November 2013 Moms

Second perinatologist appointment! (super long post)

Just got back yesterday from our first anniversary trip. Aside from dealing with some heat exhaustion, we had a great time in the Wisconsin Dells hiking and going on nature tours. We went to a water park too...I stayed in the lazy river the whole day and watched hubby go on the waterslides. :) Very relaxing, and much needed with this stressful pregnancy!

We had an appointment with the perinatologist after we got back. It went very well. Baby girl is growing beautifully - legs are in the 50th percentile...everything else is a bit smaller, but the doctor wasn't concerned. She continues to show no markers for Down Syndrome.

The doctor said that he thinks my crazy quad screen result (1 in 12 chance for Down Syndrome) at my age (22) may have more to do with elevated hCG since I have hyperemesis gravidarum. He also said pre-eclampsia (which runs in my family) or a placenta problem that could cause growth restriction issues a little later on could be the culprit. I didn't know those things could throw a quad screen out of whack...

He told us that he obviously can't know with 100% certainty that she doesn't have Down Syndrome from the ultrasound alone, but that in his opinion, he believes she is just fine. He does want me to continue coming to see him every 4 weeks, however, to watch carefully for pre-eclampsia or growth restriction issues. And while he was doing the ultrasound, he said she was an absolute doll, so that of course put a smile on my face. :)

He also recommended that we just go ahead and get the MaterniT21 test that they called and offered me after my first appointment. He said that this way, we will have a much more accurate result than the quad screen, and that if we have a growth restriction problem later on, we won't jump to thinking it's a Down Syndrome marker. I found out the reason I wasn't offered it before was because it is JUST now being offered in the hospital system this doctor is with (it's still pretty much unheard of with my regular OBGYN's practice in my small town). I'm a lot less upset about being told right away that I needed an amniocentesis now, but still mad about the way this whole thing was handled.

I was the first person at this location to have it, so there was some confusion in the lab, but we got it done. They couldn't even tell me how long it would be until the results were back. Does anyone know how long that takes?

And last but not least, he told us that if we choose to ever have another baby, that I'd want to think long and hard about getting a quad screen again. I think I will be taking that advice to heart.

Actually, I lied...one last question for you ladies. I'm planning on delivering at the hospital in my small hometown. It's a small hospital, but it encourages unmedicated birth, and has a very, very low c-section rate...things that are very important to me. However, with the way this pregnancy has been going, I am a little worried because this is not a hospital equipped for more of the high-risk, super emergency things that can go wrong. I don't want to borrow trouble, but like I said, this pregnancy has been kind of a mess (HG, the quad screen, multiple L & D visits for both HG and awful cramping, blood clots...it's just not been fun). I'm considering delivering in the hospital system my perinatologist is in. It's in a bigger city (by Iowa standards anyway) that's about 20 minutes away from my hometown. The hospital is highly equipped for any issues that arise, and has the highest rated NICU in the area. It also is a Lutheran hospital, and I'm Lutheran, so that adds some comfort to me, if that makes any sense. However, the c-section rate is higher. If something were to go wrong, this is where we would be transferred if we were originally at the small hospital in my hometown. What would you do?

Ellie & Justin {Married: 7.14.12} Catherine Victoria (Kate) {BFP: 2.18.13, EDD: 11.1.13, Born: 8.6.13 at 27 weeks and 4 days} {Moderate hyperemesis gravidarum, severe pre-eclampsia, IUGR, 87 day NICU stay with no major complications - SO BLESSED!} Baby #2 {BFP: 12.27.13, EDD: 9.8.14} Furbaby Sadie Lou {Adopted: 5.12.12 at 18 months}

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Re: Second perinatologist appointment! (super long post)

  • Local Iowa gal here (Des Moines), where are you wanting to deliver?
  • Floyd Valley in Le Mars was the original plan...now Saint Lukes in Sioux City is being considered.

    I wish I lived closer to Iowa City - I'd use the U of I hospital for sure.

    Ellie & Justin {Married: 7.14.12} Catherine Victoria (Kate) {BFP: 2.18.13, EDD: 11.1.13, Born: 8.6.13 at 27 weeks and 4 days} {Moderate hyperemesis gravidarum, severe pre-eclampsia, IUGR, 87 day NICU stay with no major complications - SO BLESSED!} Baby #2 {BFP: 12.27.13, EDD: 9.8.14} Furbaby Sadie Lou {Adopted: 5.12.12 at 18 months}

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  • With every thing you've been going through, if it was me, I'd feel better delivering at the larger hospital. I think they'd still be supportive of your natural birth plan, but in case things go south quickly, they'll be equipped to act accordingly, and fast.

     I'm glad your ultrasounds have been reassuring. Hopefully your MaterniT21 test backs up your doctor's findings. 

  • Thanks much for the advice...that's what I've been thinking, too. This was a lot easier when I was still in California - everything was all in one place through Kaiser Permanente, but now that we're staying in Iowa for the year instead of going back long before I deliver (issues with financial aid for school so we're taking the year off) it's been a huge confusing mess on top of all the pregnancy complications. I just want to do what's best for us and the little one. Guess it all just comes with having a surprise baby. :)

    Ellie & Justin {Married: 7.14.12} Catherine Victoria (Kate) {BFP: 2.18.13, EDD: 11.1.13, Born: 8.6.13 at 27 weeks and 4 days} {Moderate hyperemesis gravidarum, severe pre-eclampsia, IUGR, 87 day NICU stay with no major complications - SO BLESSED!} Baby #2 {BFP: 12.27.13, EDD: 9.8.14} Furbaby Sadie Lou {Adopted: 5.12.12 at 18 months}

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  • I would definitely go with the bigger hospital. 20 minutes doesn't seem too far for the peace of mind.

    Also, my MaterniT 21 test results came back in 10 days. Hoping everything comes back good for your LO!
  • Glad the u/s went well - I hope the test results come back looking good, keep us posted!

    As for hospitals, I would ask your peri what he thinks. If he thinks it would be a good idea for you to be in the bigger hospital, I would just make sure that the practice you deliver with knows your birth wishes. I would also look into hiring a doula (might be a good idea to have one anyway if you're trying for unmedicated.)

    Good luck!

    Mr. & Mrs. B, Est. 10.23.2009
    BFP #1: 8/31/12 ~ m/c: 9/06/12
    BFP #2: 2/28/13 ~ EDD: 11/10/13 ~ DS Born: 10/23/13

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