Wednesday, August 22, 2012

OB Concern = A Trip to the MFM

We went in for a routine growth scan and OB appointment yesterday at 33w4d. I have noticed the scans are taking longer and longer because the babies are growing and it's difficult to differentiate between the two. I enjoy the extra viewing time of course, but my back and swollen limbs do not.

Post scan, the OB had two concerns. First, the systolic/diastolic (S/D) ratio was slightly elevated on baby boy. I had no idea what the S/D ratio was at the time, but it's a measurement of the umbilical cord artery that compares the systolic and diastolic flow and it identifies the amount of resistance in the placental vasculature. Aside from the elevated S/D ratio, baby boy's growth had slowed down as well. He was weighing in at 4 lb 8 oz (30th percentile) and baby girl was weighing in at 5 lb 3 oz (50th percentile). Prior to this, the babies have been nearly identical in their growth habits. The two of these factors combined can indicate an issue with an umbilical artery that could potentially be slowing down baby boy's growth. *Gulp*

Although the OB did not find anything alarming with the results, she still wanted me to head over to the Maternal Fetal Medicine in the a.m. to get a second opinion. We arrived there this morning at 7:30 after a restless night of sleep, as you can imagine. Although we weren't in immediate danger, I was still concerned about what the appointment could reveal and where we could possibly be heading...I am not ready to have these babies yet!!

We got in quickly at the MFM office and proceeded to have another ultrasound done. It was very detailed and took an extended amount of time. The MD, Dr. H, whom I can only assume is in charge of the practice was not immediately available to review the ultrasound info so another MD, Dr. W, stepped in to speak with us. She also performed her own ultrasound viewing the S/D ratio herself. Both times it turned out completely normal. While she was talking to us, Dr. H stepped in and gave his approval of the scans as well. He didn't see any issues.

Based on today's measurements, baby boy was weighing in at 4 lb 3 oz and baby girl was weighing in at 4 lb 8 oz. Although neither one were in the 50th percentile anymore with these measurements, their weights were more in sync with one another so this was less concerning. Obviously the scans were done with different machines and by different people so there is some variability that can result from scan to scan. Also, we were told with multiples, at the later stages of pregnancy, it can be difficult to get accurate results based on positioning of the babies.

I really liked Dr. W! She talked a long time with us and told us a lot about research she did in San Diego in regards to multiples. She was extremely knowledgeable and helped ease both our concerns. Overall, she felt things looked great and she said I was doing a wonderful job. I don't know why, but hearing her say I was doing well made me extremely happy; this hasn't been easy and her acknowledging my effort in this pregnancy put a smile on my face.

I'm thankful our OB sent us over to the MFM office just to make sure everything was indeed fine. Although we were both nervous about the possible outcome, I feel completely satisfied with the information we gained. Everything looks fine. Let's hope that continues!!

I'll update more on other baby news later. I went grocery shopping after the MFM appointment and I am swollen and exhausted!!

One interesting piece of info the MD left us with, she said in her years of research/practicing she has learned to 'never trust a multiple.' A woman can come in for a scan and everything appears textbook perfect, but she can go into labor the next day. Multiples are tricky and don't tend to play by the rules. I found that bit of info to be amusing. I hope our babes cooperate for a few more weeks!


Jill said...

You are doing a great job - congrats on 33 weeks!

Jules said...

I'm amazed at how different the weight readings were! I wonder if they'll have you do all future ultrasounds at MFM (all of mine have been there since the NT scan). I love that she gave you the kudos you deserve! I'm sure that felt great! And finally, I'm so glad to hear everything is OK. Oh, and I also went grocery shopping after my ultrasound yesterday. Never again! I was so tired halfway through! I think i might have to order groceries through delivery only now (do you have Peapod?)

robin said...

"Never trust a multiple" haha oh noooo. I don't want that! I want to be predictable and easy!

I'm amazed at 33 weeks you are still out and about, going shopping and whatnot. I can barely stand up long enough to make dinner before having to lie down and recover!

Mrs. T said...

Glad everything is ok.. Hoping for a smooth next few weeks!!

Charlotte said...

Sounds scary - glad everything is going well!

Amber said...

Thanks for all the comments ladies!!
Jules-I'm continuing all ultrasounds at my regular OB's office unless there is a concern. If anything looks concerning I'll have a follow up at the MFM office. We don't have Peapod here...I desperately wish we did!! I don't want to grocery shop again!!!

AJ said...

I'm glad the appointment went well. And you are doing great!! Thanks for the great comments on my blog...its so nice to get a some additional perspectives!!