Pitocin/induction

[miachic]

Hi Dr. Fett! I know that you always tell us to consult our doctors regarding specific questions that we have but I need some help in forming some questions for my doctors on this subject.

My OB mentioned at my first appt that he would like for me to start labor on my own because Pitocin makes for a higher likelihood of water retention. He said something about 38 weeks but it's all a blur but I think he said if I'm not laboring on my own by then that he would induce at that point. I go back to see him in Jan 8 and my cardio on Jan 29 and am wondering of questions I can ask them about the specifics of Lasix use after Pitocin induction. I know there's a fine line to walk with diuresis and making sure there isn't too much electrolyte depletion, etc. but what specific questions could I ask them about Pitocin/water retention/Lasix use? Do you know of anything PPCM-related that I could pointedly ask them about the use of Pitocin? I know this question is kinda confusing but I can't quite figure out how to word what I'm trying to say :rolleyes: .

I think I'm going to go ahead and ask my OB if we can strip my membranes around 36.5 to 37 weeks if I'm not showing any signs of labor. Personally I'd just like to get the baby out (especially since I know I'll have swelling in those hot summer months).

Okay, that might have been a totally confusing question but let's see if you can help me figure out what I'm asking. :D

[JAMESFETT]

With normal heart function post diagnosis PPCM and subsequent pregnancy you can consider your pregnancy as normal and permit it to take its natural course. Again with normal pregnancy and normal heart function I don't think lasix or other heart failure medications need to be taken into consideration or used. If everything is going fine, do you think perhaps it is better to just allow the natural process to continue? Your obstetritician will know all the fine details, so that the two of you can work it out. In that case, the use of pitocin would follow considerations for its use in any other situation where normal process needs a boost from pitocin stimulation. In someone with compromised heart function, such as in PPCM diagnosed prior to delivery, it is important to first stabilize heart function, consider maturity and safety of the baby, then proceed with the delivery in the most effective, less stressful way. On that I yield to the obstetrician. In any case, best wishes to you for a wonderful 2007.

James

[miachic]

Thanks for the reassurance. I wouldn't mind letting things take their course but we'll see how I feel at 38 weeks in July right? hahaha

[tabs]

Just a quick note about pitocin and water retention. I had pit with my first delivery and was not told anything about water retention. I also had pit with my third delivery, when we already knew I had a lowered Ef, I developed huge pitting edema within 2 days post delivery. My doctor watched the edema and told me to make sure that I diruesed (sp) it all by 5 days post delivery. I was to return immediately if I did not see an increase in urine production by day 5.

It would be very prudent to talk to both your Ob and cardio about the what ifs in relation to using pit (when or if to use lasix, when to watch for fluid retention, when to seek medical help, etc.).

Just some of my experiences,
Twilah

[miachic]

Thanks Twilah! I had pit with my first too and I think that that was part of my water retention problem. I really think that if they would have pushed Lasix starting 24 hours after delivery that I wouldn't have gotten as bad as I did. I already had so much fluid just from water retention from pregnancy and I think the Pit put me over the edge. I also had mag and I've heard that that can have an effect on how your body handles Pit and labor, water retention, etc.

I think we're going to try "natural" means of trying for labor induction such as lots of exercise, alot of BDing (blush) and possibly having the doctor strip my membranes a time or two to see if that gets things moving along. We'll see. I'm hoping that since this is baby #2 my body will just jump right in and know what to do and only have to have a little bit of encouragement. :)