September 4, 2009

Day 230

50 days to go according to my iphone, 82% through. This baby will be term in four weeks (37 weeks), the point at which I was was induced with Piper. Very hard to imagine. I'm tired and uncomfortable and I'm sure I'll be getting anxious to get on with it in another month but right now I can't imagine not being pregnant. I'm trying to savor this last bit of time with just one child. With #2 neatly packaged away and all its needs met. It sleeps, it wakes, I hardly notice. It's fed whether I'm asleep or awake and I'm only changing one set of diapers. My back is sore but my arms are free. And I never have to feel bad about dividing my attention between the two. Piper and I just returned from visiting my sister in San Diego. Traveling alone with a toddler will really make you appreciate not traveling with a toddler and an infant.

IUGR was diagnosed at week 32 last time so yesterday's MFM appointment was a big one. At this point I'd already been to the ER a number of times for high blood pressure and so far this time it's stayed just on the right side of the upper limit (132/88 yesterday). My OB sees this as a good number, safely below his danger level (140/90), but the MFM reminds me this is hypertension because it represents an increase of over 20/10 points from my normal pre-pregnancy levels (1-teens/70). So far though, it doesn't appear to be having a negative impact on the baby. At around 4 lbs. the baby measures in the 32nd percentile. The IUGR diagnosis means that Piper at this point was at or below the 10th percentile. Because this wasn't identified until 32 weeks, we really don't know at what point her growth began to slow and fall off the charts, but so far we don't seem to be on the same path. The baby was 36th percentile at the last visit so there may be a slight drop-off but I think it's within the margin of error and certainly still in the safe range.

Better yet, at 32 weeks last time the placenta already showed signs of deteriorating, caused by the hypertension and the cause of the growth restriction. It was smallish, thin, and heavily calcified. At delivery it turned out to be even smaller than expected and fragmented. This time he said it still looks fine. The MFM said his gut feeling is that I may be walking the line all the way to the end, but at this point last time he was already putting bets on early induction.

For all the good news, he did mention a few reasons to remain concerned. He clarified what my OB had told me about only 15% of gestational hypertension cases repeating in successive pregnancies: this statistic is related to pre-eclampsia, which I never had. In discrete hypertension cases, it's more like 90+%. And the main reason is because when the problem is only gestational hypertension, not related to kidney problems seen in pre-eclampsia, it is really the emergence of an unknown underlying problem causing the blood vessels not to expand properly. So, we stay on top of it. Back in two weeks for more monitoring.

10 comments:

Grade A said...

Sounds like the majority of what you found out is good news, even if that familiar worry is lurking. Glad you are savoring time with Piper. You are in my thoughts for a happy, healthy birth and baby.

Artblog said...

Me too, hope all turns out good in the end, does sucketh though, sorry luv :(

HUGS xxx

Sticky Bun said...

Wow. I cannot believe you're getting so close! I'm so glad to hear that things are hanging in there with the placenta and bp. I hope it stays on this side of high for the duration. I know it's probably ridiculous to tell the mom of a toddler to take it easy, but I'll say it anyway so you can have a good laugh at least. (I hear that's good for the heart.)

Enjoy these last few weeks. And from someone who knows nothing other than two, know that there is nothing in the world more heartwarming than seeing two siblings together acting sweet. So, it'll be tough. You're back will still be sore and you won't know what it's like to ever have a free hand. But the first time you see Piper bringing a blanket for the little one or giving a sweet kiss, you'll lose the ability to remember what it was ever like before.

Good lord, how emotional am I? Anyhow, great to hear from you. Hang in there and know we're wishing you the best these last few weeks.

Red said...

I love your thoughts about enjoying these last few weeks. That is such a positive way to look at the home stretch.

Good luck for the check up.

Nearlydawn said...

Glad to hear things are going relatively well! I'm sure you have been concerned about the wee one and how this period of time would go. Hoping you keep holding steady and sail through a smoothe last few weeks.

My Reality said...

I am glad you are still hanging in there!

Tinker said...

It sounds like you'll make it farther than with Pip as long as your BP holds stable; that sounds like good news to me. Hang in there!

mekate said...

Thinking of you- and am so glad you are getting monitored so regularly- 50 days, wow. so glad things are going well, that you are on the right side of the line, and that your MFM is on it-
was just thinking back to your february transfer, how peaceful you looked during the post-transfer photo, and how that feels like 5 minutes ago, and a lifetime ago all in the same moment.

I remember a dear pregnant friend saying she wished she could stay pregnant forever- since at least in those moments she knew her baby was fed and comfortable and taken care of... all needs met.

take care of your wonderful self,

warmly,
Kate

exileinkidville said...

so glad you are on the right side of things this time. i hope that path continues. enjoy the time with Piper and keep us posted.

Cibele said...

you are so close!!!!! I am goping that all keeps going well.