Also 33 Weeks

This week's ultrasound and prenatal care visit brought some news. The baby was moving a lot as usual, and she was practicing breathing the sonographer told me. Her chest was heaving so I was initially worried but the sonographer said that it was a great sign. The doc came in and confirmed that the baby was doing all the right exercises to be ready for life outside the womb.

The baby's heartrate was fine. She is swallowing a little bit less fluid, her stomach looked very small to the doctor, so they suspect that she may be starting to have some swallowing issues now that she's bigger. They measured the fluid in my uterus and it shows very mild polyhydramnios (their cut off for polyhydramnios is a fluid measure of 22, my measure is 23, so very mild). Polyhydramnios was something they mentioned to us a long time ago as a possibility. There is only a slight increase from last week so they are comfortable continuing to monitor it. If they see a drastic increase or if I start to have additional symptoms of severe swelling, then they will do an amnioreduction which is putting a needle in and draining some of the amniotic fluid. The goal of this would be to prevent preterm labor.

At this point, however, the doctor suspects that the baby will be coming early, and it appears that it is more likely that we will be doing the EXIT procedure where they will open me up via c-section incision and then partially deliver the baby, insert an IV and breathing tube in her, and then fully deliver her. They won't do surgery on her at that time but will instead check out how all of her bodily functions are working before making decisions about her surgery.

The doctor said that the goal right now is to keep the pregnancy intact until at least 36 weeks, 37 weeks would be even better. She said that the baby may be coming early because her organs are being more squished and it may be impacting more systems, like her swallowing, for example. We could see her licking the fluid, trying to drink it up, but things may be a bit constricted on the inside, preventing her from fully swallowing like she was able to before. The doctors want her to remain in utero for as long as possible, but want to schedule a procedure before she experiences any harm. For the time being, though, the doctor said she was a "happy baby" because she's exercising and moving normally. Also, her heartrate and blood flow are normal, indicating that her brain function is fine.

The doctor said that we will develop a birth plan by 35 weeks, which is in two weeks from now. We could be meeting the baby in as little as 3-4 weeks if needed. (Whoa!!!) If they have to, they will do an amnioreduction between now and then.

I asked the doctor about the cyst draining procedure. She told me that she was one of the doctors on the "no" side. She said that while they have lots of experience draining cysts (she said they do it at least once a day), there are many blood vessels and nerves in the baby's neck and she doesn't want to do it unless it's absolutely necessary. She also said that while this cyst is most likely an esophageal duplication cyst, there's a chance that it is something else with an interior composition that would be difficult to drain. One example is a kind of "tumor" created by the lymph nodes where they create too many cells. In this case, the substance inside the cyst would be sticky and thick and difficult to drain so it would make the draining procedure worthless. She feels it is an unnecessary risk at this point. She said that it is VERY likely that it is an esophageal duplication cyst with a liquidy substance, but they won't know for sure until the baby is born and they investigate. Either way, they can do surgery to remove it after she is born.

I talked to the midwife about the fact that last Wednesday I had pretty regular contractions every five or six minutes for about 2 hours and immense swelling in one of my feet. They said it's a bit early for that kind of "practicing" that the body does, and it may be linked to the fact that my fluid levels are a little bit higher than normal. From here on in, they've asked me to come in even if I think it's a false alarm because having extra fluid is linked to preterm labor and they'd rather play it safe. I've got a list of symptoms to be on alert for, and I'll head on in to CHOP if any of them pop up. My driving radius is an hour--the doctor nixed a work event I planned to attend next week in Dover, Delaware, which is about 1.5 hours away. The doctor said I should be keeping commitments to a minimum for the next four weeks (I guess she feels the baby will be here by then) and doing a lot of lying down on my left side to promote circulation and reduce swelling. I'm making arrangements at work to get things wrapped up sooner just in case.

Lucky for us, the baby is on the bigger side, she's over 5 pounds by now, which is large for her age so if she has to come early, she's already in good shape.

My next appointment is next Tuesday--I'll be doing weekly ultrasounds and prenatal care visits so they can watch both baby and me even more regularly from here on in.

The sonographer humored me and turned on the 3D ultrasound today so I watched the baby in 3D for a few minutes. She is really, really beautiful. She made lots of cute faces, she looks just like a normal baby now with chubby cheeks. She has very full lips and a perfectly round nose. She didn't open her eyes for me but she did a lot of licking of the fluid, and she even licked the back of one of her hands like she was a kitten. It was excruciatingly adorable! She is a very active baby, and she clearly loves touching her face with her hands. I do have new pictures! They are adorable but they don't do her justice. She is just beautiful.

And, well, with the federal budgetmaking in crisis mode, it's a help to have all of this going on at CHOP. The doctor said I've learned enough about fetal anatomy and pregnancy now to get myself a job there. So, if the new Tea Party congresspeople start cutting federal jobs, I know who I'll call.