Source
r/GestationalDiabetes•
ninal2003

Accelerated growth and non stress tests

Well, I was diagnosed 6 weeks ago and I was diet controlled for a few weeks, then metformin for the last few weeks, and reevaluating weekly to potentially start insulin. I had a growth scan today and our girl is measuring pretty far ahead in head size, abdomen, and humerus (3 weeks). At 30 weeks she is estimated at 4.6 lbs. My OB wants to begin twice weekly non stress tests. He has an excellent bedside manor and way of explaining things, and I was fine in the office. This afternoon I was reading the Mayo Clinic’s description of what the tests are and why they are ordered and it scared the hell out of me. Does anyone have experience with this or words of wisdom?

Posted May 11, 2020, 9:54 PM UTC

213
Arfurbear•

NST are routine with my practice. Twice a week starting at 32 weeks for all GD patients.

I was 100% diet controlled with #1 and still had them. I’ll have them again this pregnancy starting here in a few weeks.

More monitoring is a good thing.

3
mdows•

It’s likely just him trying to be safe. I’m measuring pretty far ahead (7lb 4 oz estimated at 34 weeks) and my OB just does the bedside ultrasound when I see him since NSTs are all done at the hospital and very limited to urgent need due to covid 🤷🏻‍♀️ she’s been otherwise healthy and no issues, just a planned c section because of size

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ninal2003OP•

Thank you! When did they schedule your c section for? I’m wondering if I need to start preparing in my head for an early arrival.

1
mdows•

38 weeks, my OB said from the start he wanted a 38 week induction because of me being GD (apparently a higher risk of intrauterine death after that, so he wants all GD to deliver by 38-39 weeks if they haven’t already on their own) but because she’s pretty big he scheduled c section instead.

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mkazz52•

Hi! I'm not getting nonstress tests but something similar (a biophysical profile) on a weekly basis and have been informed by both my OB and maternal fetal medicine that it's pretty standard practice for GD. MFM recommended twice weekly (but they would have been NSTs) because I am on insulin and my OB felt once weekly BPPs were fine so it varies. GD tends to age the placenta faster than normal, so they are just an extra level of monitoring to ensure that baby is not in any sort of distress. They are actually a huge relief to me because I know he is being watched closely. Can I ask what is it that scared you about what you read?

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ninal2003OP•

Specifically this line from Mayo Clinic: “Typically, a nonstress test is recommended when it's believed that the baby is at an increased risk of death.” The test itself doesn’t worry me, it’s the fact that we need the test that scares me. Part of me also says, “hook me up now for all the monitoring!”

2
mkazz52•

Oh jesus mayo clinic. That's tactful.

Everything I've been told is that the NSTs or BPPs are standard monitoring for GD due to the placenta aging issue, no matter what baby's size is (mine is only 26%ile at last scan). So, while technically having GD does slightly increase the risk of stillbirth if not well managed, I wouldn't worry. They're done on anyone who's high risk to catch potential problems before they progress to that point.

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ninal2003OP•

Thank you! That’s reassuring. We spent Thursday night in L&D due to blood pressure and a migraine and I think after that I’m just on edge.

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mkazz52•

I don't blame you! My BP has also been going insane lately and I swear the 3rd trimester has been just as nerve wracking as the first for me. If it helps, I did have one NST and it was actually really calming. I sat in the exam room by myself for 10-15 min and just got to breathe and listen to my son's heartbeat.

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LaContrarian•

That’s just a stupid way of saying high risk pregnancy. And high risk is so any pregnancy where there is any sort of increased risk from baseline,

2
lovengbers•

I am on insulin for my fasting numbers. I started biweekly NSTs at 32 weeks. After the first week they said I could change to once a week because of COVID but I am much more reassured going in twice a week. There is increase risk of stillborn with GD but that is higher if you’re not controlled. I will be induced at 39 weeks at the latest. I have a growth scan on Friday to see how big she is.

I get the idea of needing NSTs is scary but I’m so grateful for them. Going in twice a week and listening to her heart beat gives my anxiety such a break.

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BreadPuddding•

Regular NST/BPP is pretty standard care for GDM. I had them once a week starting at...30 weeks? 32 weeks? Then twice weekly for the last 4 weeks. They annoyed the hell out of me because my son was a troll baby and would like, kick while they strapped the monitor on, and then go to sleep once they started monitoring and we’d have to wake him up. He was completely healthy, just uncooperative. I was induced two days short of my due date.

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TeaThyme420•

I had my first NST last week and it's not bad at all. They have you lay down for about 20-30 minute in a room with two straps on your belly connected to a monitor. You press a button everytime you feel baby kick and after the time is up the doctor checks out your stats and meets with you afterwards. I brought my book and just tried to relax. I start going twice a week at 37 weeks because I started insulin last week (35 weeks now). Starting insulin has been good for me because I wasn't able to keep my fasting numbers down. I will be induced a week early due to the insulin but it's well worth it in my book because that will help keep my baby boys belly from growing. His weight was in the 60th percentile but his belly was in the 90th at my last ultrasound at 30 weeks. Don't stress about the non stress test, it will be okay!

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