Sunday, November 1, 2009

1st U/S & Peri Appt - The Details

Some of you asked what made me decide to ask for the MTHFR test. After being in the world of infertility for quite some time, I've pretty much seen a lot of devastation. I've read way too many stories of women having recurrent m/c and then finding out they had MTHFR.  Once they were put on prescription strength folic acid and maybe blood thinners, they went on to have a successful pg. Such an easy fix to avoid the devastation of a m/c.  Now of course I'm fully aware that their m/c could have been completely unrelated to MTHFR and also that someone with MTHFR can have a completely normal pg without treatment.

I'm one who likes to be proactive and leave no stone unturned, which I believe is one of the reasons that I am finally where I am today. I've asked for the MTHFR test a few times in the past, but had always been told, oh you don't need that, we only test for that in someone who has had recurrent m/c.  Well as many of you know, lucky Seven was my last embyro. I couldn't afford to m/c first.  So I insisted on being tested.

I never imagined that it would actually come back positive. My ob/gyn immediately referred me to a perinatologist for a consult as she knows how important this pg is to me. The peri wanted me to have an u/s prior to the consult, I guess to make sure that I was pg before getting into any kind of treatment.

Kerry and I arrived for our surprise 1st u/s at 6w1d. We were both pretty anxious and trying to believe for the best. I peed and then headed into u/s. I first had the transabdominal u/s and immediately I exclaimed, there's a sac!  She then told me to go empty my bladder while she went and got the peri.  I had just gone! If I haven't mentioned it before, I have major frequent urination going on.

The peri and sonographer returned. The peri introduced himself and said "I've seen your ovaries several times". I said "well it's always nice to finally put a face with the ovaries". He's super nice and we both really liked him.

We got started on the intravaginal u/s. She first measured my cervix at 3.1cm, we're hoping this will lengthen some. They reassured me it would as pg progresses. She then removed the wand and said, go pee, your bladder is full again. 3rd pee in 15 mins! We were all cracking up.

Next we got to the exciting part, seeing our little bean. It measured 3mm. I addressed my concern that I thought it should be 4mm by now, they both laughed and said that's only 1mm difference. Thanks to those that pointed out that the gestational age varies during this time and 2 or 3 days off is totally normal. They use the CRL (crown to rump length) to determine GA (gestational age). 3mm put us at 5w6d, so just 2 days off, but totally within range.

Next they had me hold my breath while they looked for a heartbeat.  There it was, a blinking light on this tiny little 3mm baby! We couldn't hear anything, but the sight of it was beautiful. It measured 117 bpm, I love how Seven keeps running into the number 7.

They continued to look around and I about freaked. To the lower left of the sac was a 2nd smaller sac!  I was like, please tell me it didn't split! He said no, that's a hemmorhage.  It's actually a SCH (subchorionic hemmorhage) where the placenta separates a little from the wall of the uterus. He said it's small (5mm) and should not pose a problem and should go away on it's own. This is one of the main reasons for early pg bleeding. I told him other than around beta, I haven't had any bleeding. He said I probably wouldn't then.

If you look at my u/s in the previous post, you can see this white mass to the lower left of the baby. In a different plane of view, this area contains the 2nd sac, the SCH. It's pushing into the fetal sac causing it to look funny shaped.

After the u/s, we had our consult.  I addressed my concern that due to the MTHFR, I was terrified that my baby hadn't been getting any folic acid and how that causes things like neuro tube defects and spina bifida. The peri explained MTHFR to us as an illustration. He said that each gene is like a two lane highway. With being heterozygous, one lane is blocked and the other is open, so a car can just drive around the roadblock and keep on going. The condition would be much more serious if it was homozygous where both lanes were blocked.  He said because I had no family history of blood clotting issues or strokes, he didn't think this would cause me any problems except maybe a slight increased risk of preeclampsia. I asked that since my normal BP is very low at 100/60, would that be in my favor to not get preeclampsia and he said no, my current BP doesn't change my risk either way. He really felt that there was nothing that needed to be done differently as I was already on baby aspirin and extra folic acid.

