NT Scan and Perinatologist Update

I swear that was the longest appointment ever.  It was good news. Squishy looks great. But because of some of the issues with my last pregnancy and with Smudge, there was a lot to talk about .

First, the NT Scan. It looked great. Squishy is CRAZY active. More than Smudge ever was. Just as stubborn too. Goodie. But the NT measurement looked awesome. 1.4mm. The perinatologist said that's a great measurement at any point in the pregnancy. They also saw the nasal bone, which is good news. There were no other soft markers present that would indicate a chromosomal abnormality. They saw all of the major organs they were looking for, 2 arms and 2 legs. The umbilical cord has 3 vessels and Squishy is measuring a couple of days ahead, at 12w2d. 

See... Squishy.

It's a picture of a monitor, so please forgive the quality.
Our actual pictures won't be scanned until tomorrow.

We talked a lot about my Smudge pregnancy. He's concerned that I won't be able to VBAC, but that's not his expertise, so I'm not really considering his opinion. If Dr Z and the midwives think I can do it, that's all that matters. Dr C (from the perinatology institute) can make sure Squishy grows and thrives while s/he's inside, my midwives will take care of things from there. He had some concerns about placenta placement, but it's nice and posterior for now, so there are no concerns with my incision. Two fibroids have made an appearance (background: I had three at the beginning of my Smudge IVF cycle and at my c-section they found nine. At the beginning of my Squishy cycle there were none, so we fully expected them to make an appearance at some point, since they're likely hormonally driven) but they're on the exterior of my uterus, like the other ones were, so not concerned about them at this point. Also, the cyst that was on my right ovary (and at one point the size of my head) has completely resolved. So yay that. 

I brought up my concerns about Smudge not having grown in my last month of the pregnancy. (At 35 weeks, she was measuring approximately 5lbs 12oz, and then was born 5 weeks later at 5lbs 8oz - just this side of low weight for gestational age.) He reviewed all of my records from my pregnancy, and said that at every scan I had, she was measuring 40-50%.  He agreed that it was concerning that it appears she didn't gain any weight from 35-40 weeks. He plans on monitoring me a little bit closer at the end of this pregnancy. I'm okay with that. A few extra ultrasounds aren't going to hurt - but it they indicate that the baby is in trouble, then we will be able to do something about it. We were fortunate that Smudge was healthy, despite her lack of growth. It might not be the same next time. 

We also discussed the two congenital issues that Smudge had. Her severe hip dysplasia and her cardiac defect. The latter automatically got me signed up for a fetal echo. I'm okay with that. Dr C said I could go back to Smudge's cardiologist for the echo, which is great. I just love her (another Dr C). Her hip dysplasia was another story. As of right now, Smudge's orthopedic surgeon at Children's Hospital of Philadelphia (CHOP) is calling it Developmental Dysplasia of the Hips. If Squishy is born with hip dysplasia as well, both babies will be given the diagnosis of Congenital Dysplasia of the Hips. Unfortunately, this is something they can't look for in utero. Dr S (the ortho) has already agreed to see us soon after birth for an ultrasound, rather than waiting the standard 4 weeks. I just can't wait that long. Smudge was in treatment at 6 days old. I'd feel negligent if Squishy needed something that we weren't providing in that time. 

I know this has already been so long - but wait - there's more. 

My MTHFR comes back into play, as being homozygous for the mutation makes me a higher risk for having a child with a spinal/neural tube defect (which we were initially concerned about with Smudge). However, since my homocysteine level has been normal, he's less concerned. Even though, he's recommending that combined with my age, I have the 2nd trimester AFP blood test done. He said at their clinic, they're 95% accurate with picking up spinal defects via ultrasound, but it's better to be safe than sorry. 

After all of that, I had my blood drawn for my 1st trimester risk of chromosomal abnormalities. 

He also told us that the clinic has been involved in some groundbreaking research, and that they're now offering a blood test (not covered by insurance now, but hopefully one day will be) which can indicate the trisomies and certain other genetic disorders like Turners Syndrome with 99% accuracy. That's just amazing. Hopefully we won't have to be concerned about the risk enough to pay for this test, but it's nice to know there's a more accurate blood test available prior to having to submit to an amniocentesis, should it come to that. 

