Saturday, July 20, 2013

Week Twenty Five: The Latest News from the Perinatologist

I knew that unborn babies kick, roll, punch, and do all sorts of other fun movements. I didn't know unborn babies were so strong!

Kate has been beating up my insides more than usual the past few days. It's adorable, but I have to admit it hurts sometimes!

After we got back from our first year anniversary trip to Wisconsin (which was wonderful, by the way, but I will post about it another time), we got to see our little Jellie Bean on the ultrasound machine at the perinatologist. She passed her scan with flying colors, although momma didn't do quite as well.

I threw up right before going into the appointment, although I don't think it had anything to do with HG. It was very hot in Wisconsin during our trip, and the ride back to Iowa in my Lebaron with no air conditioning didn't make it much better. I'm fairly certain we both had some heat exhaustion and dehydration issues. We were pretty sick our last day in the Dells.

After my tummy settled down, the nurse called us to the back for the ultrasound. Our doctor said he was extremely confident that Kate will not be born with Down Syndrome, although he couldn't know for 100% fact. However he was still very concerned with why my quad screen was so out of whack when I am such a young mother and have no risk factors for Down Syndrome.

His three ideas:

1. Elevated hCG, or the pregnancy hormone. As I've written here before, this hormone, secreted by the placenta when a woman becomes pregnant, is the hormone that makes that second line appear when you take a pregnancy test. If this hormone is abnormally elevated, it can cause a quad screen to come back with unfavorable results. It's already been established by other doctors that I probably have a higher hCG level than normal, which of course, is believed to be a possible cause for hyperemesis gravidarum. You can see how this could go full circle (I could have high hCG because the baby has Down Syndrome, and the high hCG is also causing hyperemesis gravidarum), or how it could just be a fluke that's making me throw up a lot.

2. Preeclampsia, formerly known as toxemia. You can read about it here. This dangerous condition runs in my family, and my perinatologist wants to keep a close eye on me as I have had some high blood pressure issues (and of course the scary Colorado blood clot incident) throughout the pregnancy. He believes I am at high risk of developing it.

3. A placental injury or problem that could lead to growth restriction later on. The perinatologist didn't go into this much, other than to say that Baby Kate needs to have her growth carefully monitored throughout the rest of the pregnancy. She had a few measurements that were a bit behind her gestational age, but still within normal range. He wasn't worried about it yet, but said that we'll be able to tell if it needs further attention based on her measurements at our next appointment on August 14th. I did suffer a blow to my lower abdomen early on in my pregnancy, but I was taken to the ER after it happened and no problems were found. Hopefully this has nothing to do with that scary experience.

I had no idea number 2 and number 3 could have any effect on a quad screen result. It's definitely been interesting, and in a way, comforting, to learn about a few of the (many) different factors that can throw off a quad screen. I certainly don't hope for preeclampsia or a placental problem, but knowing that the terrifying 1 in 12 result I received all those weeks ago could be influenced by more than just an incredibly high risk of Down Syndrome makes me feel a little bit strange as that sounds.

At the end of the appointment, despite the reassuring opinions of the perinatologist, he thought it would be best for us to go ahead and take the MaterniT21 test, and we agreed. A big part of this decision was because once we get the results, if there is another issue uncovered (in particular, a growth restriction problem), and the test comes back with a good reading, we won't automatically jump to Down Syndrome as the most likely cause. Also, if the MaterniT21 test comes back with good news, it will be easier to pinpoint any further issues with my pregnancy since Down Syndrome will be off the table.

The MaterniT21 test is much more accurate than the quad screen, and according to our perinatologist, very close in accuracy to an amniocentesis, without the risk. The perinatologist also suggested that if Justin and I decide to have any more children in the future, that we think long and hard before getting another quad screen.

I think I will be taking that advice to heart.

I had the test done at Saint Luke's in Sioux City, and apparently was the first person ever to have it at that location. The lab couldn't even tell me when the results would be in! From what I've heard around the web, though, you can expect results in about 10 days. This means I should find out around the 27th of July (which is a Saturday, so probably a little before or after).

Please keep us in your prayers as we await our MaterniT21 test results. We will update you regarding them as soon as we can. Also pray that we might avoid having to navigate the risky territory of preeclampsia or placental problems.

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