I had a looong 2.5 hour appointment at my MFM. Lots to go over.
Genetic Counselor
I thought after I received my NIPT results that were "low risk" that I was in the clear for genetic concerns. But I was wrong... I guess the First Trimester screening may still play a role in things. I had a low PAPP-A result and low HCG, which is bad. This is all hormone-related.
What they want to do is do something called a Sequential Screening in the 2nd trimester. It's where someone would normally do the Quad Screening, but the Sequential Screening is a little more thorough than the Quad Screening.
What they do is combine the NT Ultrasound results, the First Trimester Screening Results, my detailed ultrasound results, and the Sequential Screening results to come up with a risk value of low or high.
Why all the concern on my hormone levels?
Turns out that there are a few things that the hormone levels can indicate:
1) The baby has a chromosomal abnormality that can't be seen on an ultrasound, one of the rarer ones. Only way to really know 100% is if this is the case is if I get an amnio.
2) My placenta is not functioning like it should. There's something called Placental insufficiency. This is pretty bad because that means the baby wouldn't be getting all the things it needs from the placenta. Baby can be smaller or have some issues from lack of oxygen, can lead to pre-term labor and/or birth defects, etc.
3) Nothing is wrong.
So right now, still kind of in limbo on how things can go. So, next step is to get the Sequential Screening done.
Genetic Screening
The geneticist talked and talked and talked about a lot of stuff. But one thing she would want me to do is to get screened for other genetic issues. Which also means they would want my donor to get screened as well... which is where one of the tricky parts come in. I have to call my sperm bank and ask them if they can contact the sperm donor for additional genetic testing. More on this later.
Detailed Ultrasound
It's so great when I get to see my baby boy! He was moving around and dancing. So crazy to watch him be so active and I can't feel a thing. He had a strong heartbeat of 153 bpm and was measuring about 2 days ahead, which they say is good. Everything that they can see (kidneys, length, etc) looked good and no soft markers for anything.
It also looks like my tilted uterus is coming forward. I found out I have an anterior placenta, so it might take me longer to feel the baby kick.
All in all, baby boy looked amazing and wonderful and great.
MFM Meeting
My MFM wasn't happy with my diabetes blood logs. My fasting blood sugar was higher than she'd like and I wasn't consistently tracking my glucose levels. We are upping my night time insulin to 22 iu and keeping the morning insulin at 12 iu. I might end up having to add another insulin to my day if my after-meal glucose levels remain high. Breakfast and lunch after-meals have been great, just dinner time where things get a little wonky. She has forbid me from eating french fries and pizza... sadness. My blood levels just got too high with those.
How am I feeling?
I honestly thought things were in the clear after the NIPT results that I wasn't even concerned about the meeting with the genetic counselor. I don't really know what to think or feel. I have been too busy with visitors and holiday stuff to really let myself think about things. I'm bummed that I can't just have a happy pregnancy and feel good about my baby boy. The worry about things just seems to linger from one thing to the next. I kind of wish that I would be told EVERYTHING at one time so I would be prepared better. But this is all new to me and all new things I have no clue about.
In my heart I believe my baby is going to be OK. He was so active and measuring really well, so I'm hoping the placenta is doing its job. The chromosomal abnormality possibilities.... I'm going to need to figure out how comfortable I am with dealing with it *IF* it comes or if I want to risk an amnio. For my MFM, the risk is 1:400 for a miscarriage with an amnio. They also suggest doing it by 22 weeks. So, I really have to think about that. I don't want to risk my baby doing a procedure that might just tell me there's nothing wrong. But the preparation I can do prior to his birth if something is wrong... has me teetering on the idea. Plus my anxiety is through the roof and not sure if "not knowing" is going to just be too stressful.
A lot to think about and a lot to consider. I'm not leaning one way or another right now. I guess the logical step is to get the Sequential Screening and see what my hormone levels are telling them, then decide on next steps from there.
I truly wish that everything could just be OK and not have all these worries. A boring pregnancy would be so wonderful... I also wonder if all these extra screenings are really worth it? I guess in a way, it's nice to be prepared and monitored so closely -- so we can get in front of any issues. At the same time, there's all this extra worry and there might not be anything wrong with the pregnancy or baby.
I guess I'll have to look back on this experience and ask myself if the worry outweighed the benefit of the extra monitoring. I'm split right now.
I just pray that my pregnancy goes smoothly and that I'm able to carry my baby boy to term and deliver a healthy baby.
