pPROM Update II

Well, we had our meeting with the new doctor. And, thank goodness, it went so much better. *huge sigh of relief*

I think it went more smoothly in part because we are in a different place. We know more about what's happening and what we want out of a medical team. Also, I was in a place where I could communicate that clearly, with a fresh start. On the other hand, the doctors also responded differently to our concerns and knowledge. The specialist has even dealt with pPROM twins before - yay for knowledge!

Here is a quick summary of how things went:

The Ultrasound:
Showed that Baby B is doing great. They did not tell us the sex, but from what the Tech. said, my bets are on a little boy. (We did not want to know just one, and Baby A is too hard to see to determine sex).

Baby A:
- Had 1.1cm of fluid - having measurable fluid is a definitely a step up from previous ultrasounds, although it's very little fluid in the grand scheme of things. The doctor acknowledged that this is crucial time for lung development but that doctors simply do not know how much a baby needs to survive.
- Had a strong, positive flow through the umbilical cord
- Two measurable choroid plexus cysts (cysts on brain). Generally, these can be harmless and may disappear. However, they are considered to be soft markers for chromosome abnormalities.
- The membrane appears to be stuck to one arm. This may be indicative of the membrane wrapping around part of the baby's arm, which may cause amputation.
--> The MFM Specialist and the Fellow both hypothesized that the information gained about Baby A may amount to the baby being an unhealthy baby. They suggested that perhaps Mother Nature knows something that we do not, leading to the rupture and possible demise of the baby. They also indicated that because there is a lack of fluid, they cannot do further investigation to determine if there are other markers of chromosome abnormalities (Down's syndrome or Trisomy 18). They noted that because the baby continues to grow and have a healthy heartbeat, that there is also the possibility that the baby will be fine.

The Doctors
Our appointment took place 2 hours late (long day). First the fellow came in and after a quick history, asked us why we were seeking a second opinion. I proceeded to explain/rant/cry that we had not been respected, our questions had been unanswered, our doctor lacked experience or the ability to support us in expectant management. The most amazing part was that while I kept ranting, I could see that he wanted to say something but actually stopped himself because he understood that I needed to feel heard. The fellow explained that he has a lot of OB experience and that he prefers to err on the side of hope - words that brought tears to my eyes. He highlighted that as much as we cannot predict the future, we have already beat the odds so why not continue to focus on that.
The MFM Specialist arrived a while later and immediately apologized for the long wait. She sat down and said that she had been told what we had discussed but that she wanted to hear it from me, as we had a lot to talk about. Then she put her things down and got comfortable. She also highlighted hope, her own experience with other women beating the odds. She indicated that she can and has performed delayed interval delivery using cerclage - something our last doctor said would be experimental and that she would not perform.
So, both doctors said that they are comfortable having some hope, but did not sugar-coat that the stats are grim and we have  long way to go. Finally, honest and balanced thinking from a medical professional. She gave us a little bit of hope, but more than anything, she respected us and we left feeling empowered.

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