intermezzo

Thanks for all your kind and thoughtful comments on the anniversaries of having and losing A & C. I didn’t manage to post on Wednesday, but I did think of all your babies lost far too soon. And of my own, of course. It is strange to have their actual anniversary, and this “public” anniversary, so close together. Last year I was still in a complete haze. I’ve been out at night again (in part simply because it gets dark earlier), looking at their stars, remembering those nights one year ago.

Strawberry Baby is still tucked inside and enjoys kicking my ribs. We had a growth ultrasound last week, which I thought would be reassuring around all these anniversaries, but ended up freaking me out because one of the head measurements was in the 2nd percentile or so. The MFM in charge of the ultrasound clinic that day didn’t think this was anything to worry about (“these numbers and percentiles make it look way more scientific than it really is”), but I guess it’s too easy to concern a mother who has lost a child (or more). So I read some papers and learned that (a) girls tend to have significantly smaller heads, and (b) nobody gets really concerned unless the head is 2 standard deviations smaller than the mean, or even 3, depending on how conservative one is (because, y’know, we can’t all be in the 50th percentile). And we’re not even at 2 stddevs. So I was mostly reassured, but still brought it up with my doctor. Who hadn’t even noticed, but went back to look at the numbers and said that, as long as it’s not 2 stddevs below the mean, he’s not concerned. He also explained that (counter-intuitively for me) with increased gestational age ultrasound becomes less accurate. Mainly because it is difficult to measure larger 3-dimensional objects correctly when you’re looking at a “slice” through them – chances are that your slice isn’t quite in the right place.

What he remains concerned about is my blood pressure – I suppose it doesn’t help that it was 140/90 in the office, even though at home it hovers around 120/80 and it’s usually pretty good at my non-stress-test appointments, too. My liver enzymes and platelets and urine remain fine, fortunately. It’s not so much what he says, but I can see in his face that he worries. For a while I thought, well, he’s an MFM, being worried is his job. But it’s not that. I finally remembered the first, and really only, time I’d seen him worried – at the anatomy ultrasound with the twins, when my cervix was already so very short. The situation is different now in that we actually have options for what to do. I will be full term in 2 days (incredible), so I’ll be followed closely with twice-weekly NSTs in addition to the usual weekly appointments, and he’s thinking about induction at 38w or so, depending on how things develop. (There seems to be a difference in recommendations at that point between gestational hypertension and preeclampsia, but I didn’t quite get it.) Which is rather soon – but of course I’m happy to do anything that helps keep Strawberry Baby safe.

(This was supposed to be a short post. So much for that.)

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5 thoughts on “intermezzo

  1. The nonverbal communication from our caregivers can be so powerful. It sounds like, rightly so, you will be monitored closely until Strawberry baby arrives. And that is important.

    I too had PIH (pregnancy induced hypertension) and not pre-eclampsia, which means that while the pregnancy is hard on your circulatory system, it has not (yet) affected your internal organs. Your internal organs may grow unhappy at any point, or they may not. My understanding is if it turns into pre-eclampsia, your docs will be in a greater hurry to get Strawberry baby out. I hope you get to enjoy this pregnancy a little while longer, though.

    And a cautionary note to you, my friend. IF your blood pressure remains high after delivery, INSIST on an ultrasound to see if there are any retained products in your uterus. A late postpartum hemorrhage is really not something I want you to experience.

  2. Hoping that the anniversary of A&C so close to the “public” anniversary was gentle on your heart. Glad to hear that your MFM remains vigilant in keeping you and Strawberry Baby healthy. Soon, soon, Strawberry Baby will be here soon. Fingers crossed that you don’t have to deal with anything of an emergency nature these last few weeks.

  3. I was thinking of you on the day, though unable to say so. I remember it vividly–how my heart broke for you. Those little girls touched people all over the world with their lives. How I wish they could have been long and full of happiness. I am so looking forward to the arrival of SB. I am hoping your next experience of motherhood is as smooth as possible, so I’m glad you’re getting close care.

  4. Oh my goodness. Strawberry Baby will be here before you know it! Isn’t it so nice to know that should anything more serious arise, that you have options? I know it doesn’t take the worry and stress away, but at least you know she’s considered full term in just a day now? Wow! So close! I think of you often, especially with all this time of year means to you, and I can’t wait to meet SB!

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