A Challenging Week in Angie's 2nd Pregnancy
Last week, Angie went in to her Midwife's office for a routine checkup. The Midwife found that Angie's uterus measured an inch smaller than at her last checkup. Angie was not particularly concerned because the same thing had happened when she was pregnant with Sam, and everything ended up being just fine; but the midwife wanted her to have another ultrasound to make sure the baby was growing as he should.
This was the 3rd ultrasound, because earlier in the pregnancy, they were concerned about the placenta lying in a low position that could cause problems during labor if it didn't move. Fortunately, the 2nd ultrasound showed that her placenta had moved away from the cervix. The 3rd ultrasound, which took place on Monday last week, revealed a healthy-looking little boy measuring in the 58th percentile. The ultrasound technician was amazed how well Angie hid him in her tiny belly and sent her home feeling great about everything.
The next day, Angie got a call from her Midwife, Kat, letting her know the ultrasound had revealed that the amount of amniotic fluid surrounding the baby was below normal. She explained that at her stage in pregnancy, her Amniotic Fluid Index (AFI) should be between 10 and 20 centimeters; and she only measured 8.5. She explained that if the AFI dropped to a 4, they would have to induce labor and that it was important for them to make sure the fluid level was not dropping, so she scheduled another ultrasound the following day.
We spent the rest of the day researching the causes and implications of a shortage of amniotic fluid, and we were pretty worried about what we found. As far as we could tell, this meant one of four things: 1) The placenta was not delivering adequate blood and nutrition to the baby, causing him to produce less urine, which makes up most of the fluid. 2) There was a tear in the amniotic sac, causing the fluid to leak. 3) The baby's kidneys or urinary tract were not functioning properly. 4) Angie was badly dehydrated. Since we knew the fourth option was not the case, we realized that most of the other scenarios were likely to result in an early delivery at the least and possibly more serious complications.
The following morning, a good friend from our ward took sam; and Angie, Carolyn, and I headed down to Milcreek Imaging for our 4th ultrasound. The technician found the baby's kidney's to look normal, his bladder was full, and he looked healthy and well. In fact, after a couple of minutes we saw that the bladder had emptied, indicating that his urinary tract was functioning properly. This seemed to rule out what we viewed as the worst case scenario of our baby having health problems. With the baby having measured in the 58th percentile the day before, it seemed unlikely that the placenta was not doing its job properly. The technician, understanding the implications of finding anything less than 8.5 cm of fluid, measured a couple of times; but in the end, 8.3 was the best she could come up with.
We left the clinic optimistic about having ruled out the worst scenarios, but emotional about having not only confirmed a low level of fluid, but also having seen it drop in just 2 days. We were told Kat's nurse would call us within an hour with orders on how to proceed.
Our conversations with the medical professionals, and our research, indicated that if we found a lower level of fluid, Angie would likely be put on bed rest and ordered to drink tons of water, and eat lots of food high in protein and healthy fats to fatten up the baby in case of early delivery. While we waited for the call from the nurse, I put Angie on bed rest, and Carolyn jumped into mommy mode and went grocery shopping.
The nurse called and told us what we expected to hear. Also, Angie would be scheduled to come in twice weekly for "non stress tests" and to measure the fluid.
We felt a lot of anxiety as we waited for Monday's appointment. We came up with our own theory that Angie must have a small leak in the amniotic sac, so on Saturday, we took her to the Labor and Delivery center to have them check. To our surprise, the results came back negative. After passing an early non stress test and ruling out the risk of infection due to a fluid leak, we were sent home with modified orders -- Angie would be on pelvic rest. Feeling encouraged, we decided to spend a mellow night out for my birthday.
This morning, three days since our last fluid measurement, we went in to the hospital for a fluid measurement and a non stress test. We knew that any measurement below 8.3 would be disappointing, and based on our experience, we expected that it might have dropped to 8.1 or 8. We were heartbroken when the technician only came up with 5cm. She told us she would get another person who specializes even further in measurements to come verify her findings. We spent a few minutes together trying to adjust to what we believed to be an indication that our baby would be coming much sooner than expected.
