Friday, January 4, 2008

Tomorrow Never Knows

Well, we've returned from our trip and we had a great time spending time with the family. I'm very relieved that I had no complications along the way and Blobby is still doing great. Yes, of course I used the doppler 3 or 4 times over the course of the trip so I could hear that beautiful heartbeat and feel reassured.

On Monday the 31st, I was squeezed in for another ultrasound. It was suggested by my maternal-fetal specialist, and who am I to refuse an offer for a scan? I really just wanted to get updated pictures, since the last scan was at 11 weeks and that was 5 weeks ago! Way too long for me to wait.

The u/s technician did her thing and I have to say it took a long time. Blobby wasn't in the most easily accessible position so it took some work to get a good angle. Lots of measurements were taken. Lots of body parts which I recognized. Also, little dark circles inside white areas, which apparently were worth taking the time to measure, but to me, had no more significance than little dark circles inside white areas. After her measurements were taken, she called in the maternal-fetal specialist, who spent a while taking her own measurements. She seemed to be focused on the same two areas, taking measurement after measurement. Now I was starting to become a little concerned.

After she was done, she told us that she saw a couple of things she wanted to talk to us about. Holy shit. My heart sank. This was the first time I had received any kind of possible bad news about Blobby. Let me tell you, it is not a good feeling. So after I cleaned myself up, we met with her in her office. This is what she found: a Choroid Plexus cyst in the brain, and an enlarged kidney. She called these 'very soft markers' for some genetic disorders, but explained that only about 1% of cases of the CPC have a genetic origin; the others are a normal part of fetal development and usually resolve by the third trimester. The part that bothers me so much is that we really don't know anything. If she was to tell us that seeing these abnormalities on the u/s means that our baby has a chromosomal disorder, we'd know and we'd deal with it. But nobody can tell us anything. It just sucks not knowing.

She went on to talk about the enlarged kidney. Because the fetus is only at 16 weeks gestation, it is still very early to accurately measure certain anatomical features, including the kidneys. She said it was very difficult to get a clear picture of the kidneys, but that compared to the other kidney, this one appeared enlarged. Again, this is something that may or may not have any genetic origin.

We further discussed the risks of having an amniocentesis. We are scheduled to have one following a Level 2 ultrasound on January 25th. We figured we'd reserve the appointment time, but have the u/s first. If we didn't see anything that caused any concern, we'd cancel the amnio. Because there are risks involved in amnio, including fetal trauma, loss of amniotic fluid, and even miscarriage, we would only take that risk if there was a large chance that our child could be born with a fatal disorder. Problem is, we may not really know for sure before having to make that decision. We may be basing our decision on all of these 'soft markers' which may not be significant at all. The good news is that the nuchal fold, which had been measured at my 11-week Nuchal Translucency screening, was still measuring well within the normal range.

In addition to that appointment, I had an OB appointment on 1/3. I saw a different doctor in the practice, who I loved. She really took a lot of time addressing my questions. We discussed in detail the issue of having or not having the amnio and she made a lot of good points. One of her arguments for having amnio is that it's not only about making a decision about whether to terminate a pregnancy. Another reason is, if there is a disorder that will require immediate medical attention, the doctors will know in advance what they will be dealing with. This is a really good point, but with such a low risk of having any chromosomal disorder, I'm not sure if it's worth having the amnio.

She also discussed with me reasons not to have the amnio. She could sense that we were leaning toward declining it, and confirmed that it ultimately is about what we are comfortable with. Would it be worse to give birth to a child with a disorder and be surprised, or would it be worse to potentially lose a chromosomally normal baby? After looking through the results of my 11 week NT scan and the repeat nuchal fold measurement taken at 16 weeks, she agrees that our risks are very low of having a baby with a genetic disorder. In addition, she reminded me that when you're dealing with a chromosomal disorder, the markers seen on u/s tend to be bilateral. In our case, both the cyst and the enlarged kidney were unilateral, which gives me a sense of relief that maybe the cyst is just a normal part of development and will resolve like it should, and maybe the enlarged kidney is not related to any syndrome or disorder. As the doctor added, worst case scenario, our baby will have one non-functioning kidney, but in those cases the other kidney takes over. It is not a fatal condition.

At my doctor's appointment I was also weighed. I only gained 2 pounds since my last visit. Considering that my last visit was before the holidays, that's pretty damn good. A non-pregnant person would be lucky if he or she only gained 2 pounds over the holidays, let alone someone who is expected to gain weight! I also had my glucose and protein levels checked, both fine; my blood pressure was normal. Blood was drawn for a progesterone level (I am now completely off the Prometrium) and for the quad screening which includes AFP. We should have more info about the results of the AFP next week, which will also help to come to a decision about the amnio.

So the level 2 ultrasound will be in 3 weeks. DH & I are trying not to be concerned until we have more information. Hopefully the picture will become more clear and we'll be able to arrive at a decision that we are comfortable with. A friend of mine gave me the advice that my instincts as a mother are already very strong, and that I should just go with my instincts. Because if even if there is no way to know what will come in the future, I know myself and I know how much we want this baby. I think I will heed that advice.


Baby Step said...

How very stressful. I am so sorry you are in this weird, limbo-land of not knowing exactly what is going on. I will think positive thoughts for you. My friend just gave birth to a perfect little baby boy on 12/18. The first 1/2 of the pregnancy she was worried that the chances of trisomy were pretty high. The 2nd 1/2 of the pregnancy the doctor saw something on the u/s that indicated a club foot. Obviously a club foot is not the end of the world (especially since my friend was told she would never conceive and carry a child to term!), but it was still very stressful. Well - the baby was born with perfect fingers and toes, and nothing wrong AT ALL. It just goes to show that the u/s and the people that read them are fallible.

Babe* said...

I won't give you the "try not to stress about it" assvice. I know I would if I were in your's only natural.

I'm praying that the 25th's u/s will produce a good report.

Thinking of you. (((hugs)))

SIL said...

It was soooo great seeing you and hearing blobby's heartbeat live!

I think your friend is right about maternal instincts. They are very strong and should be trusted.

Fingers, toes and everything else crossed for a great level 2 ultrasound. Whatever decision you make, it will be the right one for you and DH.


P.S. Thanks for not spilling the beans about my very well behaved (NOT) children while you were in town!

Barb said...

Lovely photos and so sorry for all the stress. Sending your baby lots of good vibes!

Natalie said...

:( Dang, that sucks.... and like you said, they can't even say yea or nay, just those possible soft markers. I'm sorry! I hope everything looks good at the next ultrasound and you can stop worrying.

Baby Steps to Baby Shoes said...

I have been thinking of you lately and wondering when an update would be forthcoming ;). I am so very glad you got to see the baby and I hope the concerns turn out to be nothing of consequence.