Friday, May 27, 2011

Ultrasound Check (16 Weeks)

Another small bleed this morning. I'd say it was about as heavy (or light, as it were) as yesterday morning and the morning before.

I went in to Pediatrix for my scheduled ultrasound at Swedish today. Based on my cycles, I'm exactly 16 weeks (although according to ultrasounds, the baby is older and will be 17 weeks on Monday).

I heard a lot of good news as well as some bad news. The good news is that the little one is thriving. She's definitely a girl, and she weighs about 5 ounces and is over four inches long from head to butt. They were able to get good views of her back, heart, diaphram and brain. Everything looked great!

They were also able to see some clotting near the cervix. The tech told me to expect a little more bleeding as that works itself out (she said it can also cause cramping). Later, the doctor came in and took a closer look at an area. She said that some blood has pooled between the amniotic sac and the uterine wall. Doing some research on the internet at home, I later determined that she was probably talking about a subchorionic hematoma. She told me that this puts me at increased risk of my water breaking early (thus going into pre-term labor). She said, "Hopefully, that won't happen too early."

After I got home, I started to think more about what she said and really wondered if it was actually likely that this would happen, based on what she said. I mean, why didn't she say, "Hopefully, that won't be a problem," instead of, "Hopefully, that won't happen too early?" Is it almost a certainty that it will break? If I don't absorb or pass the blood, then is it almost a certainty? Am I going to have my water break at any time? At this point, should I just be hoping that I can make it to 24 weeks? With these questions nagging me, I decided to call to get some clarification. A nurse is supposed to call back today, so hopefully that will happen shortly.

On the internet, there's a decent amount of information and even support groups for people with subchorionic hematomas. Apparently, if they occur in the first trimester, they can result in 40-50% chance of miscarriages (depending on the size of the hematoma). If they develop (or are found) late in the first trimester or in the second trimester, there are other concerns. I guess they can keep the placenta from implanting into the uterine wall, and they can irritate the amniotic sac, causing it to rupture. Based on what the doctor said to me, I'm guessing the placement of the hematoma in my body is in a position where it can irritate the amniotic sac (but hopefully not placenta implantation). Many women pass the clot or reabsorb it. One support group that I was reading had women commenting that it seems people who are diagnosed with this in the second trimester don't reabsorb it as often as women do early in the pregnancy.

I have a follow-up appointment scheduled in about four weeks to check to see how the blood is doing. Now that I know I'm not having any new bleeds, I'm actually hoping I can bleed this away. I've set a few goals. Although I know there is little I can do to help, I'm mentally shooting for the 24 week mark. That's July 22 (based on my cycle date, which is a little more conservative than my ultrasound date). Babies can survive as early as 18 weeks, but they usually have a rough life of infections, complications, chronic illness, surgeries, etc. Twenty-four weeks is my goal. September 2 will be when I hit 30 weeks. That is my second goal. My midwife told me, if a woman can't make it to full-term, they at least want women to make it to 30 weeks and for the fetus to reach three pounds. Full-term (38 weeks) would be October 28--two days before Oliver's second birthday. That will be my third goal. For now, though, I'm focusing on July 22. In my mind, I want my body to make it to July 22. That's what it'll take for me to have a good chance at having a baby girl who will have a good chance at being healthy. July 22.

Update: More good news! The nurse called back and said she'd spoken to the doctor. The doctor estimates my risk of "something bad happening" to be about 6%. Six percent! Those odds are about 1/16. I prefer to be an optimist and say there's a 15/16 (94%) chance that things are going to be just fine.

I'd also left a message asking about travel. She said the doctor says it is just fine for me to travel to Chicago next month. However, she said traveling later in pregnancy is probably not a good idea but to discuss it with my midwife. Apparently, women are advised not to travel at all after 36 weeks but especially if they're considered "at risk." This is not good, as I'm supposed to drive to Texas for my brother-in-law's Texas-ranch-destination wedding in mid-October. Of course, I would choose a healthy baby over travel anywhere for any reason, but it would be sad to miss the big event. I guess I'll wait and see.

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