Baby Girl scare

I have officially been downgraded from normal pregnancy to high risk pregnancy. It all started when my doctor said I was measuring large for my dates. (At every doctor's appointment from 20 weeks on, you lie on the table, while they take a tape measure from your pubic bone to the top of your uterus. The number of inches should correspond with the number of weeks pregnant you are. There is about a 2 inch leeway plus or minus, but I was measuring 4 weeks bigger.)

There are a lot of things that can cause this, namely the baby being HUGE, or you're farther along than they realized, or you have too much amniotic fluid, so they sent me to get another Ultrasound at 31 weeks. By the way, how much belly fat you have usually doesn't impede this measurement.

Well, on the ultrasound they saw that the baby measures as if she is 31 weeks along, and she was a normal size. I also didn't have too much amniotic fluid, in fact if anything, they said I was on the low side.

Cut to two weeks later when I'm having my doctor's appointment. My doctor tells me they found something on the Ultrasound. The baby has an Umbilical Vein Varix, which is kind of like a varicose vein. He says, "I don't want to worry you, but there's a chance, although a remote chance, of stillbirth (meaning the baby dies in utero)." Right, like I'm not going to worry after he says that!!!

My doctor has been in practice for at least 25 years, but this is only the 2nd time he has seen this. It's pretty rare, but they may be picking it up more as more women are having 3rd trimester ultrasounds, and ultrasound technology is getting better. He didn't seem to know very much about it, but said that they definitely wouldn't let me go past my due date of July 31st. He said I should do weekly Non-Stress Tests, which monitor the baby's heart-rate, movements, and amniotic fluid.

Friday was my first Non-Stress Test, or NST. They also did an ultrasound to check the blood flow of the cord. Both were fine, which was very reassuring. But I knew my baby's status could change from day to day. What if something happened to her before my next NST?

I spent all weekend worrying about it, of course. There wasn't very much information on the Internet, and what little info there was, wasn't very reassuring. I found myself thinking of every pregnant woman I took care of as a nurse at the U, who had a baby die in utero.

Monday morning, I searched for specific articles in medical journals about Umbilical Vein Varix, and was able to arm myself with some more information. Now I knew which questions to ask, and what the recommended protocol for this was. I also read online that I should see a Perinatologist, a specialist in Maternal and Fetal anomalies. I made an appointment to see one, and was pleased that they could get me in that day.

After my NST on Monday (which was also good), I saw the Perinatologist. Since I had done some research on my own, I was able to ask intelligent questions, and understand what she was talking about. She was very reassuring.

An umbilical cord has 2 arteries, and only 1 vein, so if there's any problem with the vein, it can cause the baby to not grow. Umbilical Vein Varixes start to become a real problem when they are 9 mm, or if the blood flow is very turbulent. Sometimes a baby can also develop a clot, which would cut off blood flow, oxygen, and nutrients to the baby's body. We were relieved to hear that Baby Girl's varix is only 1.4 mm. The problem goes away the minute the umbilical cord is clamped off, once the baby is delivered.

It seems that Umbilical Vein Varix is often associated with other problems such as heart, liver, birth defects, chromosomal abnormalities, and anemia. Luckily, she felt that Baby Girl did not have these other issues, or it would have been picked up on my other ultrasounds. (Whew!) It seems to be just an isolated issue. They do not know what causes it, and they did not notice it at my 20 week ultrasound, so it must have been something that developed in utero.

She also recommended even more monitoring of the baby. We would do weekly ultrasounds to view the cord, and do NST's TWICE weekly. I was also to monitor her kick counts. This was a HUGE relief to my mind!

Finally, she said there was some debate as to when to deliver. Some schools of thought say 34 weeks, (which is what I am at right now), and some say you should keep the baby in until 40 weeks (full term). Her school of thought and University Policy was to deliver somewhere in the middle, at 37 weeks.

She said that before 37 weeks, the baby is more likely to have other problems associated with being born premature. Before 37 weeks, it is safer to keep the baby in. After 37 weeks, there are fewer problems, and many babies do great. At this point the risk of taking her out is less than the risk of keeping her in.

She said that she shares a lot of patients with my doctor, and that she would be happy to call him and discuss her recommendations for care.

It is a HUGE relief that they will monitor her even MORE closely, and that they will deliver her as soon as it is safe to do so.