Today in the US, any woman over the age of 35 who is having a baby is considered to be of Advanced Maternal Age (AMA). As a result, you are offered several different types of genetic testing to determine your risk of having a child with some sort of genetic defect either mental or physical. All mothers of any age have access to these test but at age 35 the insurance companies have decided the risk of performing these tests on your pregnant body and the risk of you having a child with one of these defects is about even so they fell pretty good about paying for the tests. Younger ladies, I guess, have to pay out of pocket.
Our AMA appointment was on Monday at 9am. We arrived and filled out the requisite number of forms. First we were interviewed by Joanne who worked for a company that does the genetics testing. She took a detailed family history from both of us asking about medical issues, birth defects and mental retardation. While we tried to be as accurate as possible is is hard to remember everything all your relative might have had going back two generations and all your cousins a what not. Joanne made a cool chart of our family tree using neat-o symbols and lines almost like a family tree or lineage. Only this family tree will tell you if you child will be normal or born with an extra nipple or something.
After looking over our information she gave us the run down on how our chromosomes come together and make a full set of genetic information for our child. She also explained some of the more common genetic defects caused by missing or extra chromosomes. It was all very informative and extremely interesting. In a way almost comforting because really your chances are pretty low and it's nice that they can tell you that. Joanne said that really the only reason I was there was because I was 36 and there was no indication from the info that we gave that we were at higher risk of having a child with some sort of genetic defect. We decided which genetics tests we wanted to do, signed another form and were sent back to the waiting room until time for the ultrasound.
A few minutes and one trip to the bathroom later we were called into the ultrasound room. The tech got us settled into out respective places, me on the table and Jamie in a chair next to me. In addition to the set up (computer, monitor, etc) that the tech was using to 'see' inside me...they had a large TV/Monitor mounted high up on the wall so we could both see everything. This was nice because you didn't have to crane your neck around to see the monitor the tech was using.
What followed was nothing short of the grand tour around my lower abdomen and the baby growing inside me. She didn't point out all the sights in
my anatomy but she certainly did for the baby. We saw of course his head and body. Little pointed tushie. Legs, feet, hands, arms and even fingers. His little pointed nose and long curvy spine. She showed us his kidneys and bladder (which is the size of what mines feels like...tiny). We got a tour around his little heart and his aorta which was 2mm wide!! She did a Doppler image that showed the umbilical cord with the three blood vessels that carry blood to and from the baby. She said everything looked great. No signs of the malformations or genetic problems they are able to detect at this stage of fetal development via ultrasound. In fact she told us the baby was (in her opinion) bigger than 16 weeks. Her calculations put him at 6 oz which is about 18 weeks old.
We were both relieved. She printed out some pictures for us to take home and even made an extra for my mom. You can really see a baby shape in there. And so the big questions remain...Boy or Girl and just how old is this baby? One would think that if you can focus on a blood vessel that is 2mm wide you can tell if the baby has a penis or not. Her findings were inconclusive. I guess the little thing is just shy and didn't want to
present his genitals. Let's hope that keeps up. Please don't be fooled by my characterization of the baby being a "he" or a "him" it's just me putting a label on someone I would rather not continue to call an "it".
So now the bad news...
Part of the ultrasound needed to include and examination of my cervix. The tech could not get a good look at it from the outside so we had to go for the internal ultrasound. She took some measurements and we were all done. I got dressed, took another bathroom break and we waited to be seen by the doctor, Raj Bansal.
Dr. Bansal called us in and once again announced that our child looked normal. Then he dropped the bomb. During the internal ultrasound, my placenta was shown to be laying across my cervix. This condition is know as
Placenta Previa. It's a pretty serious condition if you should happen to go into labor while your placenta is down there over your cervix. It cause massive bleeding and the mother could potentially die. Placenta Previa was one of the three conditions I am most afraid of getting while I am pregnant.
Dr. Bansal told us it wasn't some thing to be terribly concerned about as 90% of previa cases tend to resolve themselves before the birth of the child. The uterus is so small at this point and the placenta can potentially take of 25-50% of the space in there. As the baby and your uterus grows bigger the placenta eventually moves up the side and away from the cervix. If the previa does not resolve then I might have to have a c-section. He put me on 'pelvic rest' which basically means no intercourse and no exams by doctors with sharp pointy objects like fingers. Try not to stress and don't do heavy lifting, etc.
Needless to say I was a little upset. As we left the office Jamie tried to console me. I was angry at the prospect of the c-section. I was afraid of what could happen if I started to bleed. I called my mom as we drove in to work to give her the update. Everyone was waiting to hear "boy" or "girl". Mom said we would pray for resolution of the previa and that God would answer our prayer just as he did when we prayed for a viable pregnancy. It calmed me down enough to get to work and do some research on the Internet. I found the following article which made me feel MUCH better. even though it only restate what the doctor had just told me -
During second trimester ultrasounds, done in some places on a routine basis, will show that there are many more previas diagnosed at this stage. Typically at 16 weeks the placenta takes up 25-50% of the surface area. Also the third trimester brings a growth of this lower uterine segment, that out flanks the growth of the placenta. For these reasons, while 5% of pregnancies are diagnosed with complete previa in second trimester ultrasounds will see 90% of them resolved by term and while 45% of pregnancies are diagnosed with marginal previas will see 95% resolved at term. A follow up ultrasound will be done, and as noted above the vast majority of previas are not seen.
Our next ultrasound will be July 31. Hopefully we will have previa resolution and the answer to the boy/girl question. I personally think it is a boy but I could be wrong so don't quote me on that. It would also be fine with me if they move up my due date. I've always thought they were about 1-2 weeks off in the calculation the due date.
