4th (20w2d) and 5th (24w2d) OB Appointment Updates

My 4th OB appointment (20w2d) was pretty uneventful. I had gained in total one pound, my uterus was measuring on track, and Murtle's heartbeat was beating away at about the usual 145 bpm. About two weeks after that appointment, I received a call from Dr. Marcus Penn, one of the senior OBs in the practice. He called to tell me the results of my last urine test (they had sent a sample to the lab because they had noticed trace amounts of blood and protein in my urine for the second month in a row). He told me that I had a slight bladder infection (which I've never known to have had before, but they are pretty common in pregnancy), so he prescribed a five-day course of penicillin / amoxicillin for me to take. He told me that while the bladder infection should not cause any problems for me or the baby, he wants to err on the side of caution and set me up to receive additional anti-biotics administered via an IV immediately prior to delivery because of the type of bacteria I have (Group B Streptococcus, or "GBS" for short). If a newborn were to contract GBS during delivery or shortly after birth, she could develop pneumonia, meningitis, sepsis, or even die. Here is a link to a great article that contains more information on GBS:

March of Dimes GBS Info

So after that minor hiccup, time slowly marched on. I have started to feel Murtle move around a bit more - especially within these past two days, but she stills seem to be a very chill baby. Anyway, lo and behold - we finally (and thankfully) made it to 24 weeks! According to a chart I found, 24 weeks is a HUGE viability milestone. If I were to have a baby at 24 weeks, her chance of survival is between 40-70% (granted, I would never wish for any mother to have to give birth so early due to the medical complications and issues that could arise from being so incredibly premature). However, each day that a baby stays in her mother's womb from 24 weeks means another 3% increase in survival odds each day. Here's the basic break-down:

Up until 21 weeks: 0% survival rate
At 22 weeks: 0-10% survival rate
At 23 weeks: 10-35% survival rate
At 24 weeks: 40-70% survival rate
At 25 weeks: 50-80% survival rate
At 26 weeks: 80-90% survival rate
At 27 weeks: greater than 90% survival rate

Therefore, 28 weeks will be the next huge milestone and one which I'll be anxiously awaiting. At that point, I should be ready to rock and roll with the nursery and other types of baby preparations

So, back to today's 24w2d appointment - it was thankfully uneventful, as well, other than the fact that I am now starting to gain more weight! I gained three pounds since my last OB appointment, which brings the grand total to four pounds! Murtle should weigh about 1.5 pounds by now and should be the length of an ear of corn already! And this is just the beginning of some rapid weight gain for her (and probably for me, too). So I need to keep that stretch mark cream flowing! The doctor I met with today was Dr. Nicole Luecke. I liked her, too, so now I have two OBs in the practice who I would most like to deliver Murtle - Dr. Luecke and Dr. Wells. I was disappointed to find out that Dr. Wells will be out for at least a few weeks (and maybe even a few months), so I might not even get a chance for her to deliver Murtle, which is a shame because she is my favorite so far. Anyway, Dr. Luecke is going to send my urine off to the lab to see if my infection cleared up. Otherwise, she just answered some routine questions I had and then sent me on my way with the orange "glucola" to drink before my next OB appointment. Onwards and upwards!

Level 2 Ultrasound / Anatomy Scan - 19 weeks 3 days

Well, we hit another milestone today...I finally had my very first Level 2 Ultrasound / Anatomy Scan and everything seems to be progressing well!

First the big news...today's tech (who was great, by the way) confirmed that Murtle is a GIRL! She measured right on track for her age (19w3d) and weighed 10 ounces. Her heart beat was beating away at 145 bpm. She seems to be a very "chill" baby, though, because she didn't move around much at all - I even drank some OJ, had a banana and ate some pineapple this morning to give her a sugar rush! I was surprised to learn that the placenta is actually in the back. I figured it was in the front since I can't feel any movements yet. I guess she's just a very, very calm baby! Hopefully that is a sign of good things to come. When the tech was doing her thing, I asked if they did 3-D ultrasounds there and the tech told me they did and ended up giving me a bunch of 2D and 3D pictures! What a nice and unexpected surprise!

Dr. Weinbaum was very nice and personable and didn't state any concerns. He wants to see me for another ultrasound at 32 weeks because they recommend seeing all of their "older" patients for a 32 week scan. I then specifically asked him if everything looked good and he said it did. I also asked if the amniotic fluid, the placenta and my cervix were ok and he said they were. All in all, a very good day!

