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Pregnant UC'ers: Use High Risk Doc?

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Posted 3/6/2009 5:09 PM (GMT 0)
Hi everyone, I'm so excited/nervous for our first ultrasound with my pregnancy-I'm about 8 weeks along. It's scheduled for next Thursday (Mar 12th). This is my first pregnancy with UC and all the meds (not counting my first UC flare that started in week 32 of my previous pregnancy--but I wasn't diagnosed until after I delivered baby #2). How many of you used a high-risk (I think they're usually called MFM) obstetrician for your care? We consulted with MFM's as we made the decision whether to try for a 3rd baby, but I am currently scheduled with my "regular" OB for this first appointment.

If you did have a high-risk doc, what additional care were you given during your pregnancy? Extra tests or ultrasounds? Medications, etc? Thanks very much for sharing your experiences!

-Erica
Posted 3/6/2009 5:26 PM (GMT 0)
I don't have much advice, but wanted to say congrats! I'm also hoping to be in your shoes sometime in the (not too near!) future. My son will be 5 months old in a week. DH and I always wanted to have two kids, but now that I've been diagnosed with UC, we of course want to see how well I can manage it first.
Posted 3/6/2009 5:30 PM (GMT 0)
I used a regular OBGYN and had two sucessful pregnancies. I was only on sulfasalazine at the time and although I was flaring quite a bit, I didn't have a huge amount of diseased colon. Because you are on Imuran it may be different. Congratulations on your pregnancy!
Posted 3/6/2009 6:16 PM (GMT 0)
I was told by my GI that if I ever did get pregnant I would need a high risk doc.

Congratulations!
Posted 3/6/2009 6:31 PM (GMT 0)
I was told by my GI to see a maternal fetal specialist before getting pregnant.  And my regular OB said the same.  And that after pregnancy they would probably both monitor.

Posted 3/6/2009 11:46 PM (GMT 0)
hey there. i just gave birth 7 weeks ago. throughout my pregnancy i saw a regular and high risk ob. however the high risk was for something other than my uc (i tested positive for a virus that can cause birth defects). during the course of my pregnancy the only thing that was done differently as a result of the uc was one extra ultrasound to check for growth at 32 weeks. also, i did alot of calling to the high risk docs myself to check on medication changes made because i flared in my 2nd tri. the high risk docs were great about talking to me over the phone and having seen them for other issues did make them available to me.

i think it may be your own comfort level that could decide - other women have gone both ways on the high risk docs especially if you are not flaring. one other consideration is that you are on imuran - i was only ever on mesalamine (class b for pregnancy) and cortifoam, but just for a short time in my third tri.

good luck and congratulations, jo
Posted 3/7/2009 12:08 AM (GMT 0)
I just had a baby 2 months ago today. My OB said that having UC didn't put me at high risk. I just had one extra U/S in the 3rd trimester to check for growth. I went into remission when I was pg. I suppose if you were flaring you would be high risk. Best of luck, wishing you a happy and healthy 9 months!
Posted 3/7/2009 1:46 AM (GMT 0)
Thanks, ladies, for all of your help!! We do have an MFM available via phone/email for consults. She was the one who finally convinced us that it was much safer for me to stay on imuran during my pregnancy than come off and risk the (much scarier) effects of a nasty flare. I guess we'll see what the ultrasound looks like at our regular OB's office this week, and take it from there. I'm glad to hear we haven't missed some critical step in growing a healthy baby!

Also thanks so much for your wishes & luck. I think it's kind of strange; with my first two pregnancies, I wasn't much concerned with the pregnancy itself--I just figured things would go smoothly. I was much more worried about what to do with the actual baby when it arrived. This time around, I'm not at all concerned about the baby--he or she will just get thrown into the mix at our already crazy house--but I'm really anxious about the next 7 months!! :)
Posted 3/7/2009 2:51 AM (GMT 0)
Hurray! best wishes for you.
Posted 3/7/2009 2:23 PM (GMT 0)
Aww congrats to you! Babys are so precious and adorable! I absolutely love babies.......until they turn into mouthy teenagers LOL

