Oligohydramnios and IUGR? Struggling to trust the hospital!

[cheeeeesecake]

I don't know if it's the same where you are, but we've just gone through a change of registrars for the year so there's a heap of new doctors starting at the hospital. That may explain *some* of the not knowing what's going on but it shouldn't excuse it. Depending on how the hospital works too, they may work in teams so you're seeing different doctors within the same team i.e. Consultant, registrar, resident. Plus you may have been seen by the after hours registrar, ward cover etc as well in amongst those Drs.

What have they said in regards to scans? For IUGR/Oligo babies we would usually be doing weekly scans (minimum) to check Doppler flow between baby and placenta. If there's any sign of compromise to flow then it's usually an indication to deliver. Depending on policy of the hospital will depend on how often they do a CTG on you. It only gives a snapshot of what's happening, but if there's any concern about baby's movements definitely tell the midwives and they should put you straight on the monitor. The trouble with IUGR babies is that they can fall off the perch quite quickly because their reserves aren't as great as those of a fat, chubby "average" baby.

I'm presuming that they have given you steroid injections if there is talk of inducing you early. For a potentially compromised baby (which is why they would induce early) you want to give Bub the best chance possible. If Doppler flow etc is all ok then you should be ok to wait until 37 weeks unless anything else presents itself.

My best advice is ask questions. Ask them of the doctors. If you don't completely understand, ask your midwives to read your notes and decipher for you to explain in plain English.

If you do call your local ob just be prepared to have difficulties. If your care has been referred to the tertiary hospital it's been done for a reason. Unless your ob had visiting rights at the hospital they cannot ask to see your medical records etc and you may find it causes some issues.

If you are anxious being in that particular hospital due to bad experience in the past, ask to see the occupational therapist. They will be able to chat to you about your anxiety and provide you with things to help you manage it. For example our OT does craft classes, cooking classes etc with patients in group settings. They have discmans/iPods that they lend to patients with relaxation programs and music on them. They have coloring in books etc that they can provide to patients.

Good luck. Feel free to PM me at any time if you need. While I don't work in your hospital, I know how busy they can be and I may be able to help you navigate the process.

Thanks so much for all that info. My dopplers and ctg were good today, I'm having twice weekly ctg and a scan in a week, so that makes sense. I was concerned about the low fluid and sudden drop in baby's growth, and no-one would answer when I asked if the baby will be ok for another week. I've not had steroid injections. That makes sense too about them working in teams. I didnt realise my ob wont be able to view my patient notes. Can i ask the hospital to email them to her? I trust her more than anyone with my babies so would appreciste her input even just to put my mind at ease.

[M'LadyEm]

Thanks so much for all that info. My dopplers and ctg were good today, I'm having twice weekly ctg and a scan in a week, so that makes sense. I was concerned about the low fluid and sudden drop in baby's growth, and no-one would answer when I asked if the baby will be ok for another week. I've not had steroid injections. That makes sense too about them working in teams. I didnt realise my ob wont be able to view my patient notes. Can i ask the hospital to email them to her? I trust her more than anyone with my babies so would appreciste her input even just to put my mind at ease.

It's a hard system to navigate at times. I would ask the question about steroids - see what they say. I can try and find some info out about steroids close to term for you, but given I'm off sick at the moment I'd be limited to google haha. I would want to be giving my baby the best chance possible. If there's any chance of baby coming early you don't want the stress of waiting 12-24hrs after decision time to have the course of steroids and time for them to work.

If you have a good relationship with your ob, maybe call and have a chat with her. Does the hospital give you any documentation after each of your appointments? Do you get copies of your scan reports etc? Those you can easily scan/photocopy/photograph and email to her. In terms of your actual notes, you may need to sign a release of information form. Trouble is that if you're having frequent appointments, they're not necessarily going to be able to forward everything on in a timely manner.

[cheeeeesecake]

It's a hard system to navigate at times. I would ask the question about steroids - see what they say. I can try and find some info out about steroids close to term for you, but given I'm off sick at the moment I'd be limited to google haha. I would want to be giving my baby the best chance possible. If there's any chance of baby coming early you don't want the stress of waiting 12-24hrs after decision time to have the course of steroids and time for them to work.

If you have a good relationship with your ob, maybe call and have a chat with her. Does the hospital give you any documentation after each of your appointments? Do you get copies of your scan reports etc? Those you can easily scan/photocopy/photograph and email to her. In terms of your actual notes, you may need to sign a release of information form. Trouble is that if you're having frequent appointments, they're not necessarily going to be able to forward everything on in a timely manner.

I asked them for copies of my scan reports a few times and they said no. They just said I have no need for them and they will keep them on my file at the hospital, but I am not allowed to take a copy. I'm used to my dr communicating everything to me and giving me copies of everything, so it's hard to not get access to any of my information. All I am allowed to take is my pregnancy book (orange book) where they write a little bit of info like blood pressure, fundal height, etc.

I will ask them about steroids at my next appt.

[M'LadyEm]

I asked them for copies of my scan reports a few times and they said no. They just said I have no need for them and they will keep them on my file at the hospital, but I am not allowed to take a copy. I'm used to my dr communicating everything to me and giving me copies of everything, so it's hard to not get access to any of my information. All I am allowed to take is my pregnancy book (orange book) where they write a little bit of info like blood pressure, fundal height, etc.

That's rubbish! All of our patients get copies of their scan reports. In fact most of the time they get the first copy as we have to wait for the digital copy to be uploaded to the system. At the end of the day it's your baby and I cannot understand why they won't "allow you" a copy of your scan report. I wish I could help you get the information that you want. I can understand notes written in the medical record need to be obtained through the right channels, but scan reports should be available for you. How hard is it to print a copy off/photocopy?! They actually sound quite obstructive.

[zelda]

I cant comment much on your bub and pregnancy but I have a fair bit of experience with hospitals, both as a high risk pregnancy (Early onset GD) and in the Cancer Centre of our hospital. Both conditions meant my care was spread out across multiple disciplines and it honestly seemed like no one had any idea what the others were doing.

I did say something and basically, it comes down to how much prep each doctor does before you walk in. Files get huge and often they dont read them before getting you to come in or they read all the files before the shift starts so lose track of who is actually in front of them. They know that in a lot of cases, people are very aware of their medical info and it's quicker for them to ask you about your latest scans/tests then to actually scroll through the file.

When I was having difficulty with some issues with staff during my pregnancy, I skipped the doctors and went to the midwifes for help. I told them I was unsure and worried about the plans because no one could tell me anything and they ended up sitting in appointments to help bridge that gap between me and the doctors and make sure everything was explained properly and (in some instances) advocating for me.

I'd be getting onto the midwifes for help in dealing with the doctors or a social worker/patient advocate. Good luck with it. It's such a difficult time and the uncertainty just makes it so much worse x

[cheeeeesecake]

That's rubbish! All of our patients get copies of their scan reports. In fact most of the time they get the first copy as we have to wait for the digital copy to be uploaded to the system. At the end of the day it's your baby and I cannot understand why they won't "allow you" a copy of your scan report. I wish I could help you get the information that you want. I can understand notes written in the medical record need to be obtained through the right channels, but scan reports should be available for you. How hard is it to print a copy off/photocopy?! They actually sound quite obstructive.

They are obstructive, I feel like they are too busy to deal with someone asking for a copy of reports. I've had experience with this hospital before - albeit not a positive one - and they tend to just shuffle the patient around from person to person, making me 'someone else's problem' until I give birth & then they will kick me out the door. I've woken up at 4am crying about how much i dont want to be there 😭 It's just an awful, horrible place with mean staff. Thanks for all your help and for listening though, i wish I could find someone to listen and communicate with me at the hospital.

[cheeeeesecake]

I cant comment much on your bub and pregnancy but I have a fair bit of experience with hospitals, both as a high risk pregnancy (Early onset GD) and in the Cancer Centre of our hospital. Both conditions meant my care was spread out across multiple disciplines and it honestly seemed like no one had any idea what the others were doing.

I did say something and basically, it comes down to how much prep each doctor does before you walk in. Files get huge and often they dont read them before getting you to come in or they read all the files before the shift starts so lose track of who is actually in front of them. They know that in a lot of cases, people are very aware of their medical info and it's quicker for them to ask you about your latest scans/tests then to actually scroll through the file.

When I was having difficulty with some issues with staff during my pregnancy, I skipped the doctors and went to the midwifes for help. I told them I was unsure and worried about the plans because no one could tell me anything and they ended up sitting in appointments to help bridge that gap between me and the doctors and make sure everything was explained properly and (in some instances) advocating for me.

I'd be getting onto the midwifes for help in dealing with the doctors or a social worker/patient advocate. Good luck with it. It's such a difficult time and the uncertainty just makes it so much worse x

Thankyou for sharing your experience - I appreciate it I dont even know how I would find a midwife who can help me, but maybe I'll ring in the morning and ask if there is a student midwife who can stay with me - at least then I would have some continuity of care.

[Little Miss Sunshine]

Just wanted to share my experience- dd1 was IUGR identified at 32 weeks. I had fortnightly scans and 2nd daily CTGs from 35 weeks. They wanted to induce me at 37 weeks but couldn't fit me in over the next few weeks. They wanted daily ctgs but I refused as it was an effort getting to the hospital, zero parking and walking up mammoth hills in middle of summer. I also refused scans from 37 weeks (they wanted them weekly at that point) as it wasn't changing the outcome and was costing $200 a pop. So I ended up carrying dd1 till 40+6 and she was ok.

Like you I had a horrendous experience at the hospital so for dd2 I brought my own pain relief.

They certainly didn't instill me with confidence, different doctors every time, looking at wrong scans, telling me they will do xyz at next visit but then I would have to ask as they were unsure why I was there, repeating my situation over and over.

It's so stressful. I'm glad it's all over and I have 2 beautiful but tiny little girls.

I hope it all works out for you xxxxx

ETA: as it was my first I was a lot more compliant until the end when I was frustrated, started questioning things and refusing scans/daily visits- one doctor labeled me as "difficult".
I was much more assertive and confident during my second pregnancy and flat out refused any further scans from 32 weeks lol and bubs was always very active

[zelda]

Thankyou for sharing your experience - I appreciate it I dont even know how I would find a midwife who can help me, but maybe I'll ring in the morning and ask if there is a student midwife who can stay with me - at least then I would have some continuity of care.

I emailed them. Outlined my concerns and frustrations with the care I was receiving. I had the email of a midwife after I was considered for a trial so I used that but definitely you should be able to call them or write them directly.

[cheeeeesecake]

I emailed them. Outlined my concerns and frustrations with the care I was receiving. I had the email of a midwife after I was considered for a trial so I used that but definitely you should be able to call them or write them directly.

Good idea, I'll try email as there really isnt any options for face to face communication.