He said that we would know how much the MTHFR was affecting me when the Homocystine level came in. If it was elevated, we would need to make sure I was put on Folgard and if it wasn't elevated, I could just continue on as if I didn't even have the MTHFR.

Well my Homocystine came back normal!  The normal ref range is 3.7 to 13.9 and mine came back 7.7.  Notice the sevens?  I think that was Seven's way of saying "chill out mom, I'm ok in here".

I asked if there was anything else I needed to be tested for. He said no, that even if something came back positive, he wouldn't change anything I'm doing, so why stress me out.

I then discussed my concerns of being at risk of incompetent cervix due a short cervix due to having a leep in 2004. He really didn't feel like 1 leep would cause me any problems. I asked if we could keep an eye on it anyway and he said absolutely.

I asked when my next u/s would be and he said 18 weeks. I about fell off the table and exclaimed, are you serious???  I let him know that I will go nuts if I have to wait that long.

After I got dressed, the peri suprisingly came back to my room to discuss the hemmorhage.  He said after looking at my chart, he noticed my last few estrogen levels went from 1163 to 3022 to 798.  After seeing that, he wondered if that 2nd sac was in fact a 2nd fetal sac, as in the embryo split but 1 didn't make it. He then said he still really thinks it's just a hemmorhage. I start asking a million questions and then he smiles and winks at me and says "I'm just finding an excuse to get you another u/s in 2 weeks".  How cool is that!

So my 2nd u/s is scheduled for Nov 10th at 7w6d. Afterwards I have my first prenatal appt.

I've been on bedrest for the last 2 days due to spotting.  It's either from the u/s or the hemmorhage.  As long as I stay off my feet, it goes away. If I'm up and about too much, it picks up.  Today it seems to have stopped, so bedrest works!

19 comments:

  1. Jill,

    I had a SCH too in one of my pregnancies and it's very very common...your body will usually just reabsorb the the blood. I'm sure the Peri probably told you that:-) Sounds like things are going perfect. Try to just relax and enjoy this as much as possible.....can't wait until that belly of yours pops out!!

    Love you!

    ReplyDelete
  2. I love how the number 7 keeps popping up, too... I think God does have a sense of humor. :0)
    Reassuring to read the good report, and so glad that you like your perinatologist! What a good doc to be so concerned about your feelings and get you in to see Seven again in a few weeks.
    Keep off those feet and enjoy the wonderful news that Seven is doing so well!!
    Love to read the good reports.
    Love and hugs,
    The Other Jill

    ReplyDelete
  3. (((JILL))) I can't even tell you how EXCITED I am for you and Kerry!!! It is absolutely magical reading your updates. I just love all the 7's and I cling to every workd you have written.

    As always, you, Kerry and lucky little #7 are in my prayers!!!

    (((HUGS)))

    Holly

    ReplyDelete
  4. this is so awesome. yes, stay off your feet with the spotting, and even though you go to the bathroom so much as it is, make sure you hydrate hydrate hydrate. this seems to help too. I'm glad you get another u/s in 2 weeks, its nice to check in and see how they are growing. Glad to see you homocystine levels came back normal and I love the number. how many different times has 7 shown in a report, result, or calculation? I always had to go empty my bladder for u/s more than once too because of how my uterus was positioned/tilted and pushing on my bladder.

    Can't wait to see next u/s photo.
    love you, get plenty of rest, and fluids.

    Lyndsay

    ReplyDelete
  5. Jill, I've been a little behind on your posts, so I just read them all right now.

    I'm so happy you found a heartbeat! That has got to be one of the most exciting things ever!

    It sounds like your peri has things under control, and I'm glad you get to go in sooner for another u/s. I was lucky that I had them every 2-4 weeks throughout the pregnancy.

    I hope you are feeling great! Don't worry about the spotting, it happens after a transvag u/s a lot!

    This is for Lucky #7---Don't make your mom and dad worry so much! Hang on tight, and be a good little fetus!