3rd OB Appointment - 16w2d

Whew! I have managed to put four more weeks under my belt since my last regularly scheduled OB appointment and I am starting to feel as though I can exhale a bit more as each day passes. I met with Dr. Barbara Wells for yesterday's appointment. Let me tell you - she was fabulous! I want her to deliver this baby! She was cheerful and warm and really seemed to genuinely care about me and the baby. She even gave me a hug at the end of the appointment - what doctor does that? I told her about my doppler experience and she volunteered that I could come in to the office at any time I needed doppler re-assurance. Anyway, she answered all of my questions and even told me they were good questions (I was thankful for that feedback, even if she secretly believes I am a neurotic freak). When it came time to do the doppler check, she enthusiastically pointed out that she could see my uterus starting to show! She asked me to sit up, but then to lay back down because every time I sat up, it disappeared. Since I couldn't see it, she directed my hand to where it was so I could feel it. When we started to listen for the heartbeat, she got this big smile on her face and said, "don't you love that?!" There was Murtle's beautiful heartbeat again - beating away between 120 - 145 bpm. She told me that variance like that was normal and as long as the beats were in the right range, all was well, thank goodness! I then had my blood drawn for the AFP screening (which is to test for neural tube defects, i.e., Spina Bifida) and then went merrily on my way. Otherwise, my blood pressure was good and I had gained one pound since my last visit - but I'm still minus one pound since getting pregnant. That's ok - hopefully it just means there will be less to lose after giving birth! I suppose it's to be expected that I still haven't gained much weight considering my nausea has still been persisting. At least food doesn't completely turn me off anymore, but it's still not overly appetizing. Hopefully this nausea will pass soon because I miss having an appetite and loving food.

Oh, and I must confess about a second home doppler experience...The evening before my appointment, my husband asked (and in a surprisingly non-joking manner) if we wanted to get the doppler out. My first response was to ask him if he were nuts considering our first experience, but since he seemed to be genuinely interested in hearing the baby's heartbeat (and his expressing baby initiative has been few and far between), I had to cave in! I kept reminding myself that chances were good we wouldn't be able to hear it, so don't freak out...and I have an appointment the next morning, anyway. Anyway, I put the headphones on him and I moved the probe around my whole stomach. It took a few minutes, but we were actually able to find a much faster heartbeat this time! What a beautiful sound! I asked him to count the beats based on a digitial clock, only to find that the heart rate seemed to be going at over 200 bpm! I tried to tell myself that we just miscounted somehow, but I couldn't help but worry that the baby was in distress. :) If it's not one thing, it's something else... Rationally, I knew that all was ok, but well, you know...

Home Dopplers....Don't Do It!! And More Spotting Scares....

I recently returned from an unexpected trip oversees that turned out to be quite stressful. In order to allay my fears that Murtle was still doing ok, I purchased one of the inexpensive home dopplers. I couldn't wait to use it last Tuesday evening and even summoned DH to join in on the fun (despite my initial reservations to even tell him about my purchase because I was afraid that I would confirm his fears that I had gone off the deep end). I was pleasantly surprised to see that while he did give me a bit of a good-natured hard time about it, he did seem eager to hear the little heartbeat again, too. So, headphones on and probe all lubed up, we listened to my heartbeat to make sure the doppler was working and then tried to find little Murtle's galloping heartbeat. To my surprise, after several minutes of searching, we could only find what we thought was a heartbeat...but that was beating at about the same pace as mine. Uh-oh. So, I quietly put it away and tried to act as though I wasn't concerned...that it was just the result of user error, but I immediately headed downstairs to research the doppler I had purchased to see if anyone else had a similar experience, yet things turned out to be ok. Luckily, I did find some stories that re-assured me a bit, but until I could confirm that all was ok, I continued to worry. I ended up going to my OB's office the next morning and told them the whole embarassing story (and promised that I would throw the dumb thing away if all turned out ok) and asked if the nurse practioner ("NP") could use her doppler to find Murtle's heartbeat. Luckily, it appeared to be a slow day in the office and the NP agreed to see me. She was someone I hadn't seen before and I think I will see only her for all of my future GYN appointments because she was wonderfully supportive and sweet. We both heard Murtle's heartbeat going at 135 (I think) bpm and she said it was "perfect." While I was relieved that everything was much better than I had thought it was the previous evening, I couldn't help but worry and wonder why it had dropped from 160 just three weeks ago. I understand that heartbeat rates typically drop throughout a pregnancy until they stabilize, but that seemed to be a pretty significant drop. Whenever my fears start to creep up, I try to put them out of my mind and focus on her smiling face and her saying, "it's perfect."

