Conference moira::parenting_v3

    The placenta is like anything else -- it has a youth, a middle age
    and an old age.  From what I've read, it soundds like the placenta
    ages anyway, as the baby grows.  The placenta starts out being
    about the size of a dinner plate, and by the time the baby is
    full-term it's about the size of your liver.  Since the placenta
    nourishes, I am inferring that two things are happening:  The baby
    isn't getting as much nourishment as it could because the placenta
    isn't functioning as efficiently as it could; the dates may have
    been miscalculated and the baby may actually be older than the
    doctors think it is.  Please note, I am NOT a medical professional
    and can only offer my speculation and repeat what I have read
    elsewhere.  If she were my patient, she would be on total bed
    rest (and probably would have been from day one), but again, this
    is MHO and not a medical opinion by any means.
    
    I think the best thing we can do at this point is start sending
    prayers and positive thoughts to all concerned.  
    
    
    
    

    Just a small nit here, the placenta starts out as a small cluster
    of cells where the fertilized embryo implants in the uterine wall.
    This is definitely much smaller than a dinner plate.

    re: -2
    
    Kate-
    
    My sister-in-law has been on total bed rest for quite some time, as she
    was for pregnancies #1 and 2. This condition didn't occur the first two
    times, but given her medical situation (the kidney, high blood
    pressure, etc.) anything is possible. She doesn't seem too concerned
    about having the baby so soon because she's dealt with two premature
    births already, but everyone would prefer that the baby not arrive for
    another few weeks (for the baby's sake, of course). But if it does, it
    will get the best care available, as did its brothers.
    
    Thanks for the responses so far. We'll welcome any more information if
    anyone has any.
    
    Nancy- 

    This is paraphrased from the baby book my OB gave me during my
    last pregnancy: 
    
    The placenta is designed to nourish the baby for a normal
    gestation period of about 9-9.5 months; after that it starts to
    dry up.  I think it's supposed to start to shrink before the baby
    is born, so it's easier to deliver and doesn't leave a bleeding
    spot on the uterus.  But as its blood supply dries up, less oxygen
    and nutrients get to the baby.  In extreme cases, the baby can
    suffer brain damage or other physical damage.  Sometimes it starts
    to atrophy too soon, as in this case.  It won't necessarily
    automatically cause premature delivery, though I think it does
    most of the time.  
    
    My OB said this is why some doctors won't let a woman go beyond
    two or three weeks overdue before inducing labor -- the risk of
    placental deterioration, sometimes rapid, is quite high.  
    
    This condition can occur in healthy pregnancies as well, though I
    think high blood pressure does increase the likelihood of it
    happening.  
    
    --bonnie

When I was pregnant I read a great article about the placenta, but naturally
I can't remember where it came from.

Basically a placenta has a life-span of about 9 months.  Studies on full-term
placentas show normal "aging" signs like hardening of the arteries, etc....
That is why you don't want your pregnany to go much past term, because the
placenta loses its ability to supply the baby with nutrients.

If hers is aging early the baby might best be supplied artificially than by
a less-than-100% placenta.  32 weeks is not nearly the risk it used to be, and
the baby has an extremely high chance of survival and normal life if born now.

Please keep us posted - a special prayer to your family from ours!

Kristen

    I want you to know first of all, I am sending my best thoughts, and
    prayers to her.
    
    Second, AJ was born a aproximately 32 weeks, and was just 5 pounds, his
    lungs were mature, and outside of the birth defect, which aparently
    happened early on in the pregnancy, has no problem at all with
    survivability.
    
    My sister went two weeks past her due date, and the doctor said she
    showed signs of an aging placenta.  Her daughter was and is healthy.
    
    Lyn

    
    I hope all goes well with her...and just wanted to pass a little info
    on another cause for premature aging of the placenta...(not that
    she is a smoker) 
    
    Another thing that prematurely ages the placenta is smoking.  That 
    is why 'smokers' babies are smaller...they are getting less 
    nourishment than a non-smoker....you can actually see the
    blackened parts of a placenta where parts of it died....
    Typically, they are born premature as well with low birthweight.
    
    In my childbirth class there are 10 couples.  7 of them smoke.  I
    was amazed...they thought it would be cute to have a small baby and
    that they would be less likely to have a C-section...I was stunned!
    
    Don't mean to get off the track here...this topic just reminded me
    of it...
    
    Kristen 

    When Stephen was born, (1 day early) the midwife noticed I had an aged
    placenta.  She said it looked like I was 2-3 weeks overdue.  The
    placenta was calcified.  They didn't really have any reason for it but
    were careful to monitor the placenta with my daughter.  She was 2 days
    late and the placenta was normal.
    