When the second technician came, I told her we hoped that the first was just really lousy at her job, and we all chuckled -- even the first technician. The told us that it was not uncommon for the follow up to find different results. The second tech worked her magic and said she found 10cm. We were shocked! We had just gone through the emotional struggle of picturing our baby being born 2 months early, and just like that, 10cm... This put our whole situation back in the realm of normal!
After the baby passed the non stress test with flying colors, the nurse told us she really couldn't get over how tiny Angie's uterus was. She had called the Midwife's office, and they had agreed that nobody could feel right about just accepting that things were fine. They recommended that we have their "super duper doctor" perform her own analysis and make sure nothing was being overlooked. We readily agreed. The reality was that we had already decided that one tech finding "normal", and the other finding "next-to-delivery" was not acceptable. We would have asked for a third opinion had they not offered it.
After a long wait in the lobby, we were taken into another ultrasound room. The tech performed a thorough check up on our baby and found him to have grown almost a pound in the last week. He measured in the 48th percentile (4.3 lbs), and he looked great. On the other hand, she could only come up with an AFI of 54cm. She called in the "super duper doctor". She came to the same conclusion. With 3 out of 4 ultrasounds finding 5cm, we had the verification we wanted but the results we did not want at all.
We peppered the doctor with questions about the implications. She reminded us that Angie's uterus is the best Neonatal Care Unit there is for the baby, and as long as he can continue showing good growth and healthy activity, he should stay there. We asked at what AFI they would induce labor, and she said if he can continue to show good growth and performance at 5cm, we could continue to monitor him closely for pretty much as long as that continued. She did say, however, that if we got to 35 or 36 weeks and he was still at 5cm, they might consider delivering him so that we're not just waiting for something to go bad. Angie was sent home on strict bed rest. We were told that if she measures less than 5cm when she comes in for the next non stress test on Thursday, she would be admitted to the hospital until it either got up above 6.5 or they had to induce labor.
This has been an anxious and challenging time to imagine our little boy being born in difficult circumstances. We know that at 32 weeks, babies can be just fine. Our nephew was born 3 months early, and we remember what a rough time he had, but we also see how well he is now. We are very grateful to know that our little boy is currently looking to be very healthy. We pray that our sweet little boy will get to continue to grow and develop much longer before being born.
This was the 3rd ultrasound, because earlier in the pregnancy, they were concerned about the placenta lying in a low position that could cause problems during labor if it didn't move. Fortunately, the 2nd ultrasound showed that her placenta had moved away from the cervix. The 3rd ultrasound, which took place on Monday last week, revealed a healthy-looking little boy measuring in the 58th percentile. The ultrasound technician was amazed how well Angie hid him in her tiny belly and sent her home feeling great about everything.
The next day, Angie got a call from her Midwife, Kat, letting her know the ultrasound had revealed that the amount of amniotic fluid surrounding the baby was below normal. She explained that at her stage in pregnancy, her Amniotic Fluid Index (AFI) should be between 10 and 20 centimeters; and she only measured 8.5. She explained that if the AFI dropped to a 4, they would have to induce labor and that it was important for them to make sure the fluid level was not dropping, so she scheduled another ultrasound the following day.
We spent the rest of the day researching the causes and implications of a shortage of amniotic fluid, and we were pretty worried about what we found. As far as we could tell, this meant one of four things: 1) The placenta was not delivering adequate blood and nutrition to the baby, causing him to produce less urine, which makes up most of the fluid. 2) There was a tear in the amniotic sac, causing the fluid to leak. 3) The baby's kidneys or urinary tract were not functioning properly. 4) Angie was badly dehydrated. Since we knew the fourth option was not the case, we realized that most of the other scenarios were likely to result in an early delivery at the least and possibly more serious complications.
The following morning, a good friend from our ward took sam; and Angie, Carolyn, and I headed down to Milcreek Imaging for our 4th ultrasound. The technician found the baby's kidney's to look normal, his bladder was full, and he looked healthy and well. In fact, after a couple of minutes we saw that the bladder had emptied, indicating that his urinary tract was functioning properly. This seemed to rule out what we viewed as the worst case scenario of our baby having health problems. With the baby having measured in the 58th percentile the day before, it seemed unlikely that the placenta was not doing its job properly. The technician, understanding the implications of finding anything less than 8.5 cm of fluid, measured a couple of times; but in the end, 8.3 was the best she could come up with.