Next Steps:
Genetic Counselor
I thought after I received my NIPT results that were "low risk" that I was in the clear for genetic concerns. But I was wrong... I guess the First Trimester screening may still play a role in things. I had a low PAPP-A result and low HCG, which is bad. This is all hormone-related.
What they want to do is do something called a Sequential Screening in the 2nd trimester. It's where someone would normally do the Quad Screening, but the Sequential Screening is a little more thorough than the Quad Screening.
What they do is combine the NT Ultrasound results, the First Trimester Screening Results, my detailed ultrasound results, and the Sequential Screening results to come up with a risk value of low or high.
Why all the concern on my hormone levels?
Turns out that there are a few things that the hormone levels can indicate:
1) The baby has a chromosomal abnormality that can't be seen on an ultrasound, one of the rarer ones. Only way to really know 100% is if this is the case is if I get an amnio.
2) My placenta is not functioning like it should. There's something called Placental insufficiency. This is pretty bad because that means the baby wouldn't be getting all the things it needs from the placenta. Baby can be smaller or have some issues from lack of oxygen, can lead to pre-term labor and/or birth defects, etc.
3) Nothing is wrong.
So right now, still kind of in limbo on how things can go. So, next step is to get the Sequential Screening done.
Genetic Screening
The geneticist talked and talked and talked about a lot of stuff. But one thing she would want me to do is to get screened for other genetic issues. Which also means they would want my donor to get screened as well... which is where one of the tricky parts come in. I have to call my sperm bank and ask them if they can contact the sperm donor for additional genetic testing. More on this later.
Detailed Ultrasound
It's so great when I get to see my baby boy! He was moving around and dancing. So crazy to watch him be so active and I can't feel a thing. He had a strong heartbeat of 153 bpm and was measuring about 2 days ahead, which they say is good. Everything that they can see (kidneys, length, etc) looked good and no soft markers for anything.
It also looks like my tilted uterus is coming forward. I found out I have an anterior placenta, so it might take me longer to feel the baby kick.
All in all, baby boy looked amazing and wonderful and great.
MFM Meeting
My MFM wasn't happy with my diabetes blood logs. My fasting blood sugar was higher than she'd like and I wasn't consistently tracking my glucose levels. We are upping my night time insulin to 22 iu and keeping the morning insulin at 12 iu. I might end up having to add another insulin to my day if my after-meal glucose levels remain high. Breakfast and lunch after-meals have been great, just dinner time where things get a little wonky. She has forbid me from eating french fries and pizza... sadness. My blood levels just got too high with those.
How am I feeling?
I honestly thought things were in the clear after the NIPT results that I wasn't even concerned about the meeting with the genetic counselor. I don't really know what to think or feel. I have been too busy with visitors and holiday stuff to really let myself think about things. I'm bummed that I can't just have a happy pregnancy and feel good about my baby boy. The worry about things just seems to linger from one thing to the next. I kind of wish that I would be told EVERYTHING at one time so I would be prepared better. But this is all new to me and all new things I have no clue about.
In my heart I believe my baby is going to be OK. He was so active and measuring really well, so I'm hoping the placenta is doing its job. The chromosomal abnormality possibilities.... I'm going to need to figure out how comfortable I am with dealing with it *IF* it comes or if I want to risk an amnio. For my MFM, the risk is 1:400 for a miscarriage with an amnio. They also suggest doing it by 22 weeks. So, I really have to think about that. I don't want to risk my baby doing a procedure that might just tell me there's nothing wrong. But the preparation I can do prior to his birth if something is wrong... has me teetering on the idea. Plus my anxiety is through the roof and not sure if "not knowing" is going to just be too stressful.
A lot to think about and a lot to consider. I'm not leaning one way or another right now. I guess the logical step is to get the Sequential Screening and see what my hormone levels are telling them, then decide on next steps from there.
I truly wish that everything could just be OK and not have all these worries. A boring pregnancy would be so wonderful... I also wonder if all these extra screenings are really worth it? I guess in a way, it's nice to be prepared and monitored so closely -- so we can get in front of any issues. At the same time, there's all this extra worry and there might not be anything wrong with the pregnancy or baby.
I guess I'll have to look back on this experience and ask myself if the worry outweighed the benefit of the extra monitoring. I'm split right now.
I just pray that my pregnancy goes smoothly and that I'm able to carry my baby boy to term and deliver a healthy baby.
Next Steps:
- 12/30/16: OB, Monthly Appointment
- 1/6/17: MFM, Diabetes Follow-up and Sequential Blood Draw
- 1/16/17: MFM, Detailed Ultrasound (Level 2) Anatomy Scan
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