    The main reason to watch it is to make sure the baby is getting enough
    nutrients.  I'll think good thoughts for your familiy!
    
    Karin

    I'd be interested to know if she's still hanging on, or
    if the baby has already been born!
    
    A little personal observation:
    In my understanding, the placenta does in fact get smaller (especially
    in the last trimester) I saw a picture of a term-baby's placenta, and
    it looked quite different than the one I delivered (at 33 weeks). One
    could see that mine was larger and seemed less "used up" than the 
    one in the picture. I was actually surprised at how large it was before
    I thought about it. 
    
    Monica

    I have a question...How did they detect the aging placenta before the
    birth?  I was diagnosed with aging placenta AFTER the baby was born. 
    It was rather scary to be told.  As soon as my daughter was born,
    the first signs were on the umbilical cord (varicous veins).  Then when
    the placenta was expelled, the doctor was more sure.  He said it looked
    as though I was an extremely heavy smoker.  I don't and never have
    smoked.  After further testing, they confirmed it.  My doctor has since
    told me that with future pregnancy that the risk would be greater and
    that it would be more likely for it to occur sooner with each
    pregnancy.  
    
    I did ask him why it occured.  He said it was most common with smokers
    or women who are in heavily smoke areas.  Also occurs in older women
    and ofcourse if you have both of these then your risk is supposedly
    even greater.  I, on the other hand, have none of these.  My doctor
    explained that in very small cases, when a woman has a history of
    delivering small birth weight babies, her chances also increase.
    
    So, back to my original question, How did they detect this before the
    birth of the baby without already being in any of these categories
    above?
    
    Lisa

    
    Thanks for the info so far. My sister-in-law was still holding her own
    (as of yesterday), and she is being tested at least twice a week to
    make sure that the baby is getting what it needs. Re: -1, I'm not sure how
    her doctor knows she has an aging placenta, or how
    they have been able to detect her other problems, but having seen what
    her medical people did for the first two, I have no doubt that she's
    getting the best care. My sister-in-law did say yesterday that she
    hopes to be able to hold out at least another week (so she will be at
    least 34 weeks along) because the baby will have a sucking reflex and
    better lung development. I realize that "they" are helping babies born
    as early as 24 weeks along, but there was a big difference in the
    amount of help that her two boys needed (28 weeks vs. 36 weeks). I (and
    alot of other people) hope this is her last child, though!
    
    I'll keep you posted when the baby arrives. Thanks again.
    
    Nancy-
    

    re: diagnosing it
    
    If they've been doing regular ultrasounds, they can see the change
    in size and shape.
    
    I think they can also tell by the baby's reactions to a stress
    test that the placenta is starting to not deliver nutrients,
    especially oxygen, efficiently.
    
    Also, doesn't the placenta produce some of the gestational
    hormones?  They could probably tell something by measuring those
    levels.
    
    --bonnie

A little personal experience about placenta size and due dates (late in this
case), and then a comment not directly related to the basenoters question:

When I was pregnant, and about a week and a half overdue, I was given the 
option of doing daily tests to see if the placenta had calcified or else I 
would be induced at 2 weeks overdue.  I remember thinking that I had had so
much blood drawn already that I could hardly handle the thought of more, so 
the tests may have been blood tests. 

Because of the tests, and even more because my doctor would be out of
town that weekend, and I had heard that the backup she was using that weekend
was homophobic, I decided to be induced at 2 weeks.  My labor was 30 hours
long (and hard), and that was even on pitocin.  When the placenta was
delivered, many of the staff remarked that it was the largest placenta they had
ever seen. 

My son was large (8 pounds, 12 ounces), and since I had conceived him
through artificial/alternate insemination we knew his exact date of conception.
Still, I feel guilty that I induced.  I keep wondering if there was
more development that my child needed, and which I denied him.

      Carol

    Carol,

    	I, too, was induced at two weeks post term and I have often
    wondered if there was a reason why Spencer had not even started to come
    out on his own. My labor was entirely on the pitocin and the baby
    literally had to be forced out with artificial contractions.

    	Perhaps he needed more time to develop, perhaps *I* did not (and
    maybe would not) have the chemical environment to initiate labor. It's
    one of those nagging thoughts that comes up every once in a while when
    women get together and discuss their labors.

    	FWIW, I asked the midwife if the first pregnancy was induced if
    that was any kind of an indication that future pregnancies would need
    to be induced. She indicated that there was no documented correlation
    but that in *her* experience, she seemed to think that once an
    induction than *chances* are another induction.

    	Not that I mind (too much) but it would be nice to be prepared for
    another induction, as opposed to going into this one without a clue of
    what induction meant on your body.

