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)! 🙂

Comments

    • Sara @MomEndeavors says

      Thanks, Lorie–always good to hear!! They say it occurs in less than 1% of pregnancies, but I have sure heard of a lot of people recently that have experienced it.

    • Sara @MomEndeavors says

      Haha–so true. I didn’t even notice at first that #1 & #2 have different cameras! LOL! And, you can SO tell that I wasn’t blogging or anything in the first two. 🙂 I like the quality of the 3rd SO much better.

  1. says

    I have 3-1/2 yr old triplets, one of whom had a 2 vessel cord. I was told the 2 vessel cord, while uncommon, is not “rare”. Luckily I was able to hang onto them for almost 35 weeks but Zoe was still 2 lbs, 13 oz at birth. However, she didn’t need any oxygen at birth and was otherwise healthy despite being a preemie! Good luck to you and your baby, hopefully the extra monitoring will help keep things in check and help for as good an outcome!

    • Sara @MomEndeavors says

      Wow–triplets, Shari?! How special! 🙂 Amazing that you carried them to 35 weeks!! Thanks for sharing your story. Was she the smallest of the 3? Glad everything turned out so well.

  2. says

    I hate that test. My brilliant 4 year old (already reading and going on 24) is one that was marked as having an elevated risk of Downs. We did the Level II ultrasound and they told us the same thing. Looked good, but wouldn’t make any promises. She was perfect. I opted not to do the test w/my son. I couldn’t see the point, other than to make us stress about the possibility of something we couldn’t do anything about.

    I haven’t had any experience with the cord issue. I hope all is well. I do have a sister that had a baby with IUGR. It was scary when he was born so tiny, but is a healthy normal 11 year old now. Best wishes for the rest of your pregnancy!

    • Sara @MomEndeavors says

      Thanks, Kendra! I hear ya. Not a fan of the blood test and now, in hindsight wouldn’t have done it. Like I said, even with my background, I just so naively assumed that if the ultrasound looked ok then the blood work would be normal. Dumb! We think this one is the last one, but if we were to have another, I won’t have it done next time. Glad your sister’s little one was ok even with IUGR! That can be SO scary!

  3. Angela Jacob says

    Oh Sarah, I hope everything is o.k. with baby. I will pray that you find out good news next time and the baby is born healthy. Take care!!

  4. Carol Dee says

    Oh Dear, all pregnacies come with a normal amount of stess. Then to get bad news delivered badly! So glad your OBGYN is so much better. Just keep tabs and moniter closely. All will be well. No matter if there is an abnormality at birth you will be prepared and are a FABULOUS Mom . My thoughts and prayers are with you. Try NOT to stress, rest when you can and know you are well loved.
    Hugs….

    • Sara @MomEndeavors says

      Aw, thanks Carol! Yes, he delivered the news SO badly. In fact, we switched perinatal centers after that. Thankfully, the new location & Dr. (and yes, my OB too) have been MUCH better!
      We’re feeling much better and yes, trying not to stress about it at all. 🙂

  5. Shelby Holland Rebideaux says

    Hi Sara, I hope that everything turns out good for you during your pregnancy, they are hard enough as it is! Hope everyone else is well. You have two handsom little boys.

    – Shelby

  6. says

    When I was pregnant with my daughter, I had gestational diabetes (2nd time). Because I was 37 and I could tell I was diabetic at about 14 weeks, I was monitored by a perinatologist at St. Joseph’s. I ended up having to see them every week during the third trimester, which included an ultrasound. The best part was that I got to see my baby every week. It was a bonus I looked forward to, especially given the circumstances. That was my bright spot. Even if you have to continue with the perinatologist, there’s your bonus.

    • Sara @MomEndeavors says

      So true! My Dr. even said that! 🙂 She said if the only “issue” is the cord, then they’ll just treat me like normal but I’ll get to have lots of extra peeks at the baby! 🙂

  7. says

    prayers for you that everything turns out just fine…and in the event that you are blessed with a child with needs…just know , coming from a mom with a son with autism, that that baby is given to you for a reason!! No other mama could love that baby like you could! Love and prayers! xoxo

  8. tess says

    hope everything goes ok for you and baby #3…with my 2nd baby i was going to a perintalogist also and they saw 2 cyst on my babys brain- one on each side- but guess what – they popped and went away- so i dont beleive everything the doctors say anymore either…i am preggo with baby #3 – 13 weeks – i hope i dont have any scares with this one.

    good luck

    • Sara @MomEndeavors says

      I’ve read about those cyts! So scary! Glad everything ended up being fin and good luck with baby #3! 🙂

  9. says

    I just stumbled across your blog tonight. After reading this post, I just had to tell you I know how you feel when you got that phone call. I have two daughters and my with my youngest, I got the call saying she had a two-vessel cord. I did what you should def. not do, which is search the internet. I was so upset after reading everything. But I want to encourage you, after many ultrasounds with my daughter, who is now three, she turned out perfectly healthy! Praying for you and baby!

    • Sara @MomEndeavors says

      Thanks, Briana. So glad you stumbled over here! 🙂 Thanks for another positive two-vessel cords story. Ironically, I’ve already seen everything on google, because one of my best friend’s found out about 4 months ago that her baby has a two-vessel cord. She was so freaked out and I did some research then. So, it was CRAZY when they mentioned it at the ultrasound! Everything has been fine for her too–just extra ultrasounds! 🙂
      Glad your little one is fine! Thanks for commenting!

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