Baby No. 3: 8 Months Along



Wow, I knew 32 weeks was a great milestone, but it's been a crazy few days getting from 31.5 weeks to here. Just over a week ago on April 29, I felt more contractions than normal and had a little bleeding so called my doctor's after hours line. They sent me into Labor and Delivery for observation. I was there for maybe 4 hours and got several doses of anti-contraction medicine. I got checked and the doctor was confident the cervix was still long and closed and that the bleeding had stopped. She ordered an ultrasound for the next day as a follow-up. I went to the ultrasound not expecting anything but was put on the phone with the doctor and told that there was fluid in the baby's chest cavity. I had her review the basics with me, of course it all being a blur, and then headed home with the report and the doctor's phone number so Dave could speak to her directly while I was sent to the other hospital for a non-stress test. They had said if the baby 'passed' the test, they were confident I would make it through the weekend without major issue. We would have another ultrasound on Monday to see if the fluid had increased. Dave canceled his work trip to NYC and we went to the ultrasound and were told that the fluid had increased, but not significantly. They then had us go down to an EKG of the baby's heart to see if they could identify any issues that could be causing this fluid. The results were normal. It was an emotional day but overall the next steps were just a non-stress test a few days later and then an ultrasound the following Monday (which would've been tomorrow).

On Thursday, my non-stress test revealed that I had more amniotic fluid than I'd had before (not necessarily a bad thing) but while I was doing the testing, the perinatologist called down and said she's rather see us immediately for a follow-up ultrasound and not wait until Monday. Dave came right over and we had the ultrasound which showed that there was now some fluid in the abdomen as well, which means the condition is now hydrops. The doctor said she wanted to admit me immediately to get steroid shots and since we had been trying to get over to UCSF all week to meet with some of their specialists on possible fetal surgery, they started working on that. I was admitted about 2pm on Thursday, given the first shot to mature the baby's lungs and 12 hours later, a second dose. I was supposed to be released about 6:30am so we could start appointments at UCSF at 8am. Well, I woke up at 5am with some bleeding and increased contractions so there was no way they were releasing me. I got checked by the doctor and she confirmed the cervix was still closed but felt pressure of the baby's head on the cerclage stitch which was likely causing the bleeding. They started me on magnesium by IV to stop the contractions. They weren't sure if the bleeding was causing the contractions or vice versa but usually if you can stop one, you can stop the other. The bleeding stopped quickly and the mag helped the contractions. Unfortunately I was on it for about 30 hours and they seriously limit your fluid intake since mag can lead your body to hold on to fluids, even accumulating in the lungs. So I had a tiny cup of water I could sip on over like an 8-hour period. It was killer and I was so ready to get off of that.

Overall, despite the change of plans on Friday, I felt a sense of relief. I was terribly anxious about going to UCSF as it likely meant we'd have to make a decision to do a fetal surgery and then remain at UCSF for care. There's no right answer. Draining the fluid through the fetal surgery could prolong my pregnancy since if the fluid increases too much, they'd have to deliver. On the otherhand, doing the procedure could send me into labor. At this point we know the baby will have issues upon delivery so it's key that he or she is as strong as possible at that point, meaning every week counts. It was a relief to have the decision made for me that we were to remain at CPMC, at least for now. Since then, I was taken off the mag about 2pm yesterday and put on an oral anti-contraction medication. It seems to be working, though they had to increase the frequency after I had several hours of more frequent contractions this morning. I'm hoping everything settles down. Tomorrow we have another ultrasound with the same doctor who viewed it on Thursday and will have a repeat EKG to double check the heart as well. I'm definitely nervous to see if anything has changed and if the fluid has increased. At this point, the best case scenario is that the fluid does not increase (or if it does, it doesn't get to a severe level) AND that I don't go into labor and can make it 2 more weeks to 34 weeks, which apparently makes a big difference in the baby's development of the lungs. Of course, anything can change at any point and it's really going to be a day by day thing.

Unfortunately the doctors still don't know what's causing the fluid, and though we're trying to rule things out, they may not be able to figure it out. There are a list of things that can be a problem, and while many have good success rates, there are some on the list that don't have a good outcome. The doctors seem to be optimistic and we're definitely in the best place and have the best care, that if there's a possibility for them to do something, they could do it here.

How far along? 32 weeks
Total weight gain: Not sure, but I think about 30lbs
Maternity clothes?: Yes
Stretch marks: Still nothing.
Feeling: I was pretty upset on Thursday and Friday morning was have been feeling much better over the past few days. Yes, it's certainly a possibility that this may not end up well, but based on multiple conversations with various doctors, I do have restored hope. It really depends on what's causing the fluid accumulation so unfortunately until we know, no one can be too confident about the outcome. I do feel so grateful for the visits and check-ins and all the help and offers Dave is receiving. It's obviously a stressful time, but he's managing really well considering.
Sleep: This has been tough in the hospital. I don't think I've slept more than 3 or 4 hours at night yet. It's tough as when they wake me up to do vitals or meds, it's hard for me to get back to sleep. They gave me a small does of ambien one night but it was already 3am when I took it and still only made it until about 7. Then I was groggy for probably another 4 hours which doesn't feel great either.
Movement: Plenty of movement and several episodes of hiccups.
Best Moment of the Week: It's been such a stressful week obviously, but I actually got a lot of relief speaking to the neonatalogist. Overall he's very optimistic and I think I was expecting a harsh reality check so that was somewhat reassuring.
Food cravings: Nothing in particular. Trying to eat as much healthy food as possible to bulk up the baby in whatever time I have left but getting bad acid reflux.
Labor signs: Oh ya
Rings on or off: They still fit but I sent my jewelry home with Dave
Belly button: Half-out most of the time, especially after a big meal :)
Gender: Still don't know and it's getting harder and harder with so many different doctors involved. There have been a few times I feel like one has maybe slipped but it's hard to tell if that's what they default to or if they're actually referring to our baby. If I had to guess, I'd say it's a boy.
Looking forward to: Getting through one day at a time, hopefully for two more weeks.

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