    			Wendy

Thanks, Wendy.  It's nice to know I'm not the only one who has had 
those thoughts.  For what it's worth, if I get pregnant again, I won't 
induce unless the baby is in distress.  Also, I found out *after* the birth
that when my mom was pregnant with me, I was 3 weeks late.  Maybe some
of us just take longer.  :-}

         Carol

    The happy outcome:
    
    Adam Cory Wassel was born this morning (January 10) six weeks early but
    weighing a hefty (for a preemie) 4 pounds, 10 ounces. Surprisingly (and
    happily), he was healthy enough to go to the regular nursery instead of
    the NICU.
    
    Turns out that the mitigating factor in Adam's early arrival was his
    mother's blood pressure and water retention problems. In any case, Adam
    is healthy and the family is happy and relieved.
    
    Thanks everyone for your input.
    
    Nancy-

    RE: .14
    
    Wendy,
    
    I was induced with my first daughter because I was two weeks late and
    the doctor was concerned about the baby. Due to fetal distress during 
    the induction, I needed a C-sec.  I always wondered if she just wasn't 
    ready to come out yet.  
    
    While I was pregnant with my second I was concerned that the same 
    thing would happen again but it didn't. I went into labor on my own and
    had a successful VBAC on my due date.    
    
    Angie

    Re: .17 (and another earlier on)
    
    Angie
    
    I was glad to hear that you didn't need to be induced with your second
    baby and that you delivered normally.  I hope I am as lucky and that
    the other noter said that if you were induced first time the chances
    are you will be induced a second time is wrong, because if you have
    half an hour to read the following then you will understand why I don't
    wan't another labour like my first.
    
    Although I was ecstatic with the result (Martin) I was disappointed in
    my labour.  I had always had this vision (from what I was taught at
    ante-natal classes) that I would be sitting at home one evening (around
    or on my expected date of delivery, contractions would start, or waters 
    break, we would last as long as poss at home then travel up to the 
    hospital, deliver with the aid of just gas and air, recover and come home.
    But, it didn't happen that way.  This is the way it did happen.
    
    Thursday am - 5 days after EDD - routine visit to clinic at hospital.
    I was then sent up stairs for bed rest due to high blood pressure (I
    had already spent 4/5 odd days there because of high blood pressure). 
    Thursday pm - examined and told that due to my blood pressure that they
    would induce in the morning.
    Friday am (6.00 am) 1st pessarie followed by monitoring.
    Friday pm (13.00 pm) 2nd pessarie followed by monitoring.  Nothing
    happened.
    Saturday am (6.00 am) examined and told that I was nearly in labour, my
    waters had broken and that they wouldn't give me a 3rd pessarie as I
    would start on my own shortly.
    Saturday am (11.00 am) examined (different midwife) told me that the
    first midwife was totally wrong, my waters were still in tact and that
    I was not showing any signs of starting labour therefore insert 3rd
    pessarie.  This reduced me to tears, I got very upset which in turn
    upset the baby which caused heartbeat to drop.  I was then rushed along
    corridors up to labour ward to determine if C-sec was necessary. 
    Luckily the hearbeat stabilized and I didn't need a section.  Due to me
    being upset I was given Oxygen.  Then labour started (hooray) 1.00pm. 
    (By the way the first midwife was right and my waters had broken).
    A drip was set up to help with contractions so I had them fast and
    furious every minute straight away - they did keep trying to slow the
    drip down but to no avail.  Then gas and air to help with pain - no
    good, then they 'told me' to have an epidural due to the amount of
    contractions and to control my blood pressure.  Anesthetist(sp) arrived
    about 2.30 pm but couldn't give epidural because I hadn't had blood
    clotting tests done.  Blood clotting tests were then done - 1 hour to
    wait for result, so they gave me pethedine injection - no good.  After
    results they sent for anesthetist again, this time due to a serious
    road accident that had happened he couldn't get to me straight away,
    5.30 pm he eventually turned up and heaven!!!!  Then the heartbeat
    dropped a bit again so they inserted a scalp monitor to keep a check. 
    So at this point, let me refresh, I had a drip, epidural, normal
    monitor on stomach, and scalp monitor wires between my legs, so I
    couldn't move, we'll I couldn't anyway because of epidural.  Anyway
    Martin was delivery safely at 10.33 although I couldn't feel to push
    him out.
    
    Long winded I know, but my point is I am glad that Angie's second
    labour was OK because after my last one I am hoping my second is as I
    originally dreamed starting on its own, at home and then delivering
    with minimum pain relief.  The thought of going through the above again
    petrifies me.
    
    Barbara
    
    ps. Second is due 4th October.