    ReplyDelete
  6. He sounds great! Though I'd think you'd get another ultrasound at 12 weeks for first trimester screening - or do they not do that given that you know you little one is chromosomally normal?

    ReplyDelete
  7. If you're on bedrest guess that means I have to ride around is this stupid kiddie coaster alone?

    Hurry back, I'm bored

    Love ya

    Sis

    ReplyDelete
  8. Go little seven go! I love all those sevens. Are you due in July?? Maybe 7/7? I'm glad everything is going so well and that you're getting extra monitoring.

    ReplyDelete
  9. Glad that things are going well for you... I wish you did get more sleep though!!! I know how exhausted you must be!!!

    I think it's amazing that you got the test... and that you was already taking frolic acid!!!

    I can't wait til June!!!!

    I love you as big as the sky!!! Mama

    ReplyDelete
  10. A very belated congratulations - I'm so happy for you and your DH!(Sorry I didn't check in sooner; I've been offline for a while.)

    Anyway, I hope the rest of your pg goes smoothly and flies by quickly. It's great that you have an ob and peri who are taking the MTHFR seriously. If it's any comfort, I've also been told being heterozygous MTHFR is less serious than being homozygous. (I have a heterozygous mutation as well.)

    Congrats again!

    ReplyDelete
  11. Love your Peri for getting you an extra u/s - sneaky little devil :)
    I'm so happy everything looks good and I'm so excited to read about your progress!

    ReplyDelete
  12. Hey Jill I'm not sure if you are aware of this, but according to the Bible, #7 is the number of completion. I think it is appropriate in your case since this pg is the completion of what you have been working for so long. Its like its God's way of telling you that He is taking care of this little one and showing His faithfulness to you. Look it up in the search engine and you'll see what I mean.

    ReplyDelete
  13. I love your peri! Another u/s in 2 weeks, how great! You get used to having these regularly, I know.

    And I'm not sure I knew you had cervix concerns after a LEEP. I had one too, and have your same concerns. I'm nice to hear the doc is not concerned.

    Great news all around, I'm so happy for you!

    ReplyDelete
  14. The whole 7 think is getting a little spooky. I think I hear the theme to the Twilight Zone, but in a good way!

    You would usually get another u/s if you were at CCRM in 2 weeks anyway, so I'm not sure why your peri would need an excuse. If your 5-day embryo really split, you'd be having identical twins, so don't worry about that crazy theory! For an embryo to split and have two separate sacs, it has to happen earlier than a day 5 embryo.

    Sounds like everything is going great. I'm really happy for you!

    ReplyDelete
  15. Go 7 Go! Stay strong and well for your mommy!

    ReplyDelete
  16. She will probably be born on June 7th, 17th or 27th!! This is just so amazing! I hold my breath and pray she continues to thrive!! Dad is reading EVERY blog update!!

    Love you so so much and little seven and little seven's pa too.

    Gma2 & Gpa1

    ReplyDelete
  17. Sounds like you have a great peri who is on your side with this whole thing. I'm glad you saw a HB and that little 7 seems to be doing really well! As you know, I had a SCH and it spotted/bled off and on throughout my 1st trimester. I think it's still there but it has stopped bleeding as I haven't seen anything for a while (phew!). So, you're completely normal and I think you're doing the right thing - bed rest when it does spot. Sometimes after I got up after a night of sleep or some bedrest, I would actually get some spotting as soon as I stood up. The nurse explained that there is only one way out for the blood and sometimes it collects and pools before "exiting" so don't be freaked out if you see that too. Good for you for asking for the MTHFR test - just goes to show you that you have to be your own advocate, something you're doing a very good job of!

    ReplyDelete
  18. Your peri sounds like a fantastic doc. :) Can't wait for the update in 2 weeks!!!

    ReplyDelete
  19. yay for normal levels! So glad you get to go back for an ultrasound so soon :-) Looking forward to the next update.

    ReplyDelete

Thank you for your comment! Hugs, Kerry and Jill