That's enough, right?

It was a lot of information in one day. I practically fell asleep on my way home and I'm still really dragging. Smudge's Dad is working hard on trying to get her to bed, because I'm pretty sure if I were doing it, I'd be asleep before she would. 

Now we wait for the results. But based on the ultrasound, we hopefully have little (other than my age and egg quality) to worry about. 

Stay tuned....

Music to My Ears

11w6d: I'll be 12w in 2 hours. I made it through the day without an emergency midwife call. No bleeding or spotting to speak of. And even better, a successful 1st home doppler (HB 164 after a while of looking; s/he was hiding under momma's pubic bone).

I give you, Squishy.

Honestly - How Many Pregnant Chicks Check the Paper EVERY Time They Wipe?

I can't be the only one.  Not by a long shot. 

Today is 11w6d, which is an interesting anniversary of sorts. With Smudge, at 11w6d, I started bleeding. I'll never forget shaking like a leaf, calling Smudge's Dad and then my nurse. Then my emergency u/s where I could breathe when I still saw her heart beating. 

Sub-chorionic hematoma AKA the scariest day of my life. The day I thought I was losing her, just like I lost her twin. 

And today, in the face of my newly surfaced pregnancy nightmares, I'll spend the day waiting for the other shoe to drop. 

Tomorrow is my NT scan. Between my age, my egg quality, my nightmares, my teething toddler and my lack of sleep, I just need it to get here already. 

I'm not feeling clever today... but I AM still pregnant!

I'm too tired to be clever today (or at least to pretend i'm clever), but I still wanted to update on my first appointment with my midwives. It went really well. I'm 10w2d today and I was nervous. I know way too many girls who have had late 1st tri losses lately and I was sure something would have happened between my 8w at Dr Z and today. But my midwife (today I saw Louise) didn't make me wait at all. I didn't get a picture, but i can't believe how big Squishy has gotten in the last 2+ weeks and I saw the heartbeat immediately. So, that's the baby update and it's a good one. 

Then we talked a lot about my labor with Smudge. She said there were positive indications for a VBAC. 1) I was full term and I went into labor sort of spontaneously (I told her about the acu-induction and everything else I did) and 2) I did get to 10cm and pushed for a long time. She said those are both very good signs that I should be able to have a good trial of labor. That made me feel a lot better, because one of the other midwives wasn't as positive at my annual, when we talked about my contractions spacing apart. But that didn't even phase Louise when I told her. I also had a VERY uncomfortable pelvic exam, where she was feeling out the shape of my pelvis.  She said that the top of my pelvis is more pointed than rounded (which would be normal), but there's plenty of posterior room and there's no physical reason she could see for why Smudge couldn't descend other than her posterior position. So, that's another check in the right column. 

She talked about nutrition, and like so many ladies have told me, told me really not to sweat the numbers right now; to try to increase my protein to stay fuller longer. She has the same goals I do: to keep my gain under 25lbs total. So, hopefully we can stay under that number. 
We also talked about the possibility of having to have another c/s, which I definitely would like to avoid. But in the case we feel like that is where I'm headed, or even if we don't think that, but I decide to for my own comfort, I can make a prenatal appointment with their cooperating doctor (Dr M) so I can meet him and discuss some of my concerns about my last c/s. Louise also told me that it's policy at my new hospital that when the baby and mother are stable, the baby is admitted in the OR and stays with mom in recovery. Since one of my biggest issues is that Smudge was kept from me for HOURS after my last c/s, that really reassured me. 

I scheduled my NT scan, anatomy scan and fetal echo (which apparently is now standard with our perinatologist, but we have no problem with that since Smudge had a cardiac defect when she was born). 10 days until we get to see Squishy again! <3

I'll leave you with pictures of our newest acquisition: A City Select Stroller with a second seat. OMG. I don't know how I haven't had this stroller the whole time, but we found an amazing deal on craigslist.

Smudge really LOVES it too. We can't get her out of it. She actually climbed into it herself this morning. So, we're going to be using it as a single stroller until Squishy gets here, which is one of the great things about it. 

Hopefully, next time I'll have some pictures for you of Squishy, and not just toys.