Since then, I've noticed that while my nausea continues to serve as a good reminder that all is well, it has started to subside. Instead of actual nausea and total food aversion (that seemed to heighten every evening), I just have some fleeting moments of feeling "icky." I am 16 weeks and 3 days today and still am not showing, nor feeling any flutters. My research has led me to believe that this can be normal. So, I continued to have faith that all is still going well...until I noticed a bit of spotting yesterday. I came to terms with those few days of spotting in my first trimester because that seemed to happen to a lot of women who went on to have normal pregnancies and healthy babies. However, I didn't expect, nor was I prepared for a spotting re-appearance during my second trimester. Similar to the spotting I had in the first trimester, this was light and not accompanied by any painful cramps. I have been feeling some heaviness, pulling, and/or what could be stretching in my uterus, but I attributed this to my finally growing uterus and not to anything I could consider to be actual cramps. Anyway, to be on the safe side, I called my OB's office yesterday afternoon. The on-call OB, Dr. Edwards, told me basically the same advice I was given for the first trimester spotting: The spotting should not be a cause for concern unless it was heavy and/or accompanied by painful cramping. She told me just to take it easy and keep an eye on things. So, that's what I did and today it seems that all is ok. I am looking forward to my next regularly scheduled OB appointment on Wednesday to hear Murtle's heartbeat again. Taking things a day at a time during a pregnancy after infertility is much easier said than done. I know I said that I would be able to relax after I hit the 12 week mark and got the results of my NT screening. Now I'm wondering if I will be able to relax at all during this pregnancy. As of now, my goal to really start enjoying this pregnancy will be after I hit the 28 week mark. We can do this!!

Happy New Year, everyone! I'm really looking forward to 2010 - it should be one of the best years ever!

An Early Christmas Present!

I just received the results from my first trimester screening:

My age related risk prior to screening for Down's was 1 in 164. After the screening, my risk is actually 1 in 3261!!!!

My age related risk prior to screening for Trisomy 13 and 18 was 1 in 295. After the screening, my risk is actually 1 in 4561!!!!

What a relief. I am so thankful that things are progressing so well (other than the constant nausea and lack of any sort of appetite). My husband and I have truly been so incredibly blessed thus far and I couldn't be more appreciative of all of the blessings that have been bestowed upon us.

First Trimester Screening - 12w3d

Wow. I may actually be able to start to "relax" about this pregnancy now. My husband and I just got back from the first trimester screening at the MFM's office. The initial results are that Murtle is looking good so far! She's measuring 12w1d (just two days behind, but that's normal and considered to be right on target) and her heartbeat was beating away at 154 bpm. (I keep saying "her" now because the tech asked if we wanted to know the sex since she was able to take a preliminary guess (but told us not to hold her to this)). We got to see the precious little head and two arms and two legs, and it appeared as though her organs were inside her body. Every once in a while she would do a little stretch or move around a bit, but for the most part, she was just happily a-chillin' (even despite my upped intake of orange juice this morning to give her a boost). The NT measurement was 1.3, which is considered to be within normal limits. We still have to wait for the bloodwork results, but considering the measurement was ok, I have faith that bloodwork results will come back A-OK, too. The anatomy scan will be in seven weeks, but I am feeling really good about things now -- finally!!

2nd OB Appointment - 12w2d

I can't believe I'm almost through the first trimester. Until my OB appointment this morning (at Chesapeake Women's Care's Annapolis office), I definitely would not have believed it due to my miscarriage nightmares and because, aside from the nausea (which I felt was purely psychological), I still don't feel (nor look) pregnant. Also, putting my non-existent baby bump aside, I actually lost two pounds since my first OB appointment four weeks ago. I suppose that shouldn't come as too much of a surprise, though, because my usual pre-pregnancy, hearty appetite has taken a severe down-turn and I actually have to force myself to eat so that some of the nausea that consistently creeps up each and every night since about the eight week point lies low. Luckily, fruit has been my saving grace, especially watermelon, clementines, and grapes.

I guess I was really nervous about today's appointment because my blood pressure was 159 over something when they first checked it, so they had to check it again 15 minutes later because they were a bit concerned about it! After that came down, the rest of the appointment went well. The OB I met today, Dr. Jessica Russell, asked how I was doing and then reviewed all of my test results from my first OB appointment (all was A-OK). Then, to my relief, she pulled out the doppler. She told me to be patient because this could be like finding a needle in a haystack, but thank goodness she was able to find the heartbeat within a minute or so on my right side. The baby's heart was blisfully beating away at about 160 bpm. Every once in a while, there would be a brief interruption in the beating - Dr. Russell told me that was when the baby was moving! So, WHEW! There's still a baby in there! Now I can truly look forward to (rather than being filled with nervous anxiety over) tomorrow's ultrasound at the MFM's office for the first trimester screening! Now I am just hoping and praying that the initial screening results look ok and that the baby is measuring on track and seems healthy.