Tuesday, August 27, 2013

Absent End Diastolic Flow, Disappointing Growth Scan, and The Wait

When we decided to start a family, we couldn't have imagined the bumps in the road and sharp turns that this journey would take us through. As I type this, I am 31 weeks and 5 days (31+5) pregnant with twin boys (I was completely wrong in my predictions about genders!) and on strict hospital bed rest since 30+5.

30 Weeks, 5 Days

At one of what became my “routine” Doppler ultrasounds, at 30+5, the Low End Diastolic Flow turned to Absent End Diastolic Flow (AEDF). That means that when my heart was at rest in between beats, our Baby B wasn’t getting any reserve blood with oxygen and nutrients at all and that would further slow down his growth. I was devastated… The concern in the doctor’s eyes told me this wasn’t something to be taken lightly. I was handed a yellow envelope with my results and told to report to Labor and Delivery at the hospital asap. I called M in tears and asked him to drive me as it didn’t sound like my car would have a driver to return it back home from the hospital. At least not for a while. And that is how my hospital bed rest started….

Growth Scan: 31+4

Today is day 8 on strict hospital bed rest. Following the first week, just after I had adjusted to my new home and stopped working (the clock on my 12 week maternity leave at work has started to tick), things had to get more challenging.  Yesterday was probably the single most difficult day this entire pregnancy that I’ve had to endure. It’s been 3 weeks since our 28 week growth scan and it was time to see how much our little twinkies had grown. I was sooo optimistic going into it. I had been eating like a beast, drinking protein shakes any minute that I wasn’t shoving food in my mouth (I even drank a shake at night when I got up to use the restroom), and I had been on bed rest. Of course, I was wishing for our boys to be at least over 3lb each – not setting completely unreal expectations.

After the growth scan, I learned that Baby A caught up from 15% last time to 20% and weighed 3lb 4oz, but Baby B dropped further in his growth – from 15% to 10% and weighed 2lb 10oz. There was a ~18% discordance between their weights because this cord flow issue slowed down B’s growth so much. Their stomachs also continued to measure a couple weeks behind and remained on the 4% curve. I kept it together during the growth scan and kept it together as I made my calls my M, my mom, and Lee. But when I took a shower, I sobbed so hard that I saw stars all around me. The brief moment of privacy that I had in the hospital was my daily shower and I used every minute of it to let as much of my hurt out and cry it out of me. I was exhausted, scared, terrified, stressed, disappointed… I felt like I failed.
At this pace, we need to accept that Baby B will be diagnosed with IUGR (intra-uterine growth restriction) at birth and will spend the first 2 years of his life catching up. That means hitting milestones later and hopefully not having too much trouble growing and gaining weight!

As part of coping with the idea of having preemies, I started reading a lot and researching information about NICU equipment, following message boards for parents of NICU babies, and being vocal about our news with online support groups. I know that when I look back on this time after the boys arrive, it will seem like it was the easy part…  We just need to have hope and take it one day at a time.

I am being monitored very closely here. Each morning I get a Doppler ultrasound to check the AEDF and make sure it has not advanced to Reverse End Diastolic Flow (REDF), which is when the blood that is pumped to the placenta and the baby via his cord during my heartbeat is going back to the placenta without ever reaching the baby during times between beats. If unaddressed, it can lead to stillbirth. So, if they were to see REDF on my morning Doppler I would have a C-section in a matter of hours. As you can imagine, I spend my mornings laying wide awake in my hospital bed waiting and when I see the Doppler graph on the ultrasound, I say a little prayer the best way I can (M and I aren’t religious) to ask for another day… It’s the hardest, most tormenting wait of my life. And the outcome of the wait only gives peace of mind for the next 24 hours.

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