We left the clinic optimistic about having ruled out the worst scenarios, but emotional about having not only confirmed a low level of fluid, but also having seen it drop in just 2 days. We were told Kat's nurse would call us within an hour with orders on how to proceed.
Our conversations with the medical professionals, and our research, indicated that if we found a lower level of fluid, Angie would likely be put on bed rest and ordered to drink tons of water, and eat lots of food high in protein and healthy fats to fatten up the baby in case of early delivery. While we waited for the call from the nurse, I put Angie on bed rest, and Carolyn jumped into mommy mode and went grocery shopping.
The nurse called and told us what we expected to hear. Also, Angie would be scheduled to come in twice weekly for "non stress tests" and to measure the fluid.
We felt a lot of anxiety as we waited for Monday's appointment. We came up with our own theory that Angie must have a small leak in the amniotic sac, so on Saturday, we took her to the Labor and Delivery center to have them check. To our surprise, the results came back negative. After passing an early non stress test and ruling out the risk of infection due to a fluid leak, we were sent home with modified orders -- Angie would be on pelvic rest. Feeling encouraged, we decided to spend a mellow night out for my birthday.
This morning, three days since our last fluid measurement, we went in to the hospital for a fluid measurement and a non stress test. We knew that any measurement below 8.3 would be disappointing, and based on our experience, we expected that it might have dropped to 8.1 or 8. We were heartbroken when the technician only came up with 5cm. She told us she would get another person who specializes even further in measurements to come verify her findings. We spent a few minutes together trying to adjust to what we believed to be an indication that our baby would be coming much sooner than expected.
When the second technician came, I told her we hoped that the first was just really lousy at her job, and we all chuckled -- even the first technician. The told us that it was not uncommon for the follow up to find different results. The second tech worked her magic and said she found 10cm. We were shocked! We had just gone through the emotional struggle of picturing our baby being born 2 months early, and just like that, 10cm... This put our whole situation back in the realm of normal!
After the baby passed the non stress test with flying colors, the nurse told us she really couldn't get over how tiny Angie's uterus was. She had called the Midwife's office, and they had agreed that nobody could feel right about just accepting that things were fine. They recommended that we have their "super duper doctor" perform her own analysis and make sure nothing was being overlooked. We readily agreed. The reality was that we had already decided that one tech finding "normal", and the other finding "next-to-delivery" was not acceptable. We would have asked for a third opinion had they not offered it.
After a long wait in the lobby, we were taken into another ultrasound room. The tech performed a thorough check up on our baby and found him to have grown almost a pound in the last week. He measured in the 48th percentile (4.3 lbs), and he looked great. On the other hand, she could only come up with an AFI of 54cm. She called in the "super duper doctor". She came to the same conclusion. With 3 out of 4 ultrasounds finding 5cm, we had the verification we wanted but the results we did not want at all.
We peppered the doctor with questions about the implications. She reminded us that Angie's uterus is the best Neonatal Care Unit there is for the baby, and as long as he can continue showing good growth and healthy activity, he should stay there. We asked at what AFI they would induce labor, and she said if he can continue to show good growth and performance at 5cm, we could continue to monitor him closely for pretty much as long as that continued. She did say, however, that if we got to 35 or 36 weeks and he was still at 5cm, they might consider delivering him so that we're not just waiting for something to go bad. Angie was sent home on strict bed rest. We were told that if she measures less than 5cm when she comes in for the next non stress test on Thursday, she would be admitted to the hospital until it either got up above 6.5 or they had to induce labor.
This has been an anxious and challenging time to imagine our little boy being born in difficult circumstances. We know that at 32 weeks, babies can be just fine. Our nephew was born 3 months early, and we remember what a rough time he had, but we also see how well he is now. We are very grateful to know that our little boy is currently looking to be very healthy. We pray that our sweet little boy will get to continue to grow and develop much longer before being born.
Wow, I'm so sorry to hear about all of this. We are praying for you guys. Keep us updated, we're thinking of you.
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