Friday, February 25, 2011

Monitoring= big fat fail

Today was our growth ultrasound and our first monitoring appointment. The good news is that he's measuring good and looking mostly good, in between a week and 2 weeks ahead, estimated weight 3 lb 3 oz (+/- 7 oz) which is very good since we're just 27+4 wks. I had hoped that he would be at 3 lbs and I know that ultrasound weight estimates aren't very accurate the farther along and bigger the babies get, but just "guessing" that he's at 3 lbs makes me pretty happy. I know lungs and other stuff still need time in utero to get a bit better, but I'm feeling pretty good now that if we had to deliver soon, he's in pretty good shape for a 27.5 weeker. (I guess thank you gestational diabetes.)

I can't believe how much his little legs filled out. They even look like little baby thighs even on the ultrasound. He had his feet over his head the whole time and is head down on his side with his feet by his head too. (So we're expecting quite a contortionist.)

The bad news is that they had me start doing monitoring today too, and he totally failed the non-stress test (NST) because of "variables" she called them where it (his heartrate?) dropped sharply and then went back up. That happened about 4 times in the 20ish minutes of monitoring, which she said they really don't like to see this early at all. She (the RN) said that it sometimes happens with full-term women and they usually are just delivering are about to deliver so not a big deal. This early, I don't know. She was a little vague about it and just reiterated that they don't like to see it especially this early. It can indicate compression of the cord, etc. And then they kept saying that they don't usually start monitoring until 32 weeks or so, so I don't know how much that might account for it or not. (Maybe this happens with a lot of 27 weekers but they don't see it because they aren't monitoring many 27 weekers? Or maybe it's just bad?) Again, not having a doctor around kind of backfired, there was a doctor they kept consulting at the real perinatal center (which is a half hour away from us with about a 45 minute waiting time, we go to this place instead because it's 5 minutes away and there's almost never a wait and there's still a doctor keeping an eye on everything at both sites, but if we had been in the first site, he would have came in and talked to us, instead we're kind of playing telephone between the RN and u/s tech and they are super nice and answer what they can but they aren't doctors.) I suppose I could have asked to talk to the doctor about it but he's not my doctor anyway, and whatever.

That earned us a full biophysical profile (BPP) where they watch movements, muscle tone, fluid level, and have to practice breathing, etc. He failed that because he's decided that practicing breathing for 30 seconds is lame. (They give you points for everything, it's either 0 points or 2 points. So we got 0 points for breathing and 0 points for the NST. 8/10 is passing, we were at 6/10.) But they said practicing breathing for 27 weekers is iffy- he did actually practice a few times but not for the required 30 seconds. So we failed monitoring on both counts, but I think everything else on the BPP was okay. For now they are having me go back Monday and I have an OB appointment too. Then monitoring again Friday (at least as far as I know, who knows what will happen depending on how it goes Monday.) I'm not too worried about the breathing but really not sure how worried to be about the decels, they kept saying they don't usually do monitoring this early as if that might explain it but it doesn't seem like it's normal at all to me. His movements were fine, I've felt him moving in the time since we left, his heart rate was okay except for the decels, fluid was good, his growth is don't know what to think of all this. I'm strangely kind of reassured because we're being watched so closely, I'm just not sure if I'm being naive and I should be packing for the hospital, or what to think right now. I think if he keeps failing, I probably am going to at least end up in the hospital with constant monitoring until they can figure out what's going on and we may be meeting him sooner than later. I really don't like this not knowing. First the unexplained dizziness which I know might just be normal, but now this, I can't help but feel like there is something going on that's not quite right that they haven't quite figured out yet and my body and the baby are trying to compensate for whatever *it* is the best they can, but eventually something is going to give. The point of the monitoring was supposed to be to ensure that the baby is okay, but he failed both tests, so now what? I understand why they didn't send me straight to the hospital, it wasn't *that* bad, my blood pressure was good, he looked good otherwise, (he's kicking me as I type this). But, I don't know. I've done some googling and came up with some crappy stuff regarding cord issues (really, there may be a cord issue too on top of everything else?) and stillbirths. Right now I can only assume that if things remain as they were today, we'll either be delivering soon (I'll take the 90% ish odds of a 28 weeker vs. the 0% odds of a baby born still, any day) or at least earn ourselves a hospital stay while they try to figure out whatever is going on and keep a closer eye on him.

In the mean time, I'm semi-reassured that he's been moving a lot this afternoon and my blood pressure and everything else is decent. (It's up slightly this afternoon but I think after this morning, that's pretty much to be expected.) Hopefully he'll be a busy boy all weekend and decide that breathing is cool and the drama is not cool on Monday. (Although I guess I'll always be wondering about this until he is safely out.)


Brooke said...

Oh Em Gee. I just hate all of the unanswered questions and uncertainty. MOST of it sounds like good news, and the only things he failed (the academic freakazoid in me hates the world "failed"--as though Lucas isn't performing up to some kind of Ivy League standard? Well he's just a BAY-BEE!) are things not usually monitored in a 27-weeker? This does seem encouraging, but I understand your anxiety. You are quite right, though, that all you can do is be closely monitored and trust the professionals to make the best decisions for you. At the same time, you are also listening to your gut feeling and voicing your concerns. So you're doing everything right. I hope little Lucas decides to hang out for a few more weeks, but whenever you meet him, all he's really got to do is come out on the right side of the statistics.

Oh--I got the book in the mail today! So quick! Thank you very much--I've seen it recommended elsewhere so I have set it to the side until... well, until I feel ready to read it. :)

*Laura Angel said...

ugh like we dont have enough to worry about. keep up with kick counts and just go in whenever you feel :)

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