ultrasound due date and c-section

[jmagdaleno]

Hi, I am 38 and pregnant w/my 2nd child. 1st child was delivered via c-section at 41 wks exactly. Attempted vaginal delivery, but after 24 +hours in labor (took me over 24 hrs to fully dilate and efface) and almost 3 hrs of pushing (daughter never made it past +1 station), c-section was performed. Diagnosis was arrest of descent and was told I have a narrow pubic arch. Despite difficult delivery, daughter experienced no distress the entire time (no decelerations, etc.). Apgars were 9 and 9-she is perfectly normal. Weighed 7 lbs 14 oz at delivery. My pregnancy (delivered at age 35) was completely normal- no high blood pressure, gestational diabetes,swelling, preterm labor (I was overdue but not induced; labor occurred naturally). I have no hx of any health problems, nor does my husband, and both families have excellent health.With this pregnancy I had my 1st u/s at 8 wks (on 2/26/09) to confirm the pregnancy.1st day of my LMP was 1/2/09- this is definitive as I was charting & using an ovulation monitor. Ovulated on day 11-12. My due date prior to the u/s was determined to be 10/9/09. This date was pushed earlier a full week to 10/2/09 b/c the CRL was 19.7 mm. Am having a planned c-section w/ this pregnancy.Concerned about lung maturity at the time of delivery. If the c-section date is scheduled @ 38 wks using the u/s due date (which would really be 37 wks based on first day of LMP), is there a risk of the lungs not being fully matured? I'm even concerned with 39 wks (which would be 38 wks based on first day of LMP). From what I understand, size doesn't mean that the lungs have properly matured, and u/s closer to time of delivery isn't a definitive indicator of lung maturity.Worried sick that baby will be delivered too early w/out full lung maturity.U/S 2 days prior to delivery w/1st child showed no excessive amniotic fluid. Please advise what week you would consider a safe delivery/lung maturity date when my due date has been moved 1 wk earlier due to u/s findings.

[YvetteY]

by the way ....I had a baby at exactly 38 weeks and he was fine.   I would have been worried, however, if it were 37 weeks.  I don't think i would have been comfortable at all with that.  I had to be induced and had a c-section as the induction didn't work.  

[YvetteY]

Someone already mentioned amniocentisis to check for lung maturity and that is the correct answer.  You can be definitely sure with this...and this is  a whole lot safer and easier at this stage in pregnancy, so I would do that without hesitation to check for lung maturity.

As for the poster who said the lungs are fully developed at 35 weeks....I'm not sure I agree with that..and I don't know that developed means the same as mature.   I thought 38 weeks the safest and earliest time to deliver.  

An to be honest the ultrasound dating doesn't make a lot of sense to me.   The true gestational age is based on LMP and if you know your LMP and when you ovulated  i wouldn't agee with the ultrasound date.  THey are going off of measurements and what not. ....some babie are bigger and smaller than normal.   And just because you're baby is bigger than normal, it doesn't mean it's more developed than normal...or does it..I don't know, but I would ask for the amnio.

[momof8215]

They forced my youngest son out 3 weeks early...21 days to be exact. My other children were quite large and they didn't want to risk it with the 3rd. My due date at the time was August 24. I was induced on the 1st and had him on the 2nd. He was absolutely perfect and weighed 8lbs. 38 weeks isn't a problem normally. They should be checking the lungs anyway before they do it. I'm sure it will be fine. That close to due date is usually never a problem. Only is rare instances. Good luck!!

[7preg3b]

lungs are usually fully developed at 35 weeks.  You should be fine..  

[GermanBaby]

The doctor can perform an amniocentesis in the third trimester to determine whether the baby's lungs are mature enough for the baby to be delivered. Certain tests are performed on the amniotic fluid to determine the maturity of the lungs. This amniocententesis performed in the third trimester does not carry the same risk of miscarriage as when performed under 20 weeks. I believe that the very tiny risk would be from infection, rupture of membranes (breaking of the water) or onset of labor.

I believe at/after 24 weeks the doctors can give you a corticosteriod that would speed the development of the lungs. At least that is what I learnt yesterday in my "week-end" labor preparation course.

I am not an expert but an "educated" guess would be that all babies mature at different rates in the uterus. Probably from a variety of factors like hormones, nutrients etc. That is probably why noone exactly knows what week is the "mature" date for your baby. For some it is -38 weeks while others it is 40 weeks+. Only 4% of women give birth on their due date ;-)

Hopefully this provides you with the information you need in order for you to ask your doctor some more detailed questions.  

[40smama]

When I was pregnant this last time (in 2008), my doctor and I had this very same debate as to when to perform the c-section.  I believe it's safer to deliver at 39 weeks although I'm not a professional.  The doctor assured me it was safe to deliver at 38 weeks so because of my insistence, we delivered at 38 1/2 weeks.  It was a compromise of sorts - I was concerned about this very issue as you.  I highly doubt your doctor will perform a c-section if he/she is any concerned about lung maturity.  You could always ask for an amnio to determine if her/his lungs are ready.

I think that the first u/s performed at your 8th week is probably highly accurate as that's one that determines the exact length of the pregnancy.  I really wouldn't be too concerned although I understand where you're coming from.  Congratulations on your pregnancy - try not to worry and if you are really concerned, talk to your dr.  Don't let him/her blow you off! - jen