Discordant Growth | Goddess in Progress

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Hospital day, 35w5d

By Goddess in Progress · Comments (2)· August 1st, 2007

Still cooking, alas.

Today was plenty of good news for babies, which is of course a mixed blessing for me. I half hoped there would be some indication for delivery, since I’m so tired and uncomfortable, but it’s just not in the cards.

Babies looked great on the ultrasound. Crowded, of course, and I was quite correct that baby boy A is way low against my cervix now. But fluid levels were good, breathing movements and all of that were good. And, though it’s always possible the estimates are off, they seem to be growing quite well. Baby boy is estimated to be about 6lb7oz, and baby girl is all the way up at 5lb7oz. 12 pounds of baby in my belly… no wonder everything hurts.

Non-stress test was fine. As always, little girl decided it was a great time for a nap and we had to get out the buzzer, but after that she woke right up. My blood pressure was high, but not as bad as Monday (which was apparently as high as 150/100 at one point!), so my doctor (who was at the hospital, anyways) sent me home.

So, here I sit! Still really uncomfortable, but the contractions have gone away for the moment. Hopefully I’ll get in a good nap this afternoon, since I was not able to sleep well last night at all. If everything stays the same, I’m off to the OB on Friday for my pre-op appointment… Who knows, maybe I’ll make it to next Thursday, after all!

Comments (2)

Categories : Hospital, Pregnancy, Ultrasounds

Tags : blood pressure, discomfort, discordant growth, NST/BPP

Hospital day, 33w6d

By Goddess in Progress · Comments (1)· July 19th, 2007

An interesting day, indeed, at the hospital. Today was a growth check with the ultrasound, in addition to the biophysical profile. Both babies passed the BPP, though we had to poke little boy to get him to wake up and move around for us. Weight estimates were encouraging, but interesting… Baby girl appears to have had a bit of a spurt and put on a full pound to reach 4lb4oz. Baby boy actually slowed down and gained only 10oz to reach 5lb3oz. Of course, these are estimates, and can arguably be further off the bigger (and more crowded) the babies get. But still, very encouraging that little miss continues to grow. An unusual twist, however, that her brother is slowing down. He also appears to have a bit less fluid than she does. As the peri said, it’s not as worrisome as it would be if little girl was the one with less fluid, but something to keep an eye on, nonetheless. Non-stress test was just fine, and as of next week, I’m going to actually go in TWICE every week. Good thing I’m done working!

The craziest part of the visit, however, was our discussion of when to deliver. First of all, if I go into labor spontaneously anytime tomorrow or later, they will not attempt to stop me. If it were to peter out on its own, they wouldn’t try to restart it, but they won’t stop me. OK. Wow. And then she said, “so, when do you think we should have these babies? I’m thinking 36-37 weeks.” Whoa!! Used to be 38, then 37-38… now 36? Holy crap! That’s two weeks!!

Basically, the plan is this: I’ll have my twice-per-week BPP and NST. If anything looks concerning, they might decide it’s a good day for a birthday. My next growth check will be in two weeks (August 1, to be precise). If either one of their growth has slowed or stopped? Birthday time. If growth is still good, they’ll schedule me for induction or c-section at right about 37 weeks.

WOW! I can barely wrap my mind around it. Three weeks at the most, possibly two or less. I’m pretty darn excited, but mostly it’s just not sinking in at all.

I’m off to my OB’s office shortly, where we definitely need to have a discussion about delivery method. Baby boy seems to have really taken over at the baby A position, and is head down, so vaginal delivery is an option on the table. We shall see.

Oh, and my blood pressure seemed to be creeping up at the NST today. We’ll see if that issue proves to be the dark horse that determines birthday time. I’ll update after the OB’s office if there are any interesting developments.

OB Update
After talking to my OB, she’s totally cool with me going directly for the c-section. She seemed to think it was probably a good idea in my case. If I change my mind and/or they both flip to vertex, I’m welcome to try for vaginal (if they don’t flip, then only if she’s the one on call, because she’ll do a breech extraction of twin B). But otherwise, she’s going to schedule my c-section for right about 37 weeks! To be moved up if things change, of course. Holy crap!!

Comments (1)

Categories : Hospital, OB Appointments, Pregnancy, Ultrasounds

Tags : blood pressure, c-section, discordant growth, NST/BPP, perinatologist, preterm labor

Hospital Day, 31w6d

By Goddess in Progress · Comments (0)· July 5th, 2007

Today was the usual ultrasound, non-stress-test routine at the hospital. The ultrasound went pretty well. While the size discrepancy between the twins is widening somewhat, my little girl is still growing. The past several checks, she had gone up just about a half pound (8 oz) over the course of two weeks. This time, she was up 12 oz to 3lb, 4oz. Not an enormous growth spurt, I suppose, but a good thing nonetheless. Her brother keeps packing it on, putting on yet another 16 oz to reach 4lb, 9oz. He is still vertex, she is still breech, and they are both way the heck up in my ribcage. As I am nearly 32 weeks, today also marked my last cervix check via ultrasound. Just like at my very first appointment with the perinatologist, 14 weeks ago, Iron Cervix is holding steady at an absolutely ridiculous 4.3cm. That’s kind of insane for even a singleton pregnancy at this point. But it appears my occasional contractions, combined with a whopping 7lb, 13oz of baby, is having absolutely no effect on my cervix. Guess they’re not intending to make their entrance any time soon. Oh, and another good day for the biophysical profile: plenty of fluid, practicing breathing, good movement, etc.

