Yesterday we attended our bi-weekly appointment with the specialist. Although far from "out of the woods" and still riddled with anxiety, I think we approached the appointment feeling pleased that we have reached 23 weeks. We have beaten the odds so far. We are preparing for my relocation to Ottawa so that I am closer to the hospital and went into the appointment equipped with questions about how to manage the pregnancy when/if I reach 24 weeks.
When we were given the information from the ultrasound we noticed that the approximate weight disparity between the two babies was larger than it ever had been. In the past the difference was about 3 days, or 2-3 ounces. However, this time the difference was 5 ounces. Unsurprisingly, this disparity was raised by the specialist who indicated that it may be indicated of growth restriction for Baby A. Can this poor child not catch a break? What can I possibly do differently to help it?? The doctor acknowledged that this may be because of the difficulty to see the baby on ultrasound but that it required weekly monitoring to determine if this is a pattern or a fluke.
The good news, is that Baby A has grown some. It has good flow from the cord, a good heartbeat, had some fluid in the bladder, a little pocket of fluid and had actually significantly changed positions and could be seen moving on the ultrasound. So, it is not all bad, but it sure is scary. That baby just does not need anything else going against it. Twin A is now breech, essentially sitting on my cervix with its head beside that of Twin B, who is still transverse. More than anything, I hope that stay in there for longer. Baby B continues to look healthy and happy.
Unfortunately, when we began speaking about the future of the pregnancy the doctor we saw yesterday was quite negative. She spoke often about forfeiting Baby A to try to protect Baby B. She kept repeating that no matter when I deliver, Baby A has very poor prospects for survival and high likelihood of disability if it survives. She essentially dismissed the 24 week mark as any type of accomplishment and said that really 27 or 28 weeks would be a better baseline. I am acutely aware of this, as I have tried to articulate in previous posts. But having a doctor who does not acknowledge any level of success was so disheartening.
She did say that she would recommend a course of steroids for the babies next week, contrary to our usual doctor's recommendation. She also indicated that if I relocate to be close to the hospital, they will send a nurse to my home a couple of times a week for monitoring and see me weekly at the hospital. I at least liked that.
Facebook status of the day: So exhausted and so filled with love. Let's keep going, Little Peas.
That's so great that you could see a nurse at your house. I tried to get that through my insurance, but because pPROM was a condition that they felt should be 'hospitalized' my insurance wouldn't cover it. So I stayed home and relied on my own nursing skills. Fun times.
ReplyDeleteAnother thing to point out, is that when I was pregnant with Aidan, I was so afraid he was going to die inside me. I don't know why, but that really freaked me out. I think it was because I had a doppler at home which I would use to check on his heartbeat and I was SO afraid of searching and NOT finding it. When I brought this concern up to my doctor he said that because I had good 'cord flow' he wasn't worried about a still birth. His actual words were "well, he likely won't die inside you". It's an awful thing to be *grateful* for, but hearing that gave me such relief. In the end, Aidan was born alive, and we did get to "meet" him, if only for an hour.
Also, if it makes you feel any better, doctors are generally much less optimistic about ANY baby born before 27-28 weeks, even a singleton non-pPROM pregnancy (so don't think it's just YOU and YOUR pregnancy). Their definition of 'success' is a baby goes home without ANY complications, and you have a much higher chance of that after 27-28 weeks. If you make it that far, they will be singing a different tune, trust me.
Keep on keeping on. Love to hear your updates.