Wednesday, December 26, 2012

Appointments galore

This has been an eventful week; on Thursday, December 10th, we had our three appointments at University of Washington. First up, the nuchal translucency (NT) scan, an ultrasound where baby's nuchal space at the back of the neck is measured and other soft markers for chromosomal issues are looked for. E2 passed everything with flying colors: NT measurement of 1.4mm; fluid in the stomach, indicating swallowing; nasal bone present (we already knew that, thanks to Dr. M.!); normal-length arms and legs; brain matter; lots of movement. E2 measured 13 weeks, even though I was only 12 weeks 2 days pregnant (that's 5 days ahead), topping out at an average 6.9cm crown to rump, with a beautiful heart rate of 159.

After that, we met with our genetics counselor, who confirmed E2's otherwise perfection, and encouraged us to have the Verifi cell-free DNA blood sample drawn there that day, rather than having Dr. M. do it as planned...after all, W, our genetics counselor, is actually trained to interpret the results. Duh. That was easy!

Once we finished with her, we raced across the lobby to our appointment with Dr. C., my MFM. I expressed my concerns with "the plan" (monitoring cervical length instead of doing prophylactic cerclage), and, true to form, she convinced me that "the plan" is sound. Basically, if ultrasounds do indicate cervical change at any point past 16 weeks, then we can do a cerclage, which isn't considered then to be a rescue/emergency cerclage. Instead, it would be an "ultrasound indicated cerclage", shown by research to be more effective than either prophylactic or rescue cerclage. Whew! We told her that we were aiming low, hoping to not deliver before 28 weeks. She said that's a perfectly reasonable expectation. I am still at risk for preterm labor; I heard her say 50% chance, although Paul's convinced that's not what she said. (You know I'll ask when I see her again, which will be at 20w2d after our anatomy scan.)

On Christmas Eve morning, we visited Dr. M. for what I expected to be the visual inspection of my cervix that I'd demanded. Paul was thrilled to get to say he told me so when we first had another transabdominal ultrasound. This time, four days later, E2 measured 3 days ahead, with a heart rate of 158. Still perfect. Dr. M. said he expects E2 to remain above the 50th percentile for length throughout the rest of my pregnancy.

Then - SURPRISE! - he whipped out Dr. Wandy and proceeded to do a transvaginal ultrasound. Alarmed, I asked, "You're still going to just look at my cervix with your eyes, right?!" He said, "Oh, no, that wouldn't be worth anything. Looking through ultrasound is the only way to really tell what's going on." The verdict? Nothing is going on...except I do have a marginal placental previa again. Damn it. I had a tiny bit of spotting on Friday night, out of the blue, and he said we can expect more, based on the location of the placenta. No sex for us. (In his words, "If I were you [Paul], I wouldn't go anywhere near her right now!)

The cool thing was, though, he looked at E2 with the transvag...and OMG! It was tittilating! For one thing, Baby looked HUGE that way, which was awesome. Everything was crystal clear. We saw all the ribs, the intestines coiled in the belly, (faintly) the organs in the chest, the arms waving around and legs straightening was the best Christmas present ever!

Dr. M. wants to see me back in another two weeks for a repeat of what we did Monday. Cool with me. We'll also get set up (whatever that means) to start the 17P shots and official cervical length ultrasounds, both of which start at 16 weeks. Thankfully, Paul will give me my weekly 17P shots so I won't have to go to Dr. M.'s office on a weekly basis.

Things are essentially good...although I won't lie: finding out we have a recurrence of one of the pregnancy complications that ruined everything with the twins, just over a week from that same point in the pregnancy, was devastating. We are both feeling quite a bit more on edge, and much less confident. Twenty-eight weeks cannot come fast enough.


  1. hi amy! just wanted to tell you, i had the same complication (partial placenta previa) as a potential complication that could have contributed to the end of first pregnancy with my own twins...BUT also had the same previa in my second, successful pregnancy with my daughter! in her pregnancy, the placenta ended up moving up a little bit on its own as my belly grew. i did have some spotting in her pregnancy too, right around the same time as you are i think (13ish weeks) and that was all i had till the very end (I will warn you, the night she was born, as my cervix dilated, i did bleed quite a bit. it was a little alarming at the time even though we used our trusty rented doppler to reassure ourselves that the baby was just fine before we headed to the hospital).

    since our twins' pregnancies were pretty similar, i will also tell you that i had my cervix monitored throughout my second pregnancy as well. they decided not to put in the cerclage because by 20 weeks it was still long, thick, and closed. they were to stop monitoring it at 28 weeks. but suddenly, when i went in for that last ultrasound, it had shrunk to i think 2.something cm, and begun to funnel. :( i was on bedrest from weeks 28-34 of my pregnancy. during that time my cervix never changed (it was still short and funneled to about 1cm open) so at week 34 i was allowed to get up and go back to work. my daughter was born at 37 weeks, 1 day.

    i remember the fear of a rainbow pregnancy SO WELL. please feel free to email me anytime you want somebody to listen.


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