If I caught the notes correctly, little girl is trailing off in the percentiles race again, but is not yet what you would call growth-restricted. So, we’ll keep on plugging. My peri told me they’d deliver me under any of the following circumstances: baby girl stops growing or falls below the 10th percentile, either of them start to do poorly on the biophysical profile or non-stress tests, or I reach 37-38 weeks. Certainly there are other potential complications out there, but those are the three main things she’s looking for. Depending on the next growth check in two weeks, they also might have me come in for the BPP and NST twice per week instead of once. Presumably that’s if she still isn’t growing all that much and they’ll want to keep an eye on her just in case she starts to show any distress.

Today’s non-stress test also went just fine. Took a while to get them on the monitor, because they kept moving around and kicking the sensors. But eventually we got some good tracking, and the nurse pronounced herself happy with the results. Sounds good to me! My blood pressure seems to be creeping up just a little, but we’ll see how it looks at next week’s OB checkup.

That’s the news that’s fit to print from here. We’re off to a breastfeeding class this evening, which is our final prenatal class. I can’t believe we’re already here!

Comments (0)

Categories : Hospital, Pregnancy, Ultrasounds

Tags : cervical length, discordant growth, NST/BPP, perinatologist

Day at the hospital, 29w5d

By Goddess in Progress · Comments (2)· June 21st, 2007

Yesterday afternoon was my usual ultrasound with the perinatologist. My mom was in town, so she got to come with us. She’d never had an ultrasound with me or my brother, so it was neat for her to be able to see everything.

Both babies look good, moving a lot, plenty of fluid, all of that good stuff. And for the first time, they are both head-down (I thought my belly looked different…). Baby girl put on another 7 oz to measure 2lb8oz, still hanging out around the 28th percentile. Her brother, on the other hand, put on 15 oz, up now to a whopping 3lb9oz. So not only is there a full pound difference between them, but he has shoved her out of her “baby A” position. She is now relegated to Baby B status.

Given her continued peanut-ness, my perinatologist decided to err on the side of caution and start my weekly non-stress tests now. So after leaving briefly to get some lunch, I headed back into Labor & Delivery to be hooked up to monitors for an hour. Both babies were tracking just perfectly. They were very active for a large portion of the time (probably helps that I’d just eaten a very carb-heavy lunch), and their heartrates were very good. Interestingly, though, I was having somewhat frequent contractions! It was not a new sensation, but one that I hadn’t been entirely sure was a contraction. Well, now I know. The nurse, a very nice Irish woman named Mary, had me drink some extra water and they spaced out a bit further. And since I’d just had my cervix checked and it was still a good 4cm, they decided it was not an issue of major concern. She just advised me to continue taking it easy, and pretty much to drink as much water as I could manage. (Yes, lie on my left side and drink lots of water.)

So, I now have an ultrasound, followed by a non-stress test, every week from now until August 15 (the peri pretty much promised I wouldn’t go past then, thankfully). That’s at least two hours in the hospital, and that’s if nothing goes wrong in between appointments. Oh, and that’s not including my usual OB appointments. We’ll see how long I manage to keep working…

It’s hard not to worry about my little girl, and how very little she is. But she technically isn’t “growth-restricted,” since that’s a designation for being under the 10th percentile, and she keeps plugging along and growing, which is good. I’m just a little worried that her enormous brother is going to take up all of the space and cause problems for her. But for now, she’s showing no signs of distress, and though her movements are frequently more subtle than her brother’s, she’s still kicking away.

We’ll see what next week brings.

Comments (2)

Categories : Hospital, Pregnancy, Ultrasounds

Tags : contractions, discordant growth, hydration, NST/BPP, perinatologist

Ultrasound, 25w6d

By Goddess in Progress · Comments (1)· May 24th, 2007

Had a good visit with the perinatologist today. Hooray!

Both babies put on eight ounces since the last visit. While baby girl A is still smaller than her brother, she put on a significant amount of weight and went from about the 17th percentile up to the 27th percentile! Baby boy B also went up from the 48th percentile to the 52nd. So while they’re still “discordant” as far as their weights go, they’re both going up, so that’s definitely a good thing. Heartbeats were good, baby boy’s kidneys were holding relatively steady. Still a little larger than we’d like, but clearly working. Oh, and as I suspected, baby A has turned back head-down. B is still firmly breech.

A couple of good pictures today, too!
Little miss is sort of bending her head back. Not sure what the big white shape is in the upper left, but I suspect it might be her brother’s foot. It was the best shot we could get, since her head is nice and low right now.

