Sunday, January 22, 2012

1st Trimester Screening

This past Thursday I was 12.1 weeks and I had my first trimester screening.  I had previously done the MSAFP (maternal serum alpha fetoprotein) blood work the week before so that if that and my US came back abnormal, I could have a CVS (chorionic villus sampling) done.

I had the US first (before knowing the AFP results) and all looked great.  There was a nasal bridge, a normal third ventricle in the brain, fluid between chin and chest and the nuchal translucency measured 1.8 mm (should be less than 3 mm).  All seemed normal and healthy with the scan.  I even got to see the sex of the baby (woo hoo!) although that is something I am not sharing until I can first tell my husband.

I then received my instant risk ratio.  Before the AFP and scan, I had a risk of 1 in 102 of Down Syndrome due to my age of 39.  After the AFP and scan, my risk lowered to 1 in 704 with an age of 29.  The Maternal Fetal Medicine (MFM) physician said I could not receive any better results.  He was quite pleased with everything and believes I have a very low risk.  Additionally, my risk for trisomy 18/13 was 1 in 187 before assessment and reduced to 1 in 3721 with an age of 20 years.

I feel very happy with the results and at peace after viewing the scan and seeing my AFP results.  I will have another MSAFP done at 16 weeks as a follow up to make sure everything is still okay and to detect for open neural tube defects.  I feel pretty confident though that all is going to go well with this pregnancy.  This egg survived over all the others, this embryo implanted and kept growing over the other 2 and this baby is still going strong no matter how many sleep deprived nights I have with my midwifery clinicals.  I am hoping every thing continues to go right with this pregnancy and we welcome a healthy baby come August.

A profile view from the scan

Sunday, January 8, 2012

10 Weeks Baby!

I have not posted in some time because I have been feeling poorly AGAIN!  Third time's the charm, right?  I am hoping I am on the mend for good now and that this sad trilogy is coming to a definite end.  I am ready to feel like my normal self again.

Two things happened this past week, both on the same day.

On 4 January, I was 10 weeks exactly.  I celebrated the day with my last dose of progesterone!  Thank goodness that is O-V-E-R!

For 7 of the 10 weeks, I self-administered progesterone injections intramuscularly into my gluteus.  Someone on Twitter had told me that it would not hurt at all.  Pish posh. This was not true.  It DID hurt.  I had such an ordeal with self-injection.  Several times I hit a nerve and one of those times it numbed my whole lateral side of my right thigh for weeks.  My bum was often sore, I had lots of knots under my skin that I rubbed fervently to break up, and several times I hit a blood vessel which spurted blood all over the place once I removed the needle.  NEVER have I had any of these things happen when I have given someone else an injection, but it is a whole other story when you have to try and give it to yourself.

the dreaded progesterone injection

22G needle, 1 1/2 inches long

At 7 weeks, I switched to Crinone 8% progesterone gel.  I thought it would be like using Monistat - insert it in the evening and have cream dripping out of you all day, but luckily this was not the case.  I did insert the gel in the evening, but had no irritating side effects during the day.  No drippage or leaking.  No itching, redness or irritation.  Overall, it was much nicer than giving myself daily injections.  However, on the last day of using Crinone, I felt some vaginal pressure.  I rushed to the toilet thinking it was going to be a blood clot or fetal tissue, but it was just 2 huge golf ball size formations of the Crinone gel.  Sorry, I know, not a pretty picture, but I want to share the full story since no one tells you these things!  Even I was a bit grossed out, but on the other hand, so glad it all came out!  I am not sure if that is typical or why it gathered into golf ball size rounds, but I am assuming that it was the residual part of the gel.  Here, I was thinking all of it was absorbing into my tissues, but no, the majority of the gel was just collecting into balls!

Having the 10 weeks of exogenous progesterone administration be over with was enough reason to elicit a party, but also on the same day, I had my first new OB appointment.  Yay!  I feel like my pregnancy is all grown up now.

I am seeing my midwife for my OB provider and it was nice to see her again after having a long holiday break.  We caught up on all midwifery things and then got down to business.  She asked lots of questions regarding my medical past and we discussed which labs I wanted.  I declined the early glucose testing as I hardly eat any sugar or processed foods, and do not want to take a sugar laden drink that is made of artificial flavors and colors.  I think that drink alone would put me over!  I did agree to an A1C hemoglobin and a fasting glucose.  We are also going to test my vitamin levels (D, B-12, Folic Acid, Ca, etc.) due to being a vegetarian.  I also asked to have my first trimester screening set up.  I want to know sooner rather than later if there are any problems such as Down's (my biggest worry).  We then looked from above at the baby and she was just bouncing up and down and waving her arms.  It was so adorable.  The bedside US at our clinic is not as good (not as high of a resolution) as the RE's office, so I did not get as good of a picture, but you can see the fetus lying head down with her back to the left.  We also observed the heart flicker and heard the heartbeat by doppler from above at 165 bpm.

All seems to be going well.  I gave about 10 tubes of blood that afternoon and should have my 1st trimester screening (blood/US) next week.  Looking forward to all good news so I can relax and plan for a healthy baby.

Sunday, January 1, 2012

Fetal Doppler

When I first found out I was pregnant, I scoured the interwebs looking for a fetal doppler.  Why? you might ask.  Well, because I just could not believe I was pregnant and I wanted to have intermittent proof that there was actually a baby in there and that the heartbeat was still going strong.

I found heaps of fetal dopplers that were astronomically expensive - between $200-400.  Yowzers!  That price was definitely out of my budget.  However, I lucked out and stumbled upon the Sonoline B Fetal Doppler at Pulse Oximeter Online.  The website states that it is normally $349.99 but it is on sale for $52.95 and they even include free shipping!

Photo Courtesy of Sonoline B
I was impressed with the price, website description (includes gel, 2 AA batteries and a 1 year warranty) and that a 3 mhz probe was available (3 mhz is preferable over 2 mhz to pick up the early fetal heartbeat and it is what we use in our clinic), but I was not sure how reliable the product was.  I checked YouTube to see if there were any reviews, and lo' and behold there was one:

Author allharr said in her video that hers worked at 9.5 weeks and gave a good review of the product.

I ordered the doppler and received it promptly as shown and described on the website at 7 weeks, however, I was not able to hear a fetal heartbeat.  Only mine.  I tried at 8 and 9 weeks as well and still nothing.  But early this New Year's morning after the clock struck midnight, I decided to try it out again for a New Year's treat.  Miraculously at 9.4 weeks, I was able to hear the heartbeat!  I am over the moon about it, and of course, I emailed my husband straight away!  I am also relieved to hear my baby's heartbeat after all this sickness I have had.  I am glad the prolonged infections have not done anything untoward to the pregnancy.

I cannot say enough good things about this device.  Why rent a doppler for $20 or more a month, when you can own one for $52?!  It is definitely worth the money if you are a curious, still-in-shock, and/or worried expecting mom-to-be like me.

Have you purchased a fetal doppler?  How often do you use it?  If you purchase this one, please let me know if you like it!