36 Week, 2 Day Ultrasound

Yesterday we had our (supposed) last appointment before the C-Section next week.  After some concerns, and threats to do the c-section last night, we now have one more appointment next week.  But the c-section still stands for Friday June 13th!

Ironically, on Sunday night I told Jon to be prepared for anything at the appointment.  I told him there was a possibility that if Bella was still not growing well, they may want to do the c-section sooner than later...as in same day.  That stressed him out a bit (and me too!), but I wanted him to hear it from me the night before, rather than the doctor the day of!

And thank goodness he had a heads up.

The good news first:

*Her heartbeat was nice and strong at 139 BPM.

*She passed her biophysical profile with flying colors- 8/8!  She was breathing well, had great movement and tone, and whatever AFV stands for, she got 100%.  Couldn't ask for anything better : )

*I have an adequate amount of amniotic fluid (11.7 cm) for Bella to swim in : )

For the not so great news:

*My placenta is now considered a Grade III (which on a 4 point grading scale is the worst you can get).  Most likely it's because there are microthrombi (tiny clots) in there since I have the 3 clotting disorders and not been able to be treated with lovenox for the last 16 weeks b/c of the placenta previa.  Such a catch 22!  And of course the placenta hasn't moved a bit...still loving to sit right on top of that cervix (not that in any way we were expecting it to move!). 

*Isabella is still a tiny little peanut.  Her estimated weight is 4lbs 7oz.  I didn't actually think this sounded terrible, considering the 36 week update on thebump.com says lower limit of average is 4 lbs 2 oz.  However, that in conjunction with all of her measurements, put her in the <10th percentile.
(Note to self- take your own advice that you give your patient's parents all the time, and only use reputable medical resources for medical information!).

Her head circumference, abdominal circumference, and whatever "BPD" stands for were all <5th percentile, and her femur length was at the 24th percentile which bumped her overall numbers up somewhere between 5 and 10%. 

All of those numbers puts her in the IUGR ("intrauterine growth retardation) category : (  Jon hates the name of it.  And I can't blame him.  Any terminology that includes the word "retardation" in it is scary when it applies to your child. 

So with all of that information, my OB was concerned that given the grade of my placenta and how small Isabella is, that clots in my placenta are causing decreased blood flow to her.  SO- she basically prepared us for the likelihood of c-section that night, but before that, she wanted us to be evaluated by the High Risk Maternal Fetal Medicine physician.

We went down the hall and were able to be seen pretty quickly which was nice.  The physician wanted to do another complete ultrasound with more in depth measurements, so we got to watch her squirm around in there for a second time which was fun.

The second ultrasound showed approximately the same weight, but she was closer to the 17th percentile for overall size.  Rather than measuring 4 things like the first ultrasound, they measured about 14, including pretty much every organ size!  The most encouraging news was that doppler flows through the umbilical cord showed that while it is on the lower limit of normal, it is still providing adequate blood flow to Isabella. 

So after all was said and done, the risks of delivering at 36 weeks vs 37.5 were greater given the information that we had, and it was decided by all the physicians that we will wait until next week.

We will go in one more time on Monday just to make sure Isabella still looks ok, and she is getting enough blood flow.  But assuming nothing changes over the weekend, we are still on target for June 13th! 

Whew, what a long, exhausting post!.  But I must say, it was a long, exhausting, and stressful day, so I guess it's only appropriate.  Glad that our baby girl is doing well, and just hoping that she comes out a healthy, tiny little peanut! 

It's crazy to think that we have one more appointment post, one more Bumpdate, and then our Little Lerma will be in our arms! 

Just one week from today I will be sitting in a hospital bed holding Isabella in my arms, rather than sitting on the couch, with my belly in my hands, enjoying the feel of all her kicks, punches and rolls! 

And while I cannot wait to post pictures of her precious little face in real life, I will leave you with one more ultrasound picture...gotta love that squishy little baby face!!