Monday, January 20, 2014


we had our appointment with the high-risk OB last friday. i was nervous, but looking forward to hopefully getting some answers to all the "what ifs" that had been spiraling around in my brain since my ultrasound at 28 weeks.

when i called to schedule the appointment, the referral sent to them by my OB said i needed a level 2 ultrasound and genetic counseling. i wasn't really sure what the genetic counseling was for so that made me slightly more nervous, but i hoped it was just precautionary.

joe met me at the clinic for the appointment and we first met with the genetic counselor. what a bizarre meeting... she looked at our records and said we are "pretty boring" and that it doesn't appear there are any major red flags in our case. that was reassuring. but then she proceeded to educate us about genetic disorders, chromosomal abnormalities, prenatal testing options, etc. she went through a thorough family history, making notes regarding any familial health concerns. finally, she said that the doctor would make his recommendations regarding further testing should he determine any were necessary once i had my ultrasound and met with him.

at that point i was just trying to stay calm. my regular OB had mentioned that fluid in the kidneys has been noted as a [very weak] marker for down syndrome. but she had assured me that in my case there were no other signs and that my chances of having a baby with chromosomal abnormalities based on the kidney fluid issue only increased from 1/700 to 1.5/700. now this genetic counselor seemed to be implying this was a more likely possibility because she mentioned it multiple times...

next, we went back for our ultrasound. the tech was young and had 2 boys of her own so she made me feel at ease. it's always fun to see the babe and he was active as usual that day. she conducted a thorough ultrasound, measuring and looking at him head to toe. we got a few shots in 3D which was really fun!

 he looks just like his big brother!

after the ultrasound was completed, the doctor came in. he had a nurse liaison with him, which made me nervous at first, like she was there as a witness to what he had to say or something. he had a thick indian accent and spoke quickly and softly so i had to focus hard to follow what he was saying.

he explained that the excess fluid around the baby (1 of the 2 reasons i had been referred there) is not a serious concern right now. he told me it was just slightly above the normal range and that amniotic fluid levels typically peak around 30 weeks, decline until 36 weeks, and then stabilize through to term at 40 weeks. so basically i am at the peak. he said the only concern is that as baby gets bigger, sometimes the pressure from extra fluid can cause stress on him. so the doctor recommended weekly non-stress tests (NSTs) and ultrasounds called biophysical profiles (BPPs) starting at 32 weeks to keep an eye on baby as he grows.

next, we discussed the baby's kidneys (the 2nd of the 2 reasons i was referred there). the doctor told me that the right kidney had resolved itself and was no longer a concern. the left, however, still had a higher level of fluid than normal. he told us he was able to eliminate chromosomal abnormalities as a cause for the kidney fluid based on everything else he saw in my ultrasound. he said that the valve that drains the kidney into the bladder is wider than normal in our little guy and that fluid is refluxing back into the kidney when it's draining because of the width and the angle at which it's laying. as the bladder grows, the valve, which currently enters the bladder at the top, will curve around to the side, which will likely stop the reflux and resolve the issue. he said he recommends that we meet with a pediatric urologist prior to birth to consult. then they will examine the baby after he is born and determine a course of action then. he said the primary concern is kidney infection, so they may put baby on antibiotics to prevent that until things resolve (most likely on their own with age).

the doctor assured me that the baby is very healthy and that the kidneys and bladder are anatomically correct and functioning properly. what a blessing! the nurse liaison was in the room to assist us with a referral for a pediatric urologist. also she will help communicate with my OB and the urologist when i deliver so that our baby gets the care he needs in monitoring this issue.

all in all, i felt like a huge weight was lifted off my shoulders when we left the appointment. my weekly appointments may be a challenge childcare-wise, but i will take that over all the other things that could've come from that appointment! and now i feel free to focus only on my excitement to meet this baby in 9 weeks! we have a lot to do to get ready! thanks for your prayers- God showed up and answered our prayers for health for this sweet babe. continued prayer that the left kidney issue will work itself out would be appreciated!

big yawn :)

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