Pregnancy Update: Unexpected Appointments

Since the preg­nancy announce­ment post, we’ve had a rather event­ful 6 weeks. I’ve been extremely lucky (and thank­ful) to have had two rather sim­ple & unevent­ful preg­nan­cies with the boys. Other than start­ing out over weight, I’ve not had any issues or complications–not with the babies nor with me (not even ges­ta­tional dia­betes or high blood pres­sure). When I saw my Dr. just before post­ing the announce­ment, she said…“you’re so easy, I don’t even need to see you for 6 or 7 weeks”. Then, wouldn’t you know, things got inter­est­ing.

We had done an NT scan at about 12 weeks to check on baby (the ultra­sound is usu­ally done at peri­na­tal cen­ters with more advanced imag­ing tech­nol­ogy, so it wasn’t done at my Dr.‘s office). This wasn’t some­thing offered when I was preg­nant with Big Brother in 2006 (the only thing then was the first trimester screen blood test, which we opted not to do since it doesn’t tell you any­thing defin­i­tive), so when in 2009 we found out about being about to do a ultra­sound at that stage to check on baby–we jumped at the chance! As part of the screen­ing, there is the blood test too. Every­thing was great for Lit­tle Brother back then. So, with this preg­nancy we decided to do it again. And, once again, we were thrilled to see our newest lit­tle one at 12 weeks. Every­thing looked great on the ultrasound–no signs that would indi­cate a problem.

So, on our way out, I gave my few drops of blood & we left feel­ing really great. I met with my Dr. a few days later where we heard the heart­beat via doppler. Again, every­thing was great. So, I (naively) just didn’t pos­si­bly think that any­thing could would not look good with the blood work. But, then I got the call. It was the Dr. at the Perinatologist’s office (who had really BAD phone-side man­ner). Here’s what he said, “So, every­thing looked fine on the ultra­sound, but your blood work came back pos­i­tive for Down Syn­drome. Just based on age alone, your risk for Down Syn­drome is about 1 in 450, but based on the results of the ultra­sound and blood work, your risk is 1 in 60.…”

I was stunned. I asked about the other Tri­somies (namely Tri­somy 13 & 18–thankfully, those came back nor­mal). The biol­ogy per­son in me wanted to know what they tested in my blood and how the results were cal­cu­lated. He explained that they test for two chemicals/proteins present dur­ing prenancy–HCG and PAPP-A. Appar­ently, my HCG was slightly high (which is com­mon in babies with Down Syn­drome) and my PAPP-A num­ber was quite low (also com­mon for babies with Down Syn­drome). So, that’s why my risk was so much higher than just the aver­age risk for age alone. Then, he went on to say…“Low PAPP-A is also asso­ci­ated with pre-eclampsia later in the preg­nancy as well as a num­ber of pla­cen­tal issues that can lead to IUGR, preterm labor, mis­car­riage, etc. so you’re def­i­nitely going to be mon­i­tored more closely through­out the preg­nancy”. WHAT?! After that, he explained options to me (amnio, more blood tests, ultra­sounds, etc.), but at that point I couldn’t focus well. There were lots of tears and finally a chat with my Dr. who had MUCH bet­ter phone skills and made me feel MUCH better.

We met with a genetic coun­selor (which was fas­ci­nat­ing because had I not become a biol­ogy teacher, I was look­ing into genetic coun­sel­ing pro­grams) who explained every­thing & all of the options in detail. Our deci­sion was to do a detailed Level II ultra­sound at around 15 weeks to check the baby over in detail for any mark­ers of Down Syn­drome (or any other prob­lem). The tech was fab­u­lous and every­thing seemed to look good as we went through.

At the end, the Dr. came in and explained that they found no indi­ca­tions of any­thing related to any Tri­somies (it doesn’t guar­an­tee that noth­ing is wrong with the baby, but it is at least a really good sign). Thank good­ness!!! But, then, he said, it looks like some­thing might be wrong that has absolutely noth­ing to do with Down Syndrome.…“it looks like the baby has a sin­gle umbil­i­cal artery”.

This is more com­monly known as a “two-vessel cord”. Nor­mally, an umbil­i­cal cord has three vessels–two arter­ies and one vein. From the ultra­sound, it looks like this one is miss­ing an artery. It too can lead to growth issues with the baby. Because 15 weeks is so early & every­thing is still so very small, they want to do an ultra­sound around 20 weeks to check the heart in detail (a fetal echocar­dio­gram) and they will con­firm whether or not the cord is indeed two-vessel at that appoint­ment also. If the cord is two-vessel, then I will have at least 3 addi­tional ultra­sounds in the 3rd trimester to check on baby’s growth. One of my best friends is actu­ally cur­rently preg­nant with a two-vessel cord (and about to give birth), so I’m not super con­cerned about that. I know things could be so, so much worse. But, it still makes things a bit more nerve-wracking nonethe­less. We are pray­ing that every­thing looks great with the heart in a cou­ple of weeks!

Whew! Have any of you dealt with any sim­i­lar things?

Other that all of that crazi­ness, every­thing is pro­ceed­ing nor­mally for me. I’m 18 weeks right now and have hit that point where I can’t really hide it any­more, but don’t quite have that popped “bump” yet. Mater­nity clothes are a must though–especially tops. Here’s what I look like now, com­pared with what I looked like in my other preg­nan­cies at sim­i­lar stages:

It’s amaz­ing how much slower every­thing was to “pop” the first time around (and how much worse my pho­tog­ra­phy skills were–nothing like pho­tos in front of a messy bed)!! Given my his­tory, I should def­i­nitely be look­ing clearly preg­nant all of the time within the next cou­ple of weeks! Right now, we’re just look­ing for­ward to the upcom­ing ultra­sound & I’m eager to start feel­ing this lit­tle one. I have an ante­rior pla­centa this time (which from our ultra­sounds it is clear that baby likes to snug­gle with), so I won’t be able to feel any­thing until baby’s move­ments are strong enough to go through the pla­centa in addi­tion to every­thing else–my Dr. said it could be as late as 23 weeks before I start feel­ing any­thing consistent.

Wow, that was long! Thanks for read­ing! Hope­fully other updates won’t be quite as event­ful! And, after the next ultra­sound I’ll be able to share baby’s gen­der (we have a pretty good idea already, but they’ll con­firm that at the next appoint­ment also)!