Friday, February 24, 2012

30w5d ultrasound and other notes

(x-post from my other blog, so if you read there, nothing new here)
I’m not used to being quite so nervous before what should be a routine ultrasound. As you know, I was a bit worried that they would tell us there was something else wrong with our little Truffle.
DH and I were both a bit concerned as the tech was doing the u/s; the cerebral ventricle she was measuring was at about 1.5cm (because Truffle is nicely head down, they couldn’t get a good shot of the other one), whereas they had told us before it was 1.2-1.3, so we were thinking that had maybe gotten worse. And there seemed to be a bit more fluid in the kidneys. But when the doc came in, she told us that the ventricle was measured at 1.5cm on the MRI, and the change in the kidneys was within measurement error, so all in all things seem to be stable.
Although going from 1.3 to 1.5 puts the ventriculomegaly into the ‘severe’ category rather than ‘moderate’. Choosing to ignore that particular fact at the moment.
And the best news – no additional findings. PHEW.
Truffle was measured (based on head diameter, 30w4d, belly size, 31w, and femur length 30w6d) at 3lb10oz. That’s a gain of a pound over the last three weeks, which is nice. Amniotic fluid was also at a good level, continuing to indicate that the kidneys are functioning reasonably well, and if there is an obstruction, it’s partial rather than complete (=bad).
His head was down, back along the left side of my uterus, with feet and hands over to the right. I find this interesting, because when I get a strong BH contraction, my uterus totally bunches up on the right hand side. I would have thought that was where most of the baby was! (Although I almost exclusively feel kicks from the middle to right of my belly).
Lots of other questions for my doc this time, mostly relating to what we can plan for and expect surrounding his birth.
The neurologist had said we should do another MRI post-birth. I was thinking this probably wasn’t necessary – we will deal with whatever may happen, and finding out there’s something else to worry about? well, I’d rather not. Dr. B said that she would defer to him, but her guess was that it would be to get a more accurate measurement of the ventricles to determine whether a shunt would need to be placed or not. I did not want to do it (because it requires sedation of my brand new munchkin) if it would not change anything, but if it could lead to a potentially helpful intervention I think it is a good idea.
As far as Truffle’s birth, there is no reason based on the kidney or brain findings at this point that we couldn’t have another vaginal, natural birth. I did promise we’d get to the hospital a little sooner this time (with T we arrived 30 min before he was born, and by the time I was on the triage table I needed to push, so especially as there was meconium that had come out when my water broke, things were a little hectic).
We should expect that the pediatric team would be on hand to do an immediate post-birth evaluation, but at this point there is no expectation that he would need to go into the NICU. She said perhaps one of the NICU step-down nurseries where the nurse to baby ratio is higher so they could keep a close eye on him – but hopefully he will be able to room with us right away.
He will have another ultrasound both of head and kidneys, and may need to take antibiotics prophylatically if the kidneys are still fluid filled, as that often leads to UTIs. I have found D-mannose quite helpful in fighting UTI’s, I wonder if there might be a way to use that instead. Will look into that.
He will also most likely have a test called a VCUG, something to do with the kidneys that I have not looked up yet.
So he will most likely be away from us more than we would like in the first few days, hopefully we can at least go with him to the tests/procedures so he’s not all on his own.
At least one procedure he will not be having is circumcision – we have been very happy with our decision not to have that done for A&T.


Spindoctor said...

Sorry you didn't get more reassuring news, you are coping so well with this. My heart goes out to you guys!

Stephanie said...

Been thinking about you lots. I want to just give you a big hug. It sounds like you have a great team with you and that you are doing the absolute best for Truffle at the moment and that is all you can do. Take each moment as it comes and know you cannot fix or change some things and while that is awful and totally sucks and you have every right to be mad or sad, you will still be amazing parents to Truffle I can read the love in your words. Truffle is lucky to have you as a mom!

Rebecca said...

I'm glad there weren't any additional findings and that the kidneys seem to be functioning. It sounds like everything is going as well as could be, given the extenuating circumstances.

Lisa said...

Nice to hear there was no additional findings.