Polyhydramnios and Upcoming Events

Today's visit to the perinatologist was more eventful than we had hoped it would be.  The doctor we expected to see, Dr. Rose, had been rescheduled to work at the University.  She had invited the kids to come see the ultrasound and to meet her.  They were able to see Lucy on the ultrasound.  Rachel certainly enjoyed it more than Joey.  After the ultrasound was finished the kids went out to the waiting room to sit with one of our friends while we talked to Dr. Esplin.  Second to Dr. Rose for us, in the Maternal-Fetal-Medicine (MFM) group, is Dr. Sean Esplin.  Dr. Esplin grew up in Doug's neighborhood, so there is a personal connection there.  But, even more, he was the one that delivered Elizabeth.

Polyhydramnios
I've never mentioned polyhydramnios before because I had hoped it wouldn't be an issue this time.  When I was pregnant with Elizabeth I had polyhydramnios.  The Mayo Clinic says this on the topic: "Polyhydramnios (pol-ee-hy-DRAM-nee-os) is the excessive accumulation of amniotic fluid — the fluid that surrounds the baby in the uterus during pregnancy. Polyhydramnios occurs in about 1 percent of pregnancies."  Generally a pregnant woman is expected to have fluid equal to 20 cm or less.  They consider 25 cm to be a concern.  I measure 32 cm.  I am only 29 weeks (6.5 months) but am already pushing 8.5 months in uterus size. 

We recently learned that excess amniotic fluid has many causes.  One of which, is that the baby is unable to breath and drink the amniotic fluid to process it and send it out as waste.  Elizabeth's trachea was not formed well.  She couldn't breath.  That was likely the cause of the polyhydramnios. And, ultimately, it was her inability to breath that took her life.  We had silently hoped that perhaps, if I didn't develop polyhydramnios, it might mean that Lucy would be in a better position for life than Elizabeth was.

With Elizabeth I reached 9 month size around 32 weeks.  I went into labor and delivered my sweet daughter the next week.  To say that the doctors are concerned about this pregnancy is to put it mildly.  So today starts a whole new set of appointments.  We will meet with the NICU staff on Thursday to discuss our desires for Lucy and how we want her to be treated.  They should be able to help us understand somewhat as to what to expect when Lucy arrives. 

Amniotic Reduction
Next Tuesday we will go in to have an amniotic reduction.  Basically it is exactly like an amniocentesis except they suck out one to two liters of fluid.  If they just let the amniotic fluid  continue to build I could risk going into labor at any time.  That doesn't sound risky until you take into account that it stresses the scars from previous c-sections.  The doctors took extra precautions to keep me from laboring with Rachel and Joey. 

The risks associated with the amniotic reduction are:

     1.  It could cause me to go into labor.
     2.  It could introduce infection.
     3.  It could cause placental abruption.  Placental abruption can cause heavy bleeding in the
          mother and deprive the baby of oxygen.

The amniotic fluid will build up again within 5-9 days.  I will be on bed rest on the days when they do the amniotic reduction.  The procedure will have to happen once a week until delivery becomes the necessary option for either Lucy and/or me.  There will be regular monitoring.  I will probably return to MFM for non-stress tests (NST) 2 or 3 days after each procedure every week.

At this point I am on lock down.  I'm not on bed rest.  But I have to be very careful about my activity level.  Lucy could come at any time.