So, this is really bad, right?

[vanillacourage]

Someone I know is 18w pregnant and is at home on strict bedrest. If she makes it to 20w they will move her to the hospital and she'll be on hospital bedrest for the duration.

Obviously, hospital bedrest is very serious. What I don't understand (but am nosy enough to ask about here) is why they'd let her be at home until 20w if they think there's benefit to being at the hospital later?

I feel so bad for them. I can't imagine the plan being "if you're lucky enough to make it to 20w, then we'll do XYZ."

[zeewifeandmama]

Yikes! That dosent sound good at all! Poor thing

[ECB]

My only thought is that it maybe it has to do w/ insurance coverage and/or cost.

[dcrunnergirl]

Why is she on bedrest? It is odd that they'd only do hospital bedrest at 20w. However, hospital bedrest is expensive and very hard, so maybe they're hoping she'll do just as well at home.

FWIW, I was on home bedrest starting at 22w due to a shortening cervix. They kept telling me that if at any point, things were changing at all, I would get put on hospital bedrest for the duration of my pregnancy. Sure enough at 28w, my cervix shortened below 2 and into the hospital I went for 4 weeks. They let me go home b/c I'd had no change from 28w-32w.

[pamela]

Probably because there is not enough that the hospital can do at that point to allow her to reach a viable point that would warrant the expense.

[OscarQ]

Nov 1, 2012 10:49:48 GMT -5 pamela said:

Probably because there is not enough that the hospital can do at that point to allow her to reach a viable point that would warrant the expense.

Sad but this is true. I'm surprised they're even moving her to the hospital at 20w but I guess it depends on what is going wrong. I'd expect them to wait until closer to 22w. The earliest preemie that's survived has been in the late 22w timeframe.

[SusanBAnthony]

Like the pp said, I bet it is bc if she goes into labor there is nothing that will help.

I knew a mom who was having preterm stuff at about that point, and chose not to go onto bedrest bc she felt like she didn't want to make it to barely viable and have a 22 weeker in the nicu for months on end, likely with problems later on. If she was going to lose the baby, she wanted to just lose it at 18-20 weeks. It was really sad, but she did end up doing ok.

[vanillacourage]

That makes sense. Sad sense, but it does. She's been on bedrest since at least 14w I think so yeah, that would be a long time on bedrest before the pregnancy was even viable.

I have no idea what the specific complication is. Something about the baby's kidneys not functioning correctly, but there must be more b/c I don't know if that would be mitigated by bedrest.

[fbf2006]

Nov 1, 2012 10:57:06 GMT -5 SusanBAnthony said:

Like the pp said, I bet it is bc if she goes into labor there is nothing that will help.

I knew a mom who was having preterm stuff at about that point, and chose not to go onto bedrest bc she felt like she didn't want to make it to barely viable and have a 22 weeker in the nicu for months on end, likely with problems later on. If she was going to lose the baby, she wanted to just lose it at 18-20 weeks. It was really sad, but she did end up doing ok.

I actually don't think they typically put a 22 weeker in the NICU. At least, when I had my preterm loss at 22 weeks, they didn't and had already warned me that viability is at 24 weeks.

[OscarQ]

Nov 1, 2012 10:58:41 GMT -5 fbf2006 said:

Nov 1, 2012 10:57:06 GMT -5 SusanBAnthony said:

Like the pp said, I bet it is bc if she goes into labor there is nothing that will help.

I knew a mom who was having preterm stuff at about that point, and chose not to go onto bedrest bc she felt like she didn't want to make it to barely viable and have a 22 weeker in the nicu for months on end, likely with problems later on. If she was going to lose the baby, she wanted to just lose it at 18-20 weeks. It was really sad, but she did end up doing ok.

I actually don't think they typically put a 22 weeker in the NICU. At least, when I had my preterm loss at 22 weeks, they didn't and had already warned me that viability is at 24 weeks.

No, in most hospitals 24 weeks is the limit although that is getting pushed towards 23 weeks. I don't think many hospitals would try with a 22 weeker. And SBA, I'm sorry for your loss.

[Deleted]

Oh man, that's rough. My neighbor had a 25 weeker a while back and they are still touch and go months later. I really hope your friend makes it much longer.

[elocrates]

I'm unfortunately all too familiar with high risk pregnancies and bedrest. Hospitals/ doctors/ insurance companies typically won't hospitalize until viability (typically quoted to be 24 weeks, but occasionally a 23 weeker or very, very rarely a 22 weeker might be viable) since if there is nothing they can do to save the baby it is not worth placing the mother at risk (from medications, hospital-acquired infections, clots, etc.).

I'm so sorry to hear your friend is in this position. If you live nearby and are able, she may appreciate a freezer meal or some easy to grab snacks, some magazines or craft projects, or an evening of babysitting if she has any other children. Otherwise a simple "I'm thinking of you" email will likely brighten her day.

[Deleted]

Nov 1, 2012 10:49:48 GMT -5 pamela said:

Probably because there is not enough that the hospital can do at that point to allow her to reach a viable point that would warrant the expense.

This. In fact, I'm surprised that they are moving her at 20 weeks. I believe that our hospital will not do any life saving measures on a baby until 24 weeks gestation.

[statlerwaldorf]

The labor and delivery floor at my hospital doesn't accept patients until 20 weeks. Before 20 weeks they don't try to save the baby.

[w2w]

There is no evidence that bedrest does anything to improve outcomes. For that reason, most ins companies aren't willing to pay for a hospital stay unless you need to be there because you might deliver early and the baby has a chance.

Hope everything works out for them.

[GailGoldie]

They generally don't even see you at L&D until you reach 20w... there is pretty much nothing they can do earlier to save a pregnancy - so they don't try much - wasting $/resources, etc.

All depends on why she's on bedrest, too.

Yes- many studies show it doesn't really help- but as my OB says- he would never tell someone NOT to be on it bc the slim chance that it will help - and doesn't hurt - is worth it (i was on BR for 6w with my first son).

prayers for her. I know quite a few who were having problems early on who made it full term.