When I was pregnant with my two kids, I just saw are regular OB. I wasn't considered high risk but I agree that maybe a high risk OB might be wise especially being on Imuran. When I was pregnant, I was only on Asacol. I didn't have Uc when I was pregnant with my son but I did when I was with my daughter. She turned out healthy as can be. A bit jauniced but a little sun helped that. I even felt wonderful when I was pregnant with my daughter. I stopped having symptoms completely but I flared around 6 months after having her.
Posted 3/8/2009 1:51 AM (GMT 0)
I saw a regular OB, but I wasn't diagnosed until I was pregnant, so that doesn't really count. His daughter has UC, though, so he was a great source of info. I'm pretty sure I'll stick with him if I dare to have a third...
Posted 3/8/2009 1:51 AM (GMT 0)
Oops, and congratulations!!! SO exciting.
Posted 3/8/2009 3:03 AM (GMT 0)
Congratulations!

I'm having a scheduled C section in 3 days. I did not see a high risk OB, but my OB has a high risk partner that she did initially discuss my condition with. My GI recommended a C section due to the severity of my colitis and the thoughts that if I did ever want to opt for surgery the more in tact I was, the better. My daughter is breach, so I guess a C section was meant to be regardless.

I also suffered a blood clot in my leg and pulmonary embolism as a result from my UC 2 years ago, so both my OB and GI kept a close eye on me both because of my UC and the extra stress pregnancy can put on your legs, cause clots, etc. I flared twice during the pregnancy, once during the first, once during the second trimesters. Both times 40 mg's of Prednisone brought it under control relatively quickly.

Overall the pregnancy was very easy for me physically. I exercised every day and am working full time up until the delivery date. The only issue was at my 34 week ultrasound, the baby was too small in her abdominal measurements (called asymmetric IUGR) and my fluid was low. No proof of course, but dr's suspect the UC was a factor. I have been on bedrest the last 5 1/2 weeks (working from home thank goodness my job is flexible), which has been frustrating as I presonally feel great. Fortunately the bedrest has done her wonders and she is well over 6 lbs now.

Good luck and don't hesitate to send me a private message if you have any questions throughout your pregnancy.
Posted 3/8/2009 5:51 PM (GMT 0)
Yea!!! Congratulations!!!!! : ) My son is 14 months now, and we found we were pregnant a month after my initial flare started and UC dx!!! Crazy!!!

Anyway, we did have a high risk doctor in addition to our OB/GYN. We saw him about three times, had a few amazing ultrasounds, and we learned we were having Jackson with their equipment (MUCH nicer and clearer than my OB's). Once we started our third trimester we started biophysicals each week. I really enjoyed them because I got to see Jackson every week. Every so often they would do a 3D/4D and give me pictures. I appreciated having the additional support from the high risk staff and the biophysicals because they ruled out many possible complications and disabilities. I was on 40mg prednisone and asacol during my pregnancy, so they felt that was the reason for the close observations. Now, we did have complications during our labor because the chord was around Jackson's neck three times, which has nothing to do with the high risk issues. My next pregnancy will be with my ileostomy, so that will be a new adventure!

Just FYI: We did have a 3D/4D session with a clinic just for the fun, and it was absolutely amazing!!! Definitely worth every penny!!!

Enjoy your first ultrasound!!! : )
Posted 3/8/2009 11:31 PM (GMT 0)

Erica,

First off all, congratulations!

I had an MFM during my pregnancy for two reasons, one due to my uc and the other because I was pregnant with twins.  The MFM worked closely with my OB and my gastro to determine the best course to take.  I ended up on bedrest in the hospital due to early contractions which some said was due to my uc and some said due to the twins.  I didn't have any problems with my uc until my 3 trimester at which time my MFM and gastro really had to work together to find some happy medium regarding meds for me to take to stop contractions that wouldn't exacerbate my uc.  I was very glad to have them all on my team.  It was reassuring.

I would make sure that the MFM you choose is in the same group or affiliated with the same hospital as your gastro if you are going to use an MFM.

Hope that helps and good luck!

Charlotte

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