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    « March 2006 | Main | May 2006 »

    18 wk u/s results: everything's probably ok

    So, a few weeks back, my OB and I were planning for the 18-22 week ultrasound. I asked if we could do it as early as possible, so she scheduled it for April 18th - 18w2d (first available appointment). In our discussions leading up to that day, she told me that they would recommend a follow-up amniocentesis, if they found two markers or "variants." You know, things outside the norm.

    Guess how many they found?

    One. "Just" one. OK, so let me backtrack and tell you how it went.

    The first run-through was with an ultrasound tech, and everything seemed to be going great - Oh, look at the four chambers of the heart...femur length looks good...humerus looks good...Oh, look it's waving! That sort of thing. But at the end, she sort of left the room abruptly, saying that everything looked good, but she had to do the numbers to see if things jived.

    So, M. and I waited several minutes, sensing that something seemed a little off. After a while, a doctor came in and asked me to expose my belly again, so she could do another run-through. Then she asked us, if we'd ever heard of a choroid plexus cyst.

    Well, neither of us knew much, so she explained: They had detected a choroid plexus cyst (CPC) in the fetus. The choroid plexus is the part of the brain that makes cerebrospinal fluid. The presence of a cyst in itself is not a problem. These cysts almost always go away by the third trimester, and they don't cause any harm. The concern is that a high percentage of fetuses with Trisomy 18 will show a CPC. About 2 percent of "normal" fetuses will have them as well. So, if a CPC shows up on ultrasound, then they'll look for a second marker, such as a heart defect or clenched fists or rocker feet - something that suggests that the baby may be at risk.

    The doctor said that they did not see a second marker on the first run-through, but that she wanted to check again to be sure. So M. and I held hands tightly and watched as she went through all the parts. While she was working, I thought of how sick I am of the terrifying ultrasounds - starting from the one that revealed a subchorionic hematoma with my first pregnancy - just so damn tired of them. But as the doctor conducted her examination, she kept assuring us that things looked good. She wasn't finding anything else to indicate a problem.

    At the conclusion of the visit, she recommended against doing a follow-up amnio. Taking into consideration the results of my early risk assessment (remember that? risk of Trisomy 18 was reported as 1/4301), plus the lack of a second ultrasound marker, she felt that the odds our baby being affected were very low. The odds of having complications from an amnio would be much higher.

    Neither of us went back to work after the appointment. We were fine - not freaked out, not obsessing - but we were exhausted, you know, just wiped out mentally. And of course, we wanted to do a consult with Dr. Google. Fortunately everything we found was pretty reassuring. Like this: http://www.ucsfhealth.org/childrens/medical_services/preg/prenatal/moreinfo/faq.html

    So, M. and I have decided to go with the doctor's advice. We're reasonably confident that things are going to be ok. Anyway, we're willing to take the risk at this point, rather than risk losing this kid to another amnio problem.

    Oh, and it's a boy. We didn't care either way, but it is exciting to know. Oh, and Nico, the Chinese gender prediction chart was wrong for me (unless we get a surprise in 5 months).

    redesign in progress

    Not done yet. It was time for a new image, though, eh? More about that later.

    better - but not out of the woods

    Again, thanks so much for your support and concern during my father's health crisis. I can't tell you how much it means to me.

    So he's home and has has shown improvement, but he still has serious problems. We don't have answers to the big questions yet - you know - like what his prognosis might be. Every time I get a new bit of information, I can't help but Google it. Like last night I learned that his eject.ion fract.ion (output of blood from the left ventricle) went from 10% last week (very very very bad) to 25% this week. Encouraging for sure, but I learned today that anything below 35% puts you at risk for sudd.en cardi.ac dea.th (normal is 55-75%). He's also got leaky valves, which aren't helping. But his BP has improved a bit, as well as his heart rate. So, we'll just keep hoping that the numbers continue to get better.

    Medical care, lifestyle changes (in his case that means some serious chilling out, because he is a big-time hot head), and a large dose of luck are the things that are going to give him a fighting chance. I hope that going forward, he has all of those things working in his favor.

    On a positive note - tomorrow I will be 16 weeks and 4 days, the most pregnant I've ever been. A pretty nice milestone, for sure.