what they are talking about because being passed between people that know nothing about diabetes causes more stress - my midwife was just as useless at my doctors - she just told me to ring my obs - much easier said than done I can assure you!

I will remember that day for the rest of my life - I have NEVER been so stressed and angry with people. 😡 HIGH BLOOD PRESSURE ALERT!!!!!

 

[beckyp]

Me again!

Found the link if you wanted to ready it...I hope it helps. 🙂

http://www.diabetessupport.co.uk/boards/showthread.php?t=7815

 

[Monkey]

No direct experience, but if you've got any concern, I'd be calling the maternity unit rather than the diabetes team. If they think you need to be seen (and I'd put money on them wanting to at least do some monitoring) then your diabetes team should, in theory, be alerted.

Really hope it's nothing to worry about, but as a mw once told me - they'd rather see thousands of women where everything is fine, than not see the one who needed attention. *hug*

 

[Babysaurus]

Quick update being typed on my phone.
Spoke to the triage midwife last night who, basically, said she had no idea about diabetes and pregnancy but said that if the movements of the baby seemed okay I should hang on till tomorrow and call the diabetes team.
So, I have and they put me through to the, erm, triage midwife - a different one this time - who, after taking all the details, said she'd have to speak to someone and then will call me back. I have an antenatal apt tomorrow at 1.30 which may be enough (though from what you lot said I am now wondering otherwise) but they may ask me to come in earlier to be monitored for a few hours - I presume by this they mean listen to the baby or similar...?

Am still running rather low but can alter that okay on the pump (as I explained to the DSN - unfortunately my regular one is away this week) but it's why I am running low that is confusing.

Thanks for the replies ladies, I'll keep you posted!

 

[Northerner]

Hoping everything is OK 🙂 Wish I could help, but am totally out of my depth here! Good luck tomorrow, I hope they can put your mind at rest 🙂

 

[RuthieG]

I have an appt with Obs/diabetes Doc's this afternoon and will ask for their general thoughts on this to see what they say (although it will of course be general based on my musings!)

Hopefully it is just one of the many unpredictable fluctuations/weirdnesses of diabetic pregnancy and all is hunkydory

 

[Babysaurus]

Hi all, Just had a call from the widwife who deals with the diabetic patients and she suggested going to A+E. I asked what they could do in A+E and she said they'd check the levels on the pump and make sure they weren't too high - hence, I said I can do that myself, possibly more precisely than they can as I am used to the levels I am at and also at the pace to alter them given the miniscule margin for error I currently have. As for insulin requirements dipping, they'd be guessing as much as I would be / am doing so really a trip to see them seems unneccessary. She also said 'they could do bloods', but on further questions this meant testing with the same method I do at home so this also seems a bit over the top to go to A+E for.

As I have an obs apt and also a scan tomorrow she, diabetic midwife, said to come to that and it may give us some answers. She suggested a growth spurt, or stopping growing could both cause some issues or it may be just one of those things. As I can feel movement there's no massive rush.

Not sure if I am happy with this or not. I suppose I am, but perhaps I was hoping for a bit more concern baby wise rather than the offer of someone to sort out my pump. I did say that the diabetes side I can sort myself, it's the why's and wherefore's which are more concerning but she didn't seem to think there was too much room for concern so perhaps that's that. Guess it's all good then really, isn't it....?

Ruthie, I'd be interested to see what they say at your apt so see if it matches what they said to me. Keep me posted - thank you!

 

[trophywench]

Well just hope you have everyone's name in case you need to sue .......

They'd go berserk if summat did go wrong and you ignored it !

 

[Monkey]

That sounds fairly reassuring tho, considering you've got an appointment tomorrow - in terms of monitoring, I imagine they'll want to hook you up to a CTG to check babies heartrate etc. I assume you're having regular scans (mine were weekly by the point you're at) to check blood flow thro the placenta and amniotic fluid levels - if not, I'd imagine they'll check tomorrow.

This is all assuming you're still feeling baby move as much as normal - if not, or if it'd put your mind at rest, call the day assessment unit and explain your worries.

 

[sugarfreerach]

How many weeks are you? My hypos started at 35 weeks and I was induced at 36 plus 2 as a result. I had a week in hospital before this but was allowed to reduce my basals myself and was allowed to keep control of my pump. The midwives didn't really get it though and said things like any hypos? No? Oh that's good. I had to explain that it was because I was now on 20% pump output now and no its not good! I wouldn't panic though and wait til you see them tomorrow.

 

[RuthieG]

Babysaurus I completely forgot to ask the doc about this (due to tears and upset as baby measuring big). Really sorry. Let us know how you go on tomorrow and as I said earlier hopefully something and nothing and just a matter of lowering basals or something simple like that
x

 

[PhoebeC]

I hypoed from about 24 weeks pretty much non stop I once phoned my nurse with typos and pains and she got me in that afternoon for monitoring They told me to always go in if i was worried as hypos for no reason can be pre eclampsia I was always low and reducing insulin till 34 weeks when on a check up it was actually pre eclampsia
I would go in if your at all worried
h
Hope your okay xx

 

[Babysaurus]

Hi, typing in the bath so this may be a bit disjointed.
Rachel - I am 37 weeks now so officially 'full term'. Your experience with the midwives is just the kind of thing that makes me so distrustful and wanting to control things myself whenever possible. I take it the induction was due to the placenta then, or was it something else?

I am reasonably okay with todays explanation, and a large part of that is because I am in tomorrow anyway so can hopefully get more answers or response face to face instead. As movement is normal, at least as much as I can tell with an anterior placenta, and I feel okay (if a little low blood sugared at all times!)I guess that must mean something. If it was another week till the next apt I may have called back and made more of it but I'm in at 1.30 tomorrow so not too long.

Monkey, my scans have been monthly and tomorrow is my last one. Will convince myself that's because they are not viewing me as someone to be extra concerned about as it makes me feel better than assuming its just due to varying hospital policy.

Phoebe, thankfully my blood pressure has been always on the low side (have had a few checks as my feet are like balloons) so am not too concerned about pre eclampsia, at least at the moment.

Thanks again for your replies everyone, at times like these they mean a lot! X

 

[sugarfreerach]

hi, glad you feel a bit more confident. Yes they induced me as by the end i was on 20% insulin output. The baby didn't show any signs of distress in the week i was in hospital but they wanted to induce anyway. I had low blood pressure all the way through my pregnancy, i actually couldn't stand up for more than 3 minutes when it was at its worst. So blood pressure doesn't necessarily mean a lot until it sky rockets when its actually pre eclampsia.