Baby boy, however, had no trouble showing off his profile. Of course, I suppose it helps that his head is practically up near my ribs.

And, just for fun, the ultrasound tech even busted out the 3D! The ones we tried to get of our girl looked like a big blob of nothing. But baby boy B was ready for his 3 dimensional debut. How’s that for cool?

Comments (1)

Categories : Pregnancy, Ultrasounds

Tags : 3D ultrasound, discordant growth, perinatologist

Ultrasound, 23w6d

By Goddess in Progress · Comments (3)· May 10th, 2007

A mixed bag at the perinatologist’s office today.

The good news is that my cervix remains shut like an iron fist. Despite the beating the twins insist on giving it every day, it’s still greater than four centimeters. This is a very good thing. My husband suggested it might be a whole new kind of kung fu (Iron Cervix!), but we’ll have to see if that catches on.

Both babies are doing well, heartrates are good, fluid levels are good, no one seems to be in any distress. My baby girl A, though, is still quite a little peanut. She’s very active, which is a good thing, and everything looks to be developing well, but she’s growing slowly. She put on about 5 oz. since our last visit, making her only 1 lb 1 oz., which is about the 17-18th percentile for babies of her gestational age. Her brother, baby boy B, put on 8 oz to become 1 lb 7 oz, and is in the 48th percentile. He’s measuring a day ahead, gestationally speaking, and she’s measuring just over a week and a half behind. Not horrible, but not encouraging, either. I’m now going to be seeing the perinatologist every two weeks instead of 3-4, to keep tabs on her progress. If we get to 28 weeks and she isn’t really catching up, they’ll likely start giving me steroid shots to speed up lung development in case they need to come early. But as long as she keeps growing (even if it isn’t as fast as I’d like) and fluid levels are good and she isn’t in distress, we’ll just keep cooking as long as possible.

Baby boy B’s kidney didn’t improve from last week, and in fact has now slightly more fluid (though he’s also growing larger, so it’s not all bad), and is something we’ll still keep an eye on.

I like my perinatologist a lot, and I like that she’s really encouraging and not an alarmist. Yes, she said there may come a point where they want to hit me up with some steroids to help with lung development in case they need to come early, etc. But I like that she calmly says these things and then moves on to something more encouraging. I don’t want her to pretend everything is peachy when it’s not, but I also don’t want her to freak me out more than necessary. She strikes a good balance, I think.

That’s the update from here. I’ll try to post pictures when I get home tonight. Got a few halfway decent face shots, though no 3D. Maybe another time.

Edited, finally. Here are the pictures!
A face shot of baby A:

And baby B with his arm in front of his face. It’s like one of those pictures at the mall. If you stare at it in just the right way, it looks like a sailboat. I swear.

We also got a good picture of the double-breech… two heads are better than one!

Comments (3)

Categories : Pregnancy, Ultrasounds

Tags : discordant growth, perinatologist

Ultrasound, 20w6d

By Goddess in Progress · Comments (2)· April 20th, 2007

Had my appointment with the perinatologist this morning, and things looked pretty good. I always enjoy going for the ultrasounds, getting a peek at the babies. Baby A (girl) has flipped over and is now breech. She was moving around a TON, actually making it a little difficult for the tech to get all of the measurements she wanted. Guess I should lay off the OJ before ultrasounds now. Baby B (boy) is also breech, as he was last time. He was moving a bit, too, but not quite as wildly as his sister. When she went to check my cervix, though, we caught one of them in the act: kicking me in the bladder! Mommy does not enjoy this! And now that they’re both feet-down, they can pretty much take turns doing so. Nice. But my cervix is still nice and long (despite the pummeling it’s taking from one or both of the babies), so that’s a very good thing.

Spoke with the peri after the ultrasound, and she said there were two things she wanted to keep an eye on, but that she isn’t too concerned about just yet. The first is that our girl is measuring 3 ounces smaller than her brother (12oz vs. 15oz). While this could be just fine, she could just be a smaller baby, we want to make sure she continues to grow well and the discrepancy doesn’t grow larger. We’ll check again at my appointment three weeks from now. If progress is good, we’ll stay on the 3-4 week rotation with appointments. If not, I’ll start going more like every 1 or 2 weeks. If it gets worse, there could be bedrest, steroid shots, etc. But for now, it’s just something to keep an eye on.

The other small issue is with our boy. One of his kidneys has a small amount more fluid in it than is desirable. Apparently the maximum on the “normal” scale is 4mm, and one of his is more like 4.3mm. This is an issue more commonly seen in boys, for unknown reasons. Could be a very minor issue that will resolve itself, could grow into a larger issue (most concerning if it is 7mm to over 10mm). Unlikely to cause permanent damage, but something to be aware of. It’s also a soft marker for Down’s Syndrome, but I’ve had no other markers or any other risk factors, so my doctor really doesn’t think that’s the issue. But she wanted to mention it, since she figured I’d go looking up “fluid in kidneys” on the internet and find links to Down’s and worry she hadn’t told me something. Again, she characterized this as a minor issue that they